An evaluation of changes over time in serum creatine kinase activity and c-reactive protein concentration in dogs undergoing hemilaminectomy or ovariohysterectomy

Abstract

Trauma of diverse origins is a common reason for presentation of pets for treatment. It is often difficult clinically to objectively measure the severity of any trauma to an animal. One approach is to measure the changes in the various serum parameters which are known to alter in response to trauma or inflammation. If the changes over time of relevant and easily measurable parameters can be established under two controlled but different conditions of surgical trauma, it may provide the foundation for evaluating their future use in establishing the severity of trauma in a patient. A prospective study was performed on animals presented to the Onderstepoort Veterinary Academic Hospital for either thoracolumbar disc disease or for elective ovariohysterectomy. The two surgical procedures chosen for the study involved significant surgical trauma, particularly to muscle, in the case of thoracolumbar decompression and relatively minor surgical trauma in the case of ovariohysterectomy. Serial evaluation of creatine kinase (CK) and C-reactive protein (CRP) were performed both pre- and post-operatively on two sets of patients derived from the two surgical categories. CK is an enzyme found predominantly in skeletal muscle and significantly elevated serum activity is largely associated with muscle damage. CRP is an acute phase protein which shows elevated serum concentration in response to a broad range of inflammatory stimuli. Analysis of the data showed a very wide range of results at each time point for both CK and CRP. There were no significant differences between the two surgical groups for either analyte preoperatively. Thereafter CK results were markedly and significantly different between the two groups. CRP results were very similar in the two groups with no statistical difference at any time point. The results of this study suggest that the evaluation of CK and CRP at any one time point in a traumatized animal is of limited value. However the evaluation of the trend of these two analytes, even over a relatively short time period, may allow for useful prognostication in clinical cases.