Comparative Evaluation of Peripheral Blood Neutrophil to Lymphocyte Ratio, Serum Albumin to Globulin Ratio and Serum C-Reactive Protein to Albumin Ratio in Dogs with Inflammatory Protein-Losing Enteropathy and Healthy Dogs

SIMPLE SUMMARY: Canine inflammatory protein-losing enteropathy caused by immunosuppressive-responsive enteropathy (IRE-PLE) is associated with a time-consuming diagnostic workup and a guarded prognosis. In human medicine, neutrophil to lymphocyte ratio, albumin to globulin ratio and C-reactive protein to albumin ratio are routinely available biomarkers that have been shown to correlate with several clinical parameters and a poor prognosis. Scattered information exists on the use of these three biomarkers in dogs with IRE-PLE. This study evaluated the clinical significance of these biomarkers in a population of dogs with IRE-PLE at the time of diagnosis and after therapy. Increased values of all three biomarkers were detected in dogs with IRE-PLE at the time of diagnosis, and correlations were observed between some of these biomarkers and the existing chronic enteropathy activity index. After therapy, changes in all three biomarkers were observed. Further studies are needed to assess their clinical significance at a longer follow-up. ABSTRACT: Few routinely available biomarkers are clinically useful in assessing dogs with inflammatory protein-losing enteropathy caused by immunosuppressive-responsive enteropathy (IRE-PLE). Only the neutrophil to lymphocyte ratio (NLR) has been studied, while no information exists on the use of the albumin to globulin ratio (AGR) and C-reactive protein to albumin ratio (CRP/ALB). We aimed to evaluate the clinical significance of the NLR, AGR and CRP/ALB in a population of dogs with IRE-PLE. The medical records of 53 IRE-PLE dogs were reviewed at the time of diagnosis (T0) and 1 month after the initiation of immunosuppressants (T1). A control group of 68 healthy dogs was used for comparison. At T0, the median values of the NLR and AGR of sick dogs were significantly higher and lower than those of healthy dogs, respectively. With the increase in the chronic enteropathy activity index, AGR and CRP/ALB significantly decreased and increased, respectively. At T1, NLR and AGR significantly increased, while CRP/ALB significantly decreased. NLR, AGR and CRP/ALB did not differ significantly between dogs classified as responders and nonresponders according to the chronic enteropathy activity index. Further studies are needed to provide more information on this subject.