Abstract
Inflammatory bowel disease (IBD) is a multifactorial chronic inflammatory disorder leading to structural changes in the intestinal wall. In humans, the neutrophil-to-lymphocyte ratio (NLR) has been proposed as a promising marker of IBD. This study evaluated the possible clinical and prognostic significance of the NLR in dogs with IBD. This retrospective study enrolled 41 dogs diagnosed with IBD presented to University of Pisa from January 2017 to January 2018. For each dog, age, sex, canine chronic enteropathy clinical activity index (CCECAI), endoscopic and histopathological grading were recorded. Complete blood count, serum total protein, albumin, cholesterol, and C-reactive protein at the time of endoscopy were recorded. A control group (CG) of healthy dogs from a blood donor database was built. NLR was calculated for both IBD and CG as the ratio between absolute neutrophils and lymphocytes. Presence of crypt distension, lacteal dilation (LD), mucosal fibrosis, intraepithelial lymphocytes was recorded. Follow-up information was obtained from electronic medical records and dogs were classified as responders and non-responders based on CCECAI variation between admission and the first recheck. IRE dogs showed higher NLR compared to healthy dogs. NLR correlated negatively with total protein, albumin, and cholesterol and correlated positively with CCECAI. Dogs with LD showed higher NLR than dogs without LD. Non-responders showed higher NLR compared to responders. In conclusion, as in IBD human patients, the NLR acts as an inflammatory marker providing further information on severity of the disease and could be useful in predicting treatment response.
Highlights
Chronic enteropathies (CE) can be subdivided retrospectively in relation to the response to treatment into food-responsive enteropathy (FRE), antibiotic-responsive enteropathy (ARE), immunosuppressant-responsive enteropathy (IRE) [1].The definition of canine inflammatory bowel disease (IBD) identifies an intestinal idiopathic inflammation that implies failed treatment trials with diet and antibiotics
Forty-one dogs with IBD were retrospectively included in the study
Our study showed that IBD dogs had higher neutrophil-to-lymphocyte ratio (NLR) values
Summary
The definition of canine inflammatory bowel disease (IBD) identifies an intestinal idiopathic inflammation that implies failed treatment trials with diet and antibiotics. In IBD, intestinal inflammation has to be demonstrated by histopathological examination and an immunosuppressant/steroid therapy is needed [1,2,3]. The term IBD is used in veterinary medicine interchangeably with IRE in cases not responding to diet or antibiotic [4]. Several studies have attempted to identify the prognostic factors of IBD. These include two clinical scoring systems [5,6], hypocobalaminemia [7], hypoalbuminemia [8], serum C-reactive protein (CRP) [5], and a high canine pancreatic lipase immunoreactivity concentration [9].
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