| Acute pancreatitis in dogs is characterized by rapid onset,lack of specific symptoms,difficult to diagnose,and easy to be missed and misdiagnosed.Severe acute pancreatitis can even cause systemic multiple organ failure,which is life-threatening.Canine acute pancreatitis is also easily complicated or secondary to other diseases,such as hyperlipidemia,hypocalcemia,CDV,and diabetes.Therefore,this study explored the relationship between commonly used indicators,disease classification,course and outcome of acute pancreatitis from three aspects: meta-analysis of Organ Score in predicting the course of acute pancreatitis in dogs,modeling of hyperlipidemic acute pancreatitis in rats and analysis of clinical cases of acute pancreatitis in dogs.The reliability of Organ Score in predicting the disease course was verified.The cases in papers were screened and calculated Organ Score for IPD meta-analysis.The English database NCBI and the Chinese databases CNKI and Wan Fang were used to search the relevant literatures by keywords,and the published clinical cases of canine acute pancreatitis at home and abroad or the published Chinese and English case reports that have been published were screened for IPD meta-analysis.To increase homogeneity,the extracted patient data were regrouped according to gender,age,treatment,hypocalcemia dogs and Organ Score for analysis.The clinical indexes of rats model with hyperlipidemic pancreatitis were compared and analyzed.Thirty-two male Sprague-Dawley(SD)rats were divided into 4 groups: non-high-fat control group(N-control group,N = 4),non-high-fat pancreatitis group(N-AP group,N = 12),high-fat control group(H-control group,n = 4)and high-fat pancreatitis group(H-AP group,n = 12).The pancreatitis group was divided into 12 h,24 h and 48 h subgroups according to the time of sampling,with 4 rats in each group.The rats in the non-high-fat group were fed with normal diet for 14 days and intraperitoneally injected with normal saline(2.5 m L/kg/day,14 days).The rats in the high-fat group were intraperitoneally injected with poloxamer 407(0.25 g/kg/day,14 days)to induce hyperlipidemia.If the serum amylase level of rats in the pancreatitis group was significantly increased,the model was considered to be successful.After 14 days,acute pancreatitis was induced by intraperitoneal injection of L-arginine(1 g/kg)twice with an interval of 1h in the pancreatitis group.After modeling,the rats were fasted,and the samples were collected at the corresponding time points.Blood samples were collected from the inferior vena cava of rats.All rats were weighed once a week after the start of hyperlipidemia modeling.The whole blood of the blood sample was counted by CBC using an automatic hematology analyzer,and the serum of the remaining part was collected by high-speed centrifuge.The levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood urea nitrogen(BUN),amylase(AMYL),lipase(LIPA)and total cholesterol(CHOL)were detected by automatic biochemical analyzer.Retrospective study of canine acute pancreatitis cases.The clinical data of dogs with pancreatitis in an animal hospital of Xinxiang City were collected,including the age of onset,the breed of onset,the season of onset,and the influence of Organ Score on treatment methods.The clinical indicators and Organ Score were preliminarily used for case analysis.Totally randomly selected patients were evaluated by Organ Score and compared with each index and the overall situation of the patients.According to the quality evaluation,33 articles were of medium quality(3 points)and 16 articles were of high quality(4-5 points).Meta-analysis found that Organ Score was significantly correlated with the disease course in male dogs,young and middle-aged dogs(1 to 10 years old),non-hypocalcemia dogs,and dogs without surgical treatment to avoid the cause of the disease(p < 0.05).However,no correlation was found in female,young or old(less than 1 or more than 10 years old),hypocalcemia and dogs requiring surgical treatment to rule out the cause of the disease(p > 0.05).Therefore,Organ Score should be avoided as a predictor of disease course and only used as a predictor of poor outcome in these cases.For the above types of dogs,it is recommended to join other evaluation systems for comprehensive research and judgment.There was no significant difference in blood routine indexes between the hyperlipidemia group and the control group(p > 0.05).Biochemical indicators showed that hyperlipidemia could interfere with the levels of total cholesterol(CHOL),lipase(LIPA)and alanine aminotransferase(ALT)in pancreatitis(p< 0.05).Therefore,measures of CHOL,LIPA,and ALT cannot be used to directly indicate the severity of acute pancreatitis in obese dogs or dogs with established hyperlipidemia.The older the dogs,the higher the incidence of pancreatitis,the higher the incidence of poodle breeds,the higher the incidence of summer,and the higher the incidence of primary pancreatitis.There was no statistically significant difference between Organ Score and treatment choice of pet owners(p > 0.05),which may be due to the small number of cases collected.According to the clinical indicators,the number of dogs with Organ Score can be calculated is more than that of dogs without Organ Score.Therefore,in clinical diagnosis and treatment,the application of Organ score can more clearly predict the course of disease and outcome prognosis.In summary,Organ Score has guiding significance for the course of disease and outcome prognosis in most clinical diagnosis and treatment processes,and the threshold for use is low,and most cases can get enough clinical indicators for Organ Score evaluation.However,when using Organ Score evaluation to guide clinical practice,it is necessary to comprehensively evaluate other clinical indicators,such as body temperature,heart rate,respiration,serum lipase,serum amylase,serum calcium and other indicators.Conventional treatment is still the majority of clinical treatment for pancreatitis,but for those dogs that need surgery to exclude the primary cause,have an acute and severe course of disease,and have a high Organ Score,surgical treatment is also a worthy option. |
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