• Open Access

Serum Pepsinogen-A, Canine Pancreatic Lipase Immunoreactivity, and C-Reactive Protein as Prognostic Markers in Dogs with Gastric Dilatation-Volvulus


  • This study was performed at the Hebrew University Veterinary Teaching Hospital. Canine pepsinogen-A, C-reactive protein, and canine pancreatic-like immunoreactivity were measured at the Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University.
  • The study was unsupported.
  • Results of this study were presented in part at the Annual Israeli Veterinary Symposium, September 2011, Beit Dagan, Israel.

Corresponding author: I. Israeli, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, PO Box 12, Rehovot, Israel 76100; e-mail: Dr_Inbar@yahoo.com.



Pepsinogens are proenzymes secreted by gastric chief cells. In humans, their serum concentrations reflect gastric mucosal morphological and functional status.


To evaluate serum canine pepsinogen-A (cPG-A), C-reactive protein (CRP), and canine pancreatic lipase immunoreactivity (cPLI) concentrations in dogs with gastric dilatation-volvulus (GDV).


Sixty-six dogs presented with GDV and 79 healthy controls.


Blood was collected prospectively, and records retrospectively reviewed.


Median cPG-A concentration was higher in GDV dogs (median, 397 μg/L; range, 37–5,410) compared to controls (median, cPG-A 304 μg/L; range, 18–848; P = .07). Mortality rate in GDV dogs was 22.7%. In nonsurvivors of GDV, median cPG-A was higher compared to survivors (median, 746 μg/L; range, 128–5,409 versus median, 346; range, 36–1,575, respectively; P = .003). The proportion of dogs with increased cPG-A increased with gastric wall damage score (P = .007). An ROC analysis of cPG-A as a predictor of death showed an area under the curve (AUC) of 0.75, higher than lactate (AUC 0.66), and corresponded to a sensitivity and specificity of 53% and 88%, respectively. CRP was increased in 48 dogs (75%), cPLI was >200 μg/L in 26 dogs (39.4%) and >400 μg/L in 12 dogs (18.2%) but both analytes had no association with outcome.


Presurgical cPG-A concentration was positively and significantly associated with gastric wall lesion severity, but, based on ROC analysis, it was only a moderate outcome predictor. CRP and cPLI were commonly increased in dogs with GDV.