C-Reactive Protein and Discospondylitis
What is C-Reactive Protein (CRP)?
It is an acute phase protein that has been used in other inflammatory conditions such as SRMA, IMPA or inflammatory bowel disease to support or monitor the clinical response to treatment.
Is it elevated with Discospondylitis?
Short answer: yes.
Long answer: It was elevated in most dogs in a recent study that were diagnosed with bacterial discospondylitis, but not all. In 8 dogs they measured it again 4-6 weeks into antibiotic treatment and it was normal in all 8 dogs.
What can we do with this information in practice?
When faced with a patient with discospondylitis you can use CRP to support the radiographic evidence of discospondylitis. I would NOT suggest using this as a disease monitoring tool for dogs with discospondylitis because, as the authors point out, the intervertebral disc is a very immune privileged area of the body therefore infection could persist that is not reflected in the CRP. One of the dogs, in the study quoted above, with normal CRP, had a recurrence of signs after stopping antibiotics. This suggests that CRP may not be a good long-term monitoring tool.
That's all for this week! Have a safe, happy week and keep those consults coming!
Nye G, Liebel FX, Harcourt-Brown T. C-reactive protein in dogs with suspected bacterial diskospondylitis: 16 cases (2010-2019). Vet Rec Open. 2020;7(1):e000386. Published 2020 Jul 20. doi:10.1136/vetreco-2019-000386