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Canine Inflammatory Disease

 

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Chronic inflammation is both associated with, and the root-cause of disease. Left unchecked, chronic inflammation can lead to disease advancement and even death. CRPCANINE is a blood test that detects systemic inflammation in response to infection, tissue damage, neoplasia, and trauma. The test is used to confirm the presence of inflammatory disease, detect hidden disorders, monitor the effectiveness of treatment, and assure complication-free recovery.

 

 CRP & The Inflammatory Process

Inflammation Cascade

 

The acute phase response is a complex, systemic early-defense system activated by infection, inflammation, trauma and tissue damage or necrosis. Although nonspecific, it serves as a core of the innate immune response. It involves physical and molecular barriers and responses that serve to prevent infection, clear potential pathogens, initiate inflammatory processes, and contribute to resolution and the healing process.

 Triggers:
  • Infection
  • Inflammation
  • Surgical trauma
  • Tissue necrosis

 

 

 

 

 

 C-Reactive Protein or CRP, serves as a major acute phase protein in both humans and canines. Levels of circulating CRP elevate rapidly, often within 4 hours of the initiation of inflammatory event and peaking within 24-48 hours. CRP correlates directly with both the severity and duration of the inflammatory stimulation. Once the trigger of the inflammation is resolved, CRP levels drop rapidly, providing near ‘real-time' monitoring ability.

 

Damage Associated with Chronic Inflammation

"Acute Inflammation Defends, Chronic Inflammation Kills"
Acute (short-term) inflammation is a vital life-sustaining function. The complex cascade of events that occurs is needed to initiate a defense against invading bacteria and to repair tissue damage that occurs from trauma, infection, and disease. While acute inflammation is normally tightly controlled and part of the healing process, chronic (long-term) inflammation is associated with a number of diseases.Inflammation Starburst

Chronic Inflammation Damages Cells

At the cellular level, the activation of the inflammation begins with production of pro-inflammatory cytokines. These inflammatory substances activate certain host defenses. When the neutralization and removal of toxic agents has occurred, anti-inflammatory signaling occurs to return tissue to a pre-inflammatory state.

However, if toxic agents remain as a result of infection, foreign body, or environmental substances, a low level long-term activation of the inflammatory process can occur. This leads to the production of free radicals and other destructive agents. Tissues/organs in the presence of these agents often leads to cellular alterations resulting in disease and even death.

 

Inflammation's Link with Mortality

A major clinical study conducted with the University of Missouri and Tufts University was published in Veterinary and Comparative Oncology. The initial intent of the study was to examine how TK and CRP could be used to detect cancer in apparently healthy dogs, but was expanded to investigate overall health. In a large study group of 360 dogs followed for up to one year, incidence of cancer and serious disease were followed. Findings summary:

   All-cause Mortality:
  • Dogs with inflammation were associated with a 20% mortality rate vs. 3% mortality for those without inflammation.
  • Detectable inflammation, as measured by elevated CRP, was associated with a 7-fold increase in mortality.

 

 

 

 

 

 

 

 

 Clinical Applications

 CRP clin app

Pre-anesthesia Screen
Dogs in an inflammatory state are at higher risk for post-operative complications due to coagulation compromise and the potential for organ failure due to ‘systemic inflammatory response syndrome'(SIRS). CRP added to the pre-surgical panel can rule-out the presence of sub-clinical disease, including the early stages of cardiac disease.
 Detect & Gauge Disease
In situations where the dog presents with non-specific signs such as lethargy, inappetence or weight-loss, CRP can let you know in quick order, of the presence of underlying disease, vs. an allergy, food intolerance or something of a benign nature. CRP levels correlate with disease severity and duration.

 

 

Wellness Screen
While CRP is non-specific, it is very sensitive to systemic inflammation. Its non-specificity is actually a benefit for a general wellness screen as one test covers many diseases. Low levels then become a "rule-out" for serious disorders and moderate to high levels become a call-to-action for further diagnostic workups.

 

Monitor Treatment & Recovery
Rapid responding CRP allows for near 'real-time' monitoring, used to quickly access the effectiveness of treatment. In general terms, if there is no notable drop in CRP within 2-3 days following initiation, the treatment can be considered ineffective. Additionally, serial assessments can detect disease relapse during the tapering of anti-inflammatory & immunosuppressive therapy.

Postoperatively, CRP levels will begin to drop 2-3 days following surgery in normal recoveries. If levels don't drop within 3-5 days, you can suspect an infection has set in. 

 

INCASE report

 

 

 

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