The association between vascular endothelial growth factor levels and clinically evident peripheral edema in dogs with systemic inflammatory response syndrome

Authors

  • Deborah C. Silverstein DVM, DACVECC,

    1. Department of Clinical Studies, University of Pennsylvania Matthew J. Ryan Veterinary Hospital, Philadelphia, PA 19104-6010
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  • Catalina Montealegre VMD,

    1. Department of Clinical Studies, University of Pennsylvania Matthew J. Ryan Veterinary Hospital, Philadelphia, PA 19104-6010
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  • Frances S. Shofer PhD,

    1. Department of Clinical Studies, University of Pennsylvania Matthew J. Ryan Veterinary Hospital, Philadelphia, PA 19104-6010
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  • Cynthia M. Otto DVM, PhD, DACVECC

    1. Department of Clinical Studies, University of Pennsylvania Matthew J. Ryan Veterinary Hospital, Philadelphia, PA 19104-6010
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  • Gift support: Crazy Kim Foundation.
    The authors declare no conflicts of interest.

Address correspondence and reprint requests to
Dr. Deborah Silverstein, Department of Clinical Studies, University of Pennsylvania Matthew J. Ryan Veterinary Hospital, 3900 Delancey St, Philadelphia, PA 19104-6010, USA. Email: dcsilver@vet.upenn.edu

Abstract

Objective – To determine the relationship between plasma vascular endothelial growth factor (VEGF) levels, severity of illness, and edema formation in critically ill dogs.

Design – Prospective, observational, descriptive, clinical study.

Setting – University Teaching Hospital.

Animals – Twenty-eight dogs.

Interventions – None.

Measurements and Main Results – Physical examination and multifrequency bioimpedance (MFBIA) measurements were performed daily on 28 critically ill dogs with evidence of severe inflammatory disease and compared with the corresponding plasma VEGF levels. The change in VEGF values and the relationship between MFBIA measurements and clinical evidence of edema were also examined. Eighteen dogs had a positive VEGF level, 12 dogs had clinical evidence of edema, and 7 dogs had both a positive VEGF level and clinical evidence of edema. There was no statistically significant correlation between VEGF levels and the presence of edema on physical examination (P=0.2). VEGF values were also evaluated with respect to WBC count, survival prediction index, presence of known sepsis, change in extracellular water, and outcome. No statistical relationship could be identified between VEGF levels in the blood of dogs with inflammatory disease and their survival prediction index (P=0.1), the WBC count (P=0.2), or presence of sepsis (P=0.2). Dogs with a VEGF level >70 pg/mL (n=3) were less likely to survive (P=0.04). Because of high variability within and between animals, conclusions regarding changes in MFBIA could not be made, suggesting that this technology requires further refinement and investigation in critically ill dogs.

Conclusions – A relationship between VEGF and clinically evident increased vascular permeability was not found in this study. Dogs with markedly elevated VEGF levels may be more likely to die, but further studies are needed to determine the diagnostic and prognostic value of VEGF in critically ill dogs.

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