Laboratory profile of malnutrition in hospitalized dogs
DOI:
https://doi.org/10.5433/1679-0359.2021v42n6p3273Keywords:
Nutritional assessment, Malnutrition, Iron metabolism, Transferrin.Abstract
Malnutrition occurs when the supply of available nutrients is less than organic demand. It is an underdiagnosed problem in veterinary medicine and can result in several negative metabolic consequences, with greater morbidity and mortality. Currently, the classification of nutritional status (NS) is performed subjectively in veterinary medicine, so studies and discoveries about laboratory markers (objectives) of malnutrition are desirable. This study evaluated the correlations between several laboratory variables (practical and low-cost measurements) and the nutritional status (NS) of 246 dogs from a veterinary school hospital in southern Brazil. In this way, the laboratory profile of malnutrition in this population is evident. NS was classified by body condition score (BCS) and muscle mass score (MMS). A patient was considered to be malnourished if the BCS was less than 3 (values from 1 to 9). The laboratory variables analyzed were hemogram, cholesterol, total protein (TP), albumin, C-reactive protein (CRP), CRP/albumin ratio, total iron-binding capacity (TIBC), transferrin (TF), transferrin saturation index (TSI), and transthyretin. The means and standard deviations of the variables, correlation analyses, and comparative analyses (Kruskal-Wallis in alfa = 5%) were calculated. This research aimed to identify objective and practical malnutrition markers that help in the elaboration of a protocol for nutritional evaluation in diseased dogs. Low values of TF, TIBC, TP, hemogram, and TSI elevation were indicative of malnutrition. Additionally, cholesterol and albuminemia are not good markers of malnutrition in dogs with systemic diseases. For the graduation of the inflammatory state (important to differentiate inflammatory hypoproteinemia from protein malnutrition), it is more reliable to measure the CRP/albumin ratio. Canine transthyretin cannot be measured with reagents designed for humans, such as those used in this study. It was possible to conclude that laboratory indicators of malnutrition in sick dogs include low values of TF, TIBC, and TP, anemia, and elevations of TSI. The joint changes in these markers gradually reinforced the diagnosis.Downloads
References
Anziliero, D., Bassi, E., Pain, K. M., Valle, S. D. F., & Kreutz, L. C. (2013). Determinação dos níveis séricos de proteína C-reativa (CRP) em cães com alterações dos parâmetros hematológicos. Ciência Animal Brasileira, 14(2), 265-272. doi: 10.5216/cab.v14i2.9054
Assumpção, C. L., & Cabral, M.D. (2002). Complicações clínicas da anorexia nervosa e bulimia nervosa. Revista Brasileira de Psiquiatria, 24(Suppl. 3), 29-33. doi: 10.1590/S1516-44462002000700007
Bagri, N. K., Jose, B., Shah, S. K., Bhutia, T. D., Kabra, S. K., & Lodha, R. (2015). Impact of malnutrition on the outcome of critically ill children. Indian Journal of Pediatrics, 82(7), 601-605. doi: 10.1007/s12 098-015-1738-y
Baldwin, K., Bartges, J., Buffington, T., Freeman, L. M., Grabow, M., Legred, J., & Ostwald, D. J. (2010). AAHA nutritional assessment guidelines for dogs and cats. Journal of the American Animal Hospital Association, 46(4), 285-296. doi: 10.5326/0460285
Bally, M. R., Blaser Yildirim, P. Z., Bounoure, L., Gloy, V. L., Mueller, B., Briel, M., & Schuetz, P. (2016). Nutritional support and outcomes in malnourished medical inpatients: a systematic review and meta-analysis. JAMA Internal Medicine, 176(1), 43-53. doi: 10.1001/jamainternmed.2015.6587
Bazzi, N. B., Leal, V., Lira, H. F., Jr., Santos, J. M., Ferreira, M. G., & Zeni, L. A. Z. R. (2016). Estado nutricional e tempo de jejum em pacientes submetidos a cirurgias colorretais eletivas. Nutrición Clínica y Dietética Hospitalaria, 36(2), 103-110. doi: 10.12873/362bazzinicole
Bohn, A. A. (2015). Diagnosis of disorders of iron metabolism in dogs and cats. Clinics in Laboratory Medicine, 35(3), 579-590. doi: 10.1016/j.cll.2015.05.007
Brunetto, M. A., & Carcioffi, A. C. (2015). Suporte nutricional do paciente gravemente enfermo. In M. M. Jericó, J. P. Andrade Neto, & Kogika, M. M. (Eds.), Tratado de medicina interna de cães e gatos (pp. 49-65, vol. 1). Rio de Janeiro, RJ: Gen-Roca.
Bush, B. M. (2004). Bioquímica plasmática. In B. M. Bush (Ed.), Interpretação de resultados laboratoriais para om clínico de pequenos animais (pp. 180-190). São Paulo, SP: Roca.
Bussab, W. O., & Morettin, P. A. (2013). Inferência estatística: análise de aderência e associação. In W. O. Bussab, & P. A. Morettin (Eds.), Estatística Básica. (8nd ed., pp. 406-426). São Paulo: Saraiva.
Cabada, M. M., Goodrich, M. R., Graham, B., Villanueva-Meyer, P. G., Deichsel, E. L., Lopez, M.,... Clinton, W. A., Jr. (2015). Prevalence of intestinal helminths, anemia, and malnutrition in Paucartambo, Peru. Revista Panamericana de Salud Pública, 37(2), 69-75.
Cançado, R. D., & Chiattone, C. S. (2002). Anemia de doença crônica. Revista Brasileira de Hematologia e Hemoterapia, 24(2), 127-136. doi: 10.1590/S1516-84842002000200009
Chandler, M. L., & Gunn-Moore, D. A. (2004). Nutritional status of canine and feline patients admitted to a referral veterinary internal medicine service. The Journal of Nutrition, 134(8), 2050S-2052S. doi: 10.10 93/jn/134.8.2050S
Cooper, B. A., Penne, E. L., Bartlett, L. H., & Pollock, C. A. (2004). Protein malnutrition and hypoalbuminemia as predictors of vascular events and mortality in ESRD. American Journal of Kidney Diseases, 43(1), 61-66. doi: 10.1053/j.ajkd.2003.08.045
Corbee, R. J., & Kerkhoven, W. J. S. V. (2014). Nutritional support of dogs and cats after surgery or illness. Open Journal of Veterinary Medicine, 4(4), 44-57. doi: 10.4236/ojvm.2014.44006
Corkins, M. R., Guenter, P., DiMaria-Ghalili, R. A., Jensen, G. L., Malone, A., Miller, S.,… Resnick, H. E. (2014). Malnutrition diagnoses in hospitalized patients. Journal of Parenteral and Enteral Nutrition, 38(2), 186-195. doi: 10.1177/0148607113512154
De Luis, D. A. de, Izaola, O., Cuellar, L., Terroba, M. C., Cabezas, G., Rojo, S.,... Sagrado, M. G. (2006). Nutritional assessment: predictive variables at hospital admission related with length of stay. Annals of Nutrition and Metabolism, 50(4), 394-398. doi: 10.1159/000094362
Ernest, N., Akpan, P., & Uko, E. (2013). Reduced levels of some iron parameters of protein energy malnourished children in Calabar, Nigeria. Journal of Biology, Agriculture and Healthcare, 3(13), 114-120.
Fabretti, A. K., Fonseca, I. B., Pancieri, I. V. C., Knupp, F. C., Bordini, D. M., & Pereira, P. M. (2014). Avaliação clínica, laboratorial e perfil eletroforético na determinação do prognóstico de cães hospitalizados. Semina: Ciências Agrárias, 35(6), 3113-3126. doi: 10.5433/1679-0359.2015v36n1p217
Fabretti, A. K., Fonseca, I. C. B., Coelho, A. F., Silva, C. N., & Pereira, P. M. (2015). Evaluation of clinical, laboratory, and electrophoretic profiles for diagnosis of malnutrition in hospitalized dogs. Semina: Ciências Agrárias, 36(1), 217-230. doi: 10.5433/1679-0359.2015v36n1p217
Fabretti, A. K., Siqueira, R. C. S., Chaves, R. O., Camacho, C. A., & Pereira, P. M. (2018). Exames laboratoriais na desnutrição de pequenos animais. Revista Clínica Veterinária, 23(133), 40-54.
Felder, S., Braun, N., Stanga, Z., Kulkarni, P., Faessler, L., Kutz, A.,… Schuetz, P. (2016). Unraveling the link between malnutrition and adverse clinical outcomes: association of acute and chronic malnutrition measures with blood biomarkers from different pathophysiological states. Annals of Nutrition and Metabolism, 68(3), 164-172. doi: 10.1159/000444096
Gagne, J. W., & Wakshlag, J. J. (2015). Pathophysiology and clinical approach to malnutrition in dogs and cats. In D. L. Chan, (Ed.), Nutritional management of hospitalized small animals (pp. 117-127). Oxford, OH: John Wiley & Sons.
Gama-Axelsson, T., Heimbürger, O., Stenvinkel, P., Bárány, P., Lindholm, B., & Qureshi, A. R. (2012). Serum albumin as predictor of nutritional status in patients with ESRD. Clinical Journal of the American Society of Nephrology, 7(9), 1446-1453. doi: 10.2215/CJN.10251011
Ghadiri-Anari, A., Nazemian, N., & Vahedian-Ardakani, H. (2014). Association of body mass index with hemoglobin concentration and iron parameters in Iranian population. ISRN Hematology, 52(53), 1-3. doi: 10.1155/2014/525312
Hébuterne, X., Lemarié, E., Michallet, M., de Montreuil, C. B., Schneider, S. M., & Goldwasser, F. (2014). Prevalence of malnutrition and current use of nutrition support in patients with cancer. Journal of Parenteral and Enteral Nutrition, 38(2), 196-204. doi: 10.1177/0148607113502674
Ingenbleek, Y. (2019). Plasma transthyretin as a biomarker of sarcopenia in elderly subjects. Nutrients, 11(4), 895-913. doi: 10.3390/nu11040895
Ingenbleek, Y., & Bernstein, L. H. (2015). Plasma transthyretin as a biomarker of lean body mass and catabolic states. Advances in Nutrition, 6(5), 572-580. doi: 10.3945/an.115.008508
Jagadeswaran, D., Indhumathi, E., Hemamalini, A. J., Sivakumar, V., Soundararajan, P., & Jayakumar, M. (2019). Inflammation and nutritional status assessment by malnutrition inflammation score and its outcome in pre-dialysis chronic kidney disease patients. Clinical Nutrition, 38(1), 341-347. doi: 10.10 16/j.clnu.2018.01.001
Kaneko, J. J., Harvey, J. W., & Bruss, M. L. (2008a). Iron metabolism and its disorders. In J. J. Kaneko, J. W. Harvey, & M. L. Bruss (Eds.). Clinical biochemistry of domestic animals (6nd. ed., pp. 259-1285). Nova York, NW: Elsevier.
Kaneko, J. J., Harvey, J. W., & Bruss, M. L. (2008b). Proteins, proteomics, and the dysproteinemias. In J. J. Kaneko, J. W. Harvey, & M. L. Bruss (Eds), Clinical biochemistry of domestic animals (6nd ed., pp. 117-155). Nova York, NW: Elsevier.
Keller, U. (2019). Nutritional laboratory markers in malnutrition. Journal of Clinical Medicine, 8(6), 775-786. doi: 10.3390/jcm8060775
Kuribayashi, T., Shimada, T., Matsumoto, M., Kawato, K., Honjyo, T., Fukuyama, M.,… Yamamoto, S. (2003). Determination of serum C-reactive protein (CRP) in healthy beagle dogs of various ages and pregnant beagle dogs. Experimental Animals, 52(5), 387-390. doi: 10.1538/expanim.52.387
Laflamme, D. P. (1997). Development and validation of a body condition score system for dogs. Canine Practice, 22(4), 10-15.
Lim, S. L., Ong, K. C., Chan, Y. H., Loke, W. C., Ferguson, M., & Daniels, L. (2012). Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality. Clinical Nutrition, 31(3), 345-350. doi: 10.1016/j.clnu.2011.11.001
Maicá, A. O., & Schweigert, I. D. (2008). Avaliação nutricional em pacientes graves. Revista Brasileira de Terapia Intensiva, 20(3), 286-295. doi: 10.1590/S0103-507X2008000300012
Melo, E. R., Figueiredo, S. A., Oliveira, R. T., Agripino, E. C. B., Silva, M. H. S. N. da, Domingues, H. D. C. A., & Barbosa, J. M. A. X. (2020). Anemia of chronic disease: a review of pathophysiology, diagnosis and treatment. Brazilian Journal of Development, 6(12), 98941-98947. doi: 10.34117/bjdv6 n12-400
Michel, K. E. (2015). Nutritional assessment in small animals. In D. L. Chan (Ed.), Nutritional management of hospitalized small animals (pp. 1-6). Oxford, OH: John Wiley & Sons.
Michel, E. K. (2017). Nutritional assessment. In S. J. Ettinger, & E. C. Feldman (Eds.), Textbook of veterinary internal medicine expert consult (Vol. 1, 8nd ed., pp. 1830-1833). Amsterdã, NH: Elsevier.
Nakajima, M., Ohno, K., Goto-Koshino, Y. G., Fujino, Y., & Tsujimoto, H. (2014). Plasma transferrin concentration as a nutritional marker in malnourished dogs with nutritional treatment. The Journal of Veterinary Medical Science, 76(4), 539-543. doi: 10.1292/jvms.13-0583
Nakajima, M., Ohno, K., Takeuchi, Y., Takeuchi, A., Nakashima, K., Fujino, Y., & Tsujimoto, H. (2012). Usefulness of plasma transferrin levels as dynamic assessment of protein nutrition in dog. Journal of Animal Physiology and Animal Nutrition, 15(2), 65-71. doi: 10.1292/jvms.13-0583
Pimentel-Gomes, F. (2009). Testes não paramétricos. In: F. Pimentel-Gomes (Ed.), Curso de estatística experimental (15nd ed., pp 377-394). São Paulo, SP: ESALQ.
Pires, L. S. A., Dittrich, R. L., Souza, A. C., Bertol, M. A. F., & Patrício, L. F. L. (2011). Parâmetros utilizados na avaliação do metabolismo do ferro em cães. Ciência Rural, 41(2), 272-277. doi: 10.1590/ S0103-84782011000200015
Pointer, E., Reisman, R., Windham, R., & Murray, L. (2013). Starvation and the clinicopathologic abnormalities associated with starved dogs: a review of 152 cases. Journal of the American Animal Hospital Association, 49(2), 101-107. doi: 10.5326/JAAHA-MS-5762
Ramos, B. S. N., Moraes, V. S., Pinheiro, R. M., Souza, V. R. C., Alves, J. C., & Coelho, C. S. (2019). Effects of resistance training on serum iron, total iron-binding capacity and transferrin saturation in police working dogs. Comparative Exercise Physiology, 15(4), 253-258. doi: 10.3920/CEP190032
Richards, C. H., Roxburgh, C. S. D., MacMillan, M. T., Isswiasi, S., Robertson, E. G., Guthrie, G. K.,… McMillan, D. C. (2012). The relationships between body composition and the systemic inflammatory response in patients with primary operable colorectal cancer. Plos One, 7(8), e41883. doi: 10.1371/ journal.pone.0041883
Sahin, S., Tasar, P. T., Simsek, H., Çicek, Z., Eskiizmirli, H., Aykar, F. S.,… Akcicek, F. (2013). The prevalence of anemia and malnutrition and the relationship between anemia and malnutrition. European Geriatric Medicine, 4(1), 133. doi: 10.1016/j.eurger.2013.07.438
Sahin, S., Tasar, P. T., Simsek, H., Çicek, Z., Eskiizmirli, H., Aykar, F. S.,… Akcicek, F. (2016). Prevalence of anemia and malnutrition and their association in elderly nursing home residents. Aging Clinical and Experimental Research, 28(5), 857-862. doi: 10.1007/s40520-015-0490-5
Saker, K. E., & Remillard, R. L. (2010). Critical care nutrition and enteral-assisted feeding. In M. Hand, C. D. Tratcher, R. L. Remillard, P. Roudebush, & C. Novotny (Eds.), Small animal clinical nutrition (5nd ed., pp. 351-390). Topeka, KS: Mark Morris Institute.
Slee, A., Birch, D., & Stokoe, D. (2016). The relationship between malnutrition risk and clinical outcomes in a cohort of frail older hospital patients. Clinical Nutrition ESPEN, 15(1), 57-62. doi: 10.1016/j.clnesp. 2016.06.002
Sullivan, D. H. (2001). What do the serum proteins tell us about our elderly patients? The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 56(2), M71-M74. doi: 10.1093/ gerona/56.2.m71
Szöke, D., & Panteghini, M. (2012). Diagnostic value of transferrin. Clinica Chimica Acta; International Journal of Clinical Chemistry, 413(15-16), 1184-1189. doi: 10.1016/j.cca.2012.04.021
Tamimi, N. S. M., & Wali, A. A. (2019). Health problems of Iraqi Police dogs referred to Baghdad Veterinary Hospital during 2015-2017. Veterinary World, 12(7), 1046-1051. doi: 10.14202/vetworld. 2019.1046-1051
Thakur, N., Chandra, J., Pemde, H., & Singh, V. (2014). Anemia in severe acute malnutrition. Nutrition, 30(4), 440-442. doi: 10.1016/j.nut.2013.09.011
Tvarijonaviciute, A., Martinez, S., Gutierrez, A., Ceron, J. J., & Tecles, F. (2011). Serum acute phase proteins concentrations in dogs during experimentally short-term induced overweight. A preliminary study. Research in Veterinary Science, 90(1), 31-34. doi: 10.1016/j.rvsc.2010.05.008
Veena, A., Amit, D., Sonagra, B., Rekha, M. B., & Jayaprakash, M. D. S. (2013). Study of serum iron, TIBC, transferrin saturation and ferritin in iron deficiency anemia in tertiary care hospital. International Journal of Pharmacy and Biological Sciences, 3(1), 14-23.
Wissler, C. (1905). The Spearman correlation formula. Science, 22(558), 309-311.
Wong, T. C., Su, H. Y., Chen, Y. T., Wu, P. Y., Chen, H. H., Chen, T. H.,… Yang, S. H. (2016). Ratio of C-reactive protein to albumin predicts muscle mass in adult patients undergoing hemodialysis. PLoS One, 11(10), e0165403. doi: 10.1371/journal.pone.0165403
World Small Animal Veterinary Association (2013). Muscle condition score. Ontario, On: Author.
Freeman, L., Becvarova, I., Cave, N., MacKay, C., Nguyen, P., Rama, B.,… van Beukelen, P. (2011). WSAVA Nutritional assessment guidelines. Journal of Small Animal Practice, 52(7), 385-396. doi: 10. 1111/j.1748-5827.2011.01079.x
Zhang, Z., Pereira, S. L., Luo, M., & Matheson, E. M. (2017). Evaluation of blood biomarkers associated with risk of malnutrition in older adults: a systematic review and meta-analysis. Nutrients, 9(8), 829-849. doi: 10.3390/nu9080829
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