Myoglobin as a prognostic indicator for outcome in dogs with gastric dilatation-volvulus: Original Study

Objective To determine whether myoglobin (Mb) is a useful prognostic indicator for outcome and to investigate any relationship between Mb and mortality in dogs with gastric dilatation-volvulus (GDV). Design Prospective study. Setting Veterinary teaching hospital. Animals Seventy-two dogs with GDV. Interventions Blood sampling. MeasurementsMain Results Mb levels were measured at the time of diagnosis (Mbt₀), 24 hours (Mbt₁), and 48 hours (Mbt₂) after signs of GDV were recognized. Fifty-seven dogs survived (group I) and 15 dogs did not survive (group II). Mb t₀ differed significantly between groups (P=0.04). Mbt₀ in group I ranged from <30 to >700 ng/mL (n=57, median 74 ng/mL), and in group II from 34 to >700 ng/mL (n=15, median 238 ng/mL). Analysis of a receiver operating characteristic curve of Mbt₀ suggested that the best single cutpoint would be 168 ng/mL (sensitivity 60.0%, specificity 84.2%). Fifty percent of dogs with Mbt₀>168 ng/mL were euthanized, while 88.9% with Mbt₀<168 ng/mL survived. Mbt₁ and Mbt₂ differed significantly between groups I and II. Mbt₁ in group I ranged from 32 to >700 ng/mL (n=55, median 123 ng/mL), and Mbt₁ in group II ranged from 131 to 643 ng/mL (n=7, median 343 ng/mL) (P=0.006). Mbt₂ in group I ranged from 30 to 597 ng/mL (n=54, median 101 ng/mL), and in group II from 141 to >700 ng/mL (n=8, median 203 ng/mL) (P=0.02). Conclusions In this study, Mbt₀ is a moderately sensitive and specific prognostic indicator. Almost 90% of the dogs below the cutpoint survived to discharge, whereas 50% with Mbt₀ above the cutpoint did not survive.