From Peritonitis to prognostic indicator – every day clinical uses of C-Reactive Protein (CRP)

By Cokehabit (talk) - I took this myself., CC BY-SA 3.0, https://en.wikipedia.org/w/index.php?curid=19133709

Image courtesy of ‘By Cokehabit (talk) – I took this myself., CC BY-SA 3.0, https://en.wikipedia.org/w/index.php?curid=19133709’

1 in 4 surgically treated cases of pyometra were found to have postoperative complications, of which peritonitis was the most common¹. Risk of infection following pyometra surgery, enterotomy or indeed any procedure entering the abdominal or chest cavity is always of concern. This short article briefly discusses what CRP is and how it can be of practical help in managing these and other cases.

CRP is an acute phase protein (APP) that rapidly increases in response to infection, inflammation and physical trauma. In response to an inflammatory insult, rises in APP levels are known to precede the rise in white blood cell (WBC) parameters². CRP was found to be a more sensitive and reliable method of evaluating the post-operative period in bitches post-ovariohysterectomy, than both rectal temperature or WBC count³.

Post-operatively this makes CRP an ideal early marker of potential issues to enable rapid intervention and facilitate appropriate prompt treatment. CRP is especially helpful when used for monitoring either recovery, or the response to treatment, over a period of time. For example, by taking sequential CRP measurements it is possible to help determine if a selected antimicrobial or other treatment is being effective/the recovery is proceeding as expected or, if further evaluation is in fact required. This is because although CRP will remain elevated as long as an inflammatory stimulus persists, once removed CRP will decrease rapidly over 24-48 hours². Expanding upon this, CRP can be a valuable prognostic indicator in a variety of critical illnesses. Dogs surviving problems such as; systemic inflammatory response syndrome, parvovirus, acute pancreatitis and other acute abdominal problems showed declining CRP levels as treatment progressed. In contrast, dogs that subsequently died showed continually elevated or increasing CRP levels².

For more detailed information about how and when to use CRP most effectively in practice and to find out other indications for its use, please contact Avacta Animal Health.

(1) Jitpean, S., Ström-Holst, B., Emanuelson, U.,Höglund, O.V., Pettersson, A., Alneryd-Bull, C. & Hagman, R. (2014). Outcome of pyometra in female dogs and predictors of peritonitis
and prolonged postoperative hospitalization in surgically treated cases. BMC Veterinary Research 10:6
(2) Bell, R. & Wilson, C. (2014). Acute phase proteins:how they are useful for practitioners. Veterinary Times, December 8th, 2014.
(3) Dabrowski, R. & Wawron, W. (2014). Acute-phase response in monitoring post-operative recovery in bitches after ovariohysterectomy. Ann. Anim. Sci., Vol. 14, No. 2: 287–295