{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:02:38Z","timestamp":1791385358068,"version":"4.3.3"},"reference-count":50,"publisher":"American Veterinary Medical Association (AVMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2008,9,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:p><jats:bold>Objective<\/jats:bold>\u2014To establish a clinical severity index that correlates severity of body system abnormalities with outcome in dogs with acute pancreatitis (AP) and determine the usefulness of serum C-reactive protein (C-RP) concentration as an objective measure of AP severity.<\/jats:p>\n<jats:p><jats:bold>Design<\/jats:bold>\u2014Retrospective cohort study.<\/jats:p>\n<jats:p><jats:bold>Animals<\/jats:bold>\u201461 client-owned dogs with ultrasonographically or histologically confirmed AP.<\/jats:p>\n<jats:p><jats:bold>Procedures<\/jats:bold>\u2014Medical records of AP-affected dogs were reviewed, and signalment, physical examination findings, clinicopathologic data, and outcome (death or discharge from the hospital) were evaluated. The correlation of specific abnormalities in endocrine, hepatic, renal, hematopoietic, cardiovascular, and respiratory systems; local pancreatic complications; and intestinal integrity were evaluated, and a clinical severity index was developed for AP in dogs. The severity index score was compared with outcome and, for 12 dogs, with serum C-RP concentration.<\/jats:p>\n<jats:p><jats:bold>Results<\/jats:bold>\u2014The clinical severity index had a good correlation with outcome and interval from hospital admission until end point (days until outcome), but there was no difference in days until outcome between survivors and nonsurvivors. All 12 dogs evaluated had high serum C-RP concentration, but this variable was not related to outcome; however, within a 2-day period after onset of clinical signs, serum C-RP concentration in survivors and nonsurvivors differed significantly.<\/jats:p>\n<jats:p><jats:bold>Conclusions and Clinical Relevance<\/jats:bold>\u2014Among AP-affected dogs, the clinical severity index may be useful for treatment comparisons and prediction of intensive management requirements. Serum C-RP concentration was best related to AP severity within a 2-day period after onset of clinical signs, but daily measurement may be more useful for monitoring progress.<\/jats:p>","DOI":"10.2460\/javma.233.6.936","type":"journal-article","created":{"date-parts":[[2008,9,16]],"date-time":"2008-09-16T16:36:00Z","timestamp":1221582960000},"page":"936-944","source":"Crossref","is-referenced-by-count":85,"title":["Development of a clinical severity index for dogs with acute pancreatitis"],"prefix":"10.2460","volume":"233","author":[{"given":"Caroline S.","family":"Mansfield","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fleur E.","family":"James","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian D.","family":"Robertson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"key":"ref1","series-title":"In Pract","first-page":"64","article-title":"Pancreatitis in the dog: dealing with a spectrum of disease","volume":"Feb","author":"Watson","year":"2004"},{"key":"ref2","series-title":"Aust Vet J","first-page":"416","article-title":"Plasma and urinary trypsinogen activation peptide in healthy dogs, dogs with pancreatitis and dogs with other systemic diseases","volume":"78","author":"Mansfield","year":"2000"},{"key":"ref3","series-title":"Compend Contin Educ Pract Vet","first-page":"531","article-title":"Pathophysiology of organ failure in severe acute pancreatitis in dogs","volume":"22","author":"Ruaux","year":"2000"},{"key":"ref4","series-title":"Aust Vet Pract","first-page":"67","article-title":"General practice attitudes to the treatment of spontaneous canine acute pancreatitis","volume":"28","author":"Ruaux","year":"1998"},{"key":"ref5","series-title":"Res Vet Sci","first-page":"137","article-title":"Assessing the severity of canine pancreatitis","volume":"74","author":"Mansfield","year":"2003"},{"key":"ref6","series-title":"J Small Anim Pract","first-page":"445","article-title":"Diagnosis and management of pancreatitis","volume":"35","author":"Williams","year":"1994"},{"key":"ref7","series-title":"Aust Vet J","first-page":"804","article-title":"A severity score for spontaneous canine acute pancreatitis","volume":"76","author":"Ruaux","year":"1998"},{"key":"ref8","series-title":"Am J Surg","first-page":"76","article-title":"The role of cytokines in the pathogenesis of acute pancreatitis","volume":"175","author":"Norman","year":"1998"},{"key":"ref9","series-title":"J Am Vet Med Assoc","first-page":"665","article-title":"Clinical, clinicopathologic, radiographic, and ultrasonographic abnormalities in dogs with fatal acute pancreatitis: 70 cases (1986\u20131995)","volume":"213","author":"Hess","year":"1998"},{"key":"ref10","series-title":"J Am Vet Med Assoc","first-page":"673","article-title":"Risk factors associated with acute pancreatitis in dogs: 101 cases (1985\u20131990)","volume":"203","author":"Cook","year":"1993"},{"key":"ref11","series-title":"Am J Vet Res","first-page":"1966","article-title":"Serum amylase and lipase activities in the diagnosis of pancreatitis in dogs","volume":"42","author":"Strombeck","year":"1981"},{"key":"ref12","series-title":"Vet Clin Pathol","first-page":"85","article-title":"Acute phase proteins in dogs and cats: current knowledge and future perspectives","volume":"34","author":"Ceron","year":"2005"},{"key":"ref13","series-title":"J Vet Emerg Crit Care","first-page":"183","article-title":"C-reactive protein concentrations in canine acute pancreatitis","volume":"14","author":"Holm","year":"2004"},{"key":"ref14","series-title":"Arch Surg","first-page":"586","article-title":"A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis","volume":"128","author":"Bradley","year":"1993"},{"key":"ref15","series-title":"Am J Vet Res","first-page":"948","article-title":"Evaluation of the survival prediction index as a model of risk stratification for clinical research in dogs admitted to intensive care units at four locations","volume":"62","author":"King","year":"2001"},{"key":"ref16","series-title":"Br J Surg","first-page":"1783","article-title":"Amelioration of experimental acute pancreatitis with a potent platelet-activating factor antagonist","volume":"81","author":"Formela","year":"1994"},{"key":"ref17","series-title":"Am J Gastroenterol","first-page":"213","article-title":"Proinflammatory cytokines in early assessment of the prognosis of acute pancreatitis","volume":"94","author":"Chen","year":"1999"},{"key":"ref18","series-title":"Br J Surg","first-page":"68","article-title":"Early prediction of organ failure by combined markers in patients with acute pancreatitis","volume":"92","author":"Mentula","year":"2005"},{"key":"ref19","series-title":"J Gastroenterol Hepatol","first-page":"550","article-title":"Elevated level of inter-leukin-6 predicts organ failure and severe disease in patients with acute pancreatitis","volume":"22","author":"Sathyanarayan","year":"2007"},{"key":"ref20","series-title":"J Vet Med A Physiol Pathol Clin Med","first-page":"164","article-title":"Evaluation of a commercially available enzyme-linked immunosorbent assay (ELISA) for the determination of C-reactive protein in canine serum","volume":"50","author":"Kjelgaard-Hansen","year":"2003"},{"key":"ref21","series-title":"J Vet Med Sci","first-page":"1275","article-title":"C-reactive protein concentration in canine idiopathic polyarthritis","volume":"68","author":"Ohno","year":"2006"},{"key":"ref22","series-title":"J Vet Intern Med","first-page":"865","article-title":"Preliminary studies of serum acute-phase protein concentrations in hematologic and neoplastic diseases of the dog","volume":"19","author":"Tecles","year":"2005"},{"key":"ref23","series-title":"J Vet Intern Med","first-page":"635","article-title":"C-reactive protein concentration in dogs with chronic valvular disease","volume":"20","author":"Rush","year":"2006"},{"key":"ref24","series-title":"Am J Vet Res","first-page":"613","article-title":"C-reactive protein concentration in dogs with inflammatory leukograms","volume":"55","author":"Burton","year":"1994"},{"key":"ref25","series-title":"Vet Res Commun","first-page":"85","article-title":"Changes in serum C-reactive protein levels in dogs with various disorders and surgical traumas","volume":"17","author":"Yamamoto","year":"1993"},{"key":"ref26","series-title":"Vet Rec","first-page":"814","article-title":"Effects of different glucocorticoid treatments on serum acute phase proteins in dogs","volume":"154","author":"Martinez-Subiela","year":"2004"},{"key":"ref27","series-title":"Hepatobiliary Pancreat Dis Int","first-page":"294","article-title":"APACHE system is better than Ranson system in the prediction of severity of acute pancreatitis","volume":"5","author":"Yeung","year":"2006"},{"key":"ref28","series-title":"J Clin Gastroenterol","first-page":"195","article-title":"Balthazar computed tomography severity index is superior to Ranson criteria and APACHE II and III scoring systems in predicting acute pancreatitis outcome","volume":"36","author":"Chatzicostas","year":"2003"},{"key":"ref29","series-title":"Arch Surg","first-page":"730","article-title":"Severity scoring for prognostication in patients with severe acute pancreatitis: comparative analysis of the Ranson score and the APACHE III score","volume":"137","author":"Eachempati","year":"2002"},{"key":"ref30","series-title":"Crit Care Med","first-page":"901","article-title":"Prognostic usefulness of scoring systems in critically ill patients with severe acute pancreatitis","volume":"27","author":"Williams","year":"1999"},{"key":"ref31","series-title":"Br J Surg","first-page":"1020","article-title":"Bacterial infection and extent of necrosis are determinants of organ failure in patients with acute necrotizing pancreatitis","volume":"86","author":"Isenmann","year":"1999"},{"key":"ref32","series-title":"J Vet Intern Med","first-page":"291","article-title":"A scoring index for disease activity in canine inflammatory bowel disease","volume":"17","author":"Jergens","year":"2003"},{"key":"ref33","series-title":"J Am Vet Med Assoc","first-page":"397","article-title":"Treatment for pancreatic abscesses via omentalization with abdominal closure versus open peritoneal drainage in dogs: 15 cases (1994\u20132004)","volume":"228","author":"Johnson","year":"2006"},{"key":"ref34","series-title":"J Am Anim Hosp Assoc","first-page":"189","article-title":"Pancreatic masses in seven dogs following acute pancreatitis","volume":"26","author":"Edwards","year":"1990"},{"key":"ref35","series-title":"J Am Vet Med Assoc","first-page":"1104","article-title":"Pancreatic abscess in dogs: six cases (1978\u20131986)","volume":"193","author":"Salisbury","year":"1988"},{"key":"ref36","series-title":"Vet Rec","first-page":"245","article-title":"Usefulness of systemic inflammatory response syndrome criteria as an index for prognosis judgement","volume":"150","author":"Okano","year":"2002"},{"key":"ref37","series-title":"J Vet Intern Med","first-page":"791","article-title":"Effect of early enteral nutrition on intestinal permeability, intestinal protein loss, and outcome in dogs with severe parvoviral enteritis","volume":"17","author":"Mohr","year":"2003"},{"key":"ref38","series-title":"Br J Surg","first-page":"1665","article-title":"Enteral nutrition is superior to parenteral nutrition in severe acute pancreatitis: results of a randomised prospective trial","volume":"84","author":"Kalfarentzos","year":"1997"},{"key":"ref39","series-title":"Eur J Surg","first-page":"1357","article-title":"Randomized trial of the effect of early enteral nutrition on markers of the inflammatory response in predicted severe acute pancreatitis","volume":"166","author":"Powell","year":"2000"},{"key":"ref40","series-title":"Gut","first-page":"431","article-title":"Compared with parenteral nutrition, enteral feeding attenuates the acute phase response and improves disease severity in acute pancreatitis","volume":"42","author":"Windsor","year":"1998"},{"key":"ref41","series-title":"J Gastrointest Surg","first-page":"252","article-title":"Early increase in intestinal permeability in patients with severe acute pancreatitis: correlation with endotoxemia, organ failure, and mortality","volume":"3","author":"Ammori","year":"1999"},{"key":"ref42","series-title":"Am J Gastroenterol","first-page":"2255","article-title":"Hypocaloric jejunal feeding is better than total parenteral nutrition in acute pancreatitis: results of a randomized comparative study","volume":"97","author":"Abou-Assi","year":"2002"},{"key":"ref43","series-title":"Hepatobiliary Pancreat Dis Int","first-page":"150","article-title":"Early intrajejunal nutrition: bacterial translocation and gut barrier function of severe acute pancreatitis in dogs","volume":"1","author":"Qin","year":"2002"},{"key":"ref44","series-title":"Vet Radiol","first-page":"27","article-title":"Pancreatic ultrasonography in dogs with experimentally induced acute pancreatitis","volume":"26","author":"Murtaugh","year":"1985"},{"key":"ref45","series-title":"Vet Radiol Ultrasound","first-page":"139","article-title":"Ultrasonographic findings in cholecystokinin-induced pancreatitis in dogs","volume":"36","author":"Lamb","year":"1995"},{"key":"ref46","series-title":"J Small Anim Pract","first-page":"410","article-title":"Dilation of the pancreatic duct: an ultrasonographic finding in acute pancreatitis","volume":"30","author":"Lamb","year":"1989"},{"key":"ref47","series-title":"Vet Radiol Ultrasound","first-page":"72","article-title":"Combined use of ultrasonography and contrast-enhanced computed tomography to evaluate acute necrotizing pancreatitis in two dogs","volume":"44","author":"Jaegar","year":"2003"},{"key":"ref48","series-title":"Pathology of domestic animals","first-page":"407","article-title":"The pancreas","author":"Jubb","year":"1993"},{"key":"ref49","series-title":"J Am Anim Hosp Assoc","first-page":"411","article-title":"Pancreatic pseudocyst associated with acute pancreatitis in a dog: ultrasonographic diagnosis","volume":"21","author":"Rutgers","year":"1985"},{"key":"ref50","series-title":"J Am Anim Hosp Assoc","first-page":"681","article-title":"A clinicopathologic survey of acute pancreatitis in 30 dogs and 5 cats","volume":"15","author":"Schaer","year":"1979"}],"container-title":["Journal of the American Veterinary Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/233\/6\/javma.233.6.936.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/233\/6\/javma.233.6.936.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/233\/6\/javma.233.6.936.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T13:52:46Z","timestamp":1741355566000},"score":1,"resource":{"primary":{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/233\/6\/javma.233.6.936.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,9,15]]},"references-count":50,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.2460\/javma.233.6.936","relation":{},"ISSN":["0003-1488"],"issn-type":[{"value":"0003-1488","type":"print"}],"subject":[],"published":{"date-parts":[[2008,9,15]]}}}