Prognostic Utility of Degenerative Left Shifts in Dogs

BACKGROUND: A degenerative left shift (DLS) in dogs is reported to be a poor prognostic indicator, but no studies have been reported to verify this claim. HYPOTHESIS/OBJECTIVES: To characterize the canine population affected by DLS and to determine if the presence and severity of the DLS are associa...

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Bibliographic Details
Published in:Journal of veterinary internal medicine 2013-11, Vol.27 (6), p.1517-1522
Main Authors: Burton, A.G., Harris, L.A., Owens, S.D., Jandrey, K.E.
Format: Article
Language:English
Subjects:
Animals
Case-Control Studies
Complete blood count
Dog Diseases - blood
Dog Diseases - immunology
Dogs
Female
Gastroenteritis
Hematology
Leukocyte Count - veterinary
Leukocytes
Male
Neutrophils
Neutrophils - immunology
Prognosis
Retrospective Studies
Scandals
Septic peritonitis
Survival
Survival Analysis
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Summary:BACKGROUND: A degenerative left shift (DLS) in dogs is reported to be a poor prognostic indicator, but no studies have been reported to verify this claim. HYPOTHESIS/OBJECTIVES: To characterize the canine population affected by DLS and to determine if the presence and severity of the DLS are associated with increased risk of euthanasia or death. ANIMALS: Three‐hundred and nineteen dogs with DLS (cases) and 918 dogs without DLS (controls) presented to the University of California, Davis Veterinary Medical Teaching Hospital between April 1, 1995 and April 1, 2010. METHODS: Retrospective case–control study. All cases had a CBC performed within 24 hours of presentation that showed an immature neutrophil count higher than the mature neutrophil count. Controls were matched by year of presentation and primary diagnosis. Survival analysis was used to determine the risk of death or euthanasia associated with DLS and other potential predictors. RESULTS: Half of cases versus 76% of controls were alive at discharge. Median in‐hospital survival time was 7 days for cases and 13 days for controls. DLS was a significant predictor of death or euthanasia in both univariate and multivariate analysis (hazard ratio, HR, 1.9; 95% CI 1.54–2.34). CONCLUSIONS AND CLINICAL IMPORTANCE: DLS in dogs is associated with an increased risk of death or euthanasia. This finding, however, varies with disease diagnosis and should be interpreted in light of the individual patient.
ISSN:0891-6640
1939-1676
DOI:10.1111/jvim.12208