The prognostic value of hematological ratios incorporating neutrophils and albumin as key factors in the pathophysiology and outcome of acute pancreatitis (AP) in dogs needs assessment. This study compared the predictive power of the neutrophil count-to-lymphocyte ratio (NLR), neutrophil count-to-albumin ratio (NAR), neutrophil percentage-to-albumin ratio (NPAR), and NLR-to-albumin ratio (NLR-Alb) for in-hospital mortality in dogs with AP. This retrospective cohort study included 128 dogs with AP (59.37 % survivors / 40.63 % non-survivors) and 40 healthy dogs. NLR, NAR, NPAR, and NLR-Alb were calculated upon admission. Logistic regression and the area under the receiver-operating characteristic curve (AUROC) evaluated their predictive value. All markers were significantly higher in non-surviving dogs with AP than in survivors. A one-point increase in NLR, NLR-Alb, and NAR increased the mortality risk by 4 %, 12 %, and 16 %, respectively. The AUROC, sensitivity, and specificity at the cutoff for each marker were:.622, 62.75 %, and 61 % for NLR;.708, 64.7 %, and 75.3 % for NAR;.609, 78.4 %, and 44.2 % for NPAR;.649, 82.4 %, and 45.4 % for NLR-Alb. Values above their cutoffs increased the mortality risk by 2.42, 5.6, 2.87, and 3.69-fold, respectively. In conclusion, NAR can better predict outcomes in dogs with AP than NLR. NLR-Alb is also superior to NLR but exhibits low specificity in identifying non-survivors. NPAR offers no prognostic advantage over other markers. Using these markers to predict mortality may improve treatment efficiency in dogs with AP.

In dogs, acute pancreatitis (AP) is frequently associated with systemic inflammation and renal dysfunction, both of which may adversely affect outcomes. This retrospective cohort study evaluated the prognostic utility of the creatinine-to-albumin ratio (CAR), neutrophil–creatinine index (NCI), and neutrophil-to-lymphocyte ratio (NLR) for predicting in-hospital mortality. One hundred and thirty-four dogs diagnosed with AP and forty healthy controls were included. All indices were calculated from routine hematological and biochemical data obtained at admission before treatment initiation. Prognostic performance was assessed using logistic regression, receiver operating characteristic (ROC) curve analysis, and comparison of ROC curves using the DeLong test. The results showed that all indices were significantly higher in dogs with AP than in healthy controls and were further increased in non-survivors. The mortality prevalence increased significantly across CAR and NCI percentiles, whereas no consistent association was observed for the NLR. CAR (AUC = 0.747, cutoff > 0.48, OR = 5.63) and NCI (AUC = 0.747, cutoff > 26, OR = 7.08) showed the highest discriminatory ability, followed by serum creatinine (AUC = 0.734, cutoff > 1.19 mg/dL, OR = 6.08). A ROC curve comparison revealed no significant differences between creatinine and CAR (p = 0.479), creatinine and NCI (p = 0.712), or CAR and NCI (p = 0.982). However, the NCI demonstrated significantly greater discriminatory performance than the NLR (AUC = 0.619; p = 0.021). In multivariable analyses, CAR and NCI remained independently associated with the outcome after adjustment for the NLR. These findings suggest that CAR and NCI may provide useful prognostic information in dogs with acute pancreatitis. Because they are derived from routinely available laboratory parameters, they may represent practical tools for early risk stratification at hospital admission.

Acute pancreatitis in dogs causes severe abdominal pain, typically managed with systemic opioids, which can impair gastrointestinal motility and delay recovery. This prospective clinical communication evaluated the opioid-sparing effect and clinical outcomes of an ultrasound-guided transversus abdominis plane block added to a multimodal analgesic protocol in dogs with acute pancreatitis. Twelve dogs were allocated into a locoregional block group (n = 6) and a control group managed with opioids (n = 6), matched on five severity scores recorded at admission. The primary outcome was opioid consumption during the first 24 h after enrollment; secondary outcomes were pain during the same period, time to first voluntary food intake, hospitalization length, and inflammatory response. The block group received significantly fewer methadone doses (median 0 vs. 4.5; p = 0.015) and five of six dogs required no methadone beyond the enrollment dose. Cumulative pain scores during the first 24 h were also significantly lower in the block group (p = 0.037). The time to first voluntary food intake was shorter in the block group (12 vs. 48 h; p = 0.02). No significant differences were found in hospitalization length or survival. Adding a transversus abdominis plane block to a multimodal protocol was associated with a marked opioid-sparing effect and promoted earlier voluntary food intake, although these preliminary findings require confirmation in larger studies.