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Myoglobin as a prognostic indicator for outcome in dogs with gastric dilatation‐volvulus
Author(s) -
Adamik Katja N.,
Burgener Iwan A.,
Kovacevic Alan,
Schulze Sebastian P.,
Kohn Barbara
Publication year - 2009
Publication title -
journal of veterinary emergency and critical care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.886
H-Index - 47
eISSN - 1476-4431
pISSN - 1479-3261
DOI - 10.1111/j.1476-4431.2009.00421.x
Subject(s) - medicine , gastroenterology , prospective cohort study , area under the curve , nuclear medicine
Objective– To determine whether myoglobin (Mb) is a useful prognostic indicator for outcome and to investigate any relationship between Mb and mortality in dogs with gastric dilatation‐volvulus (GDV). Design– Prospective study. Setting– Veterinary teaching hospital. Animals– Seventy‐two dogs with GDV. Interventions– Blood sampling. Measurements and Main Results– Mb levels were measured at the time of diagnosis (Mbt 0 ), 24 hours (Mbt 1 ), and 48 hours (Mbt 2 ) after signs of GDV were recognized. Fifty‐seven dogs survived (group I) and 15 dogs did not survive (group II). Mb t 0 differed significantly between groups ( P =0.04). Mbt 0 in group I ranged from <30 to >700 ng/mL ( n =57, median 74 ng/mL), and in group II from 34 to >700 ng/mL ( n =15, median 238 ng/mL). Analysis of a receiver operating characteristic curve of Mbt 0 suggested that the best single cutpoint would be 168 ng/mL (sensitivity 60.0%, specificity 84.2%). Fifty percent of dogs with Mbt 0 >168 ng/mL were euthanized, while 88.9% with Mbt 0 <168 ng/mL survived. Mbt 1 and Mbt 2 differed significantly between groups I and II. Mbt 1 in group I ranged from 32 to >700 ng/mL ( n =55, median 123 ng/mL), and Mbt 1 in group II ranged from 131 to 643 ng/mL ( n =7, median 343 ng/mL) ( P =0.006). Mbt 2 in group I ranged from 30 to 597 ng/mL ( n =54, median 101 ng/mL), and in group II from 141 to >700 ng/mL ( n =8, median 203 ng/mL) ( P =0.02). Conclusions– In this study, Mbt 0 is a moderately sensitive and specific prognostic indicator. Almost 90% of the dogs below the cutpoint survived to discharge, whereas 50% with Mbt 0 above the cutpoint did not survive.