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Rabbit APP

Acute Phase Protein Laboratory

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C-reactive protein (CRP), serum amyloid A (SAA), and haptoglobin (HP) have all been identified as acute phase proteins in the rabbit species. CRP and SAA are identified as major APP with 10-100 fold increases within 24 hours of insult. HP is a minor APP with increases after 4-6 days.

In a study of samples from clinically abnormal rabbits with various presentations, CRP was observed to increase 21-fold versus 11-fold for SAA. The correlation between the two APP was r=0.72 (p<0.0001). While an elevated WBC count showed 100% specificity for inflammation, the sensitivity was poor at 25%. In contrast, the sensitivity for CRP and SAA, respectively was 92% and 79% with a specificity of 92-94%. There were some cases with CRP increases in the absence of SAA increases and vice versa. It has been proposed that different pathways of stimulation are present and there may be differential reactivity based on the type of stimulus.

Importantly, CRP has been show to have key value as an adjunct test to serological testing for E. cuniculi. As antibody titers can often be present in clinically normal rabbits, the presence of elevated CRP may support the presence of an inflammatory process consistent with infection. Abnormal IgM and IgG titers in conjunction with an elevated CRP level provides a positive predictive value of 100%.

Acute phase proteins can provide key prognostic value. With a positive response to treatment, CRP and SAA levels can decrease within 24 hours.

References

C. Cray. Biomarkers of inflammation in exotic pets. Journal of Exotic Pet Medicine, 22:245-250, 2013.

C. Cray, M. Rodriguez, and Y. Fernandez. Acute phase protein levels in rabbits with suspected Encephalitozoon cuniculi infection. Journal of Exotic Pet Medicine, 22:280-286, 2013.

C. Cray, S. McKenny, E. Perritt, and K.L. Arheart. Utility of IgM titers with IgG and C-reactive protein quantitation in the diagnosis of suspected Encephalitozoon cuniculi infection in rabbits. Journal of Exotic Pet Medicine, 24:356-360, 2015.