Platelet-to-lymphocyte ratio as an indicator of idiopathic epilepsy in dogs.

PLR may serve as an accessible adjunctive biomarker to help differentiate idiopathic from structural epilepsy in dogs.

This retrospective study investigated the utility of hematologic indices, particularly the platelet-to-lymphocyte ratio (PLR), as diagnostic biomarkers for idiopathic epilepsy (IE) in dogs. The study enrolled 46 dogs with IE, 24 with hydrocephalus, 39 with meningoencephalitis of unknown etiology (MUE), 17 with brain tumors (BTs), and 55 healthy controls. Structural epilepsy was defined as a subset of dogs with seizures secondary to structural brain disease (6 hydrocephalus, 24 MUE, 11 BT). PLR outperformed other hematologic indices in diagnostic accuracy. Dogs with IE had significantly higher median PLR (132.3) than healthy controls (94.9), but significantly lower PLR than dogs with MUE (240.8), BT (246.5), or hydrocephalus (164.0). ROC curve analysis revealed AUC values of 0.73 for IE vs. controls, 0.78 for IE vs. all structural brain diseases, and 0.85 for IE vs. structural epilepsy. Optimal PLR cutoffs were 111.0 (sensitivity 67.4%, specificity 78.2%) for IE vs. controls, 161.9 (sensitivity 71.3%, specificity 76.1%) for IE vs. structural brain diseases, and 178.3 (sensitivity 84.8%, specificity 78.1%) for IE vs. structural epilepsy. These findings suggest that PLR, a readily accessible and inexpensive hematologic parameter, may serve as a useful adjunctive biomarker in distinguishing IE from structural brain diseases in dogs, potentially aiding clinical decision-making before advanced diagnostics such as MRI and CSF analysis are pursued.

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