A Multicenter Observational Study Comparing Survival of Pugs and Dogs of Other Breeds With Protein-Losing Enteropathy
Abstract
BACKGROUND: Protein-losing enteropathy (PLE) in dogs often carries a guarded prognosis, and it is unclear if survival differs among breeds. HYPOTHESIS/OBJECTIVES: Survival of pugs with PLE is shorter than that of other breeds of dogs with PLE. ANIMALS: Forty-seven pugs and 148 dogs of other breeds were diagnosed with PLE at seven United Kingdom (UK) referral hospitals. METHODS: Retrospective, multicenter observational study. Case records were reviewed to identify dogs diagnosed with PLE. Cox's proportional hazards regression was used to determine variables associated with survival. RESULTS: Median (interquartile range) survival in pugs with PLE and dogs of other breeds was 104 (22-719) days and 759 (61-1632) days, respectively (p = 0.002). The hazard of death was higher in pugs (hazard ratio [HR]: 1.961; 95% confidence interval [CI]: 1.108-3.741; p = 0.002) than in other dogs. Neutrophil counts in peripheral blood were associated with an increased hazard of death (HR change per 1 x 10(9)/L: 1.045; 95% CI: 1.014-1.077; p = 0.004), whereas cobalamin concentration (HR: 0.995; 95% CI: 0.991-0.999) and cobalamin supplementation (HR: 0.517; 95% CI: 0.271-0.988) were positively associated with decreased hazard of death. A time-dependent effect on survival was identified for serum globulin concentrations, whereby globulin concentration was positively associated with hazard of death in dogs surviving 61-959 days (HR: 1.126; 95% CI: 1.040-1.219) and > 959 days (1.253; 95% CI: 1.048-1.497), but not 0-60 days (HR: 0.949; 95% CI: 0.891-1.011 days). CONCLUSIONS AND CLINICAL IMPORTANCE: Results of our observational study suggest a worse prognosis for pugs with PLE compared to a selection of dogs of other breeds seen at UK referral centers.