New study links low cholesterol to mortality in canine and feline patients

24 November 2020

A new study, published in the latest issue of the Journal of Small Animal Practice (JSAP), showed that hypocholesterolaemia is associated with mortality in cats and dogs and may be a negative prognostic indicator.

The study titled “Period prevalence and mortality rates associated with hypocholesterolaemia in dogs and cats: 1,375 cases” determined the period prevalence of hypocholesterolaemia and the associated mortality rates in dogs and cats at the Veterinary Medical Teaching Hospital, University of California, Davis.

The medical records of cats and dogs presenting to the hospital from 1st September 2011 to 30th August 2016 were retrospectively reviewed to identify all animals that had at least 1 cholesterol measurement; a total of 16,977 dogs and 3,788 cats were identified. Patient signalment and clinical information were collated from the medical records, including the primary disease processes in patients with moderate to severe hypocholesterolaemia. The period prevalence and mortality rate of hypocholesterolaemia were calculated.

The period prevalence of hypocholesterolaemia was 7.0% in dogs and 4.7% in cats. The mortality rate of hypocholesteraemic dogs and cats was 12% in both species, which was significantly higher than that of animals with normal serum cholesterol.

“The odds of death in dogs and cats with hypocholesterolaemia were 3.2 and 2.5 times higher than in those with normocholesterolaemia respectively,” said Steven Epstein, corresponding author for the paper. “Furthermore, there was a significant linear trend towards higher mortality in association with more severe hypocholesterolaemia in both species.

“Disease of the hepatic, gastrointestinal and lymphoreticular systems were most commonly associated with hypocholesterolaemia, and infectious and neoplastic disease were the most commonly associated pathophysiological processes in both species. In dogs with neoplasia, lymphoma was over-represented.”

Nicola Di Girolamo, Editor of JSAP concluded: “These findings suggest that low cholesterol levels are associated with mortality in canine and feline patients. It is not clear whether hypocholesterolaemia is simply a marker for disease severity, or if it has active physiological effects contributing to poor outcomes. At this stage, it seems indicated to enhance intensity of diagnostic effort and therapy for affected animals.”

The full article can be found in the November issue of the Journal of Small Animal Practice which is free for BSAVA members. It can also be read online here.

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1A. W. K. Tan, S. E. Epstein and K. Hopper (2020) Period prevalence and mortality rates associated with hypocholesterolaemia in dogs and cats: 1,375 cases. Journal of Small Animal Practice, 61 (11). Available at: