NEUTROPHIL TO LYMPHOCYTE RATIO IN CANINE SYSTEMIC INFLAMMATORY RESPONSE SYNDROME
Gori E1, Pierini A1, Lippi I1, Ceccherini G1 , Lubas G1, Marchetti V1
1 Veterinary Teaching Hospital “Mario Modenato”, Department of Veterinary Sciences, University
of Pisa, Via Livornese Lato monte, San Piero a Grado 56122, Pisa, Italy.
Introduction: The neutrophil to lymphocyte ratio (NLR) has been proposed as a readily accessible
and independent predictor parameter of poor survival in human patients with tumors, cardiovascular diseases and critically ill. As far as we know NLR has been evaluated only in oncological veterinary patients.
Objective: To evaluate NLR in dogs with systemic inflammatory response syndrome (SIRS) and its
association with the severity of illness, outcome and sepsis. BLR (band neutrophil-to-lymphocyte ratio) and BNLR (band-to-neutrophil-to-lymphocyte ratio) were evaluated as well.
Methods: Data were retrospectively collected and enrolled animals subsequently divided in 3
groups: 90 with SIRS, 50 healthy and 50 with chronic diseases as control groups. A SIRS grading was obtained based on how many criteria were fulfilled. The APPLEfast score was applied to the SIRS group. The survival rate was assessed at day 15 after their admission. Dogs with cytology or positive culture for active bacterial infections were recorded as septic. Mann Whitney U-test, Kruskal-Wallis test and Dunn’s multiple comparison test were used to compare groups using statistical software.
Results: In the SIRS group, thirty-nine dogs (43%) died during the study period. APPLEfast score >25 (p=0.03) and SIRS grading >2 (p=0.001) were associated with poor outcome. NLR was higher in the SIRS group compared to the control groups (p<0.0001 and p<0.0001, respectively) and not associated with outcome. NLR was not statistically different between SIRS grading groups or APPLEfast score groups. NLR was lower in septic dogs than in non-septic group (p=0.016). Dogs with SIRS grading >2 showed a higher BLR than dogs with SIRS grading =2 (p=0.04). Any association of BLR and BLNR with outcome, sepsis and APPLEfast groups was found.
Conclusions: Our results demonstrate the utility of NLR evaluation in dogs with SIRS (higher) and
in septic dogs (lower). Further prospective, large-scale studies investigating the role of BLR and BLNR in canine SIRS are warranted.
