Specificity of a canine pancreas-specific lipase assay for diagnosing pancreatitis in dogs without clinical or histologic evidence of the disease
To evaluate the specificity of a canine pancreas-specific lipase (cPSL) assay for diagnosing pancreatitis in dogs without clinical or histologic evidence of the disease.
20 dogs from another study with macroscopic evidence of pancreatitis and 44 dogs surrendered for euthanasia or expected to die.
Prior to death, physical examination of each dog was performed and blood samples were collected for serum biochemical, serum cPSL, and hematologic analyses. After death, the pancreas was removed, sectioned in 1- to 2-cm slices, and evaluated by a pathologist. Dogs were classified by whether they had clinical or macroscopic pancreatitis. Each pancreatic section was histologically examined, and mean cumulative scores (MCSs) were assigned for 8 histologic characteristics. For each characteristic, comparisons were made between dogs with and without pancreatitis to establish histologic criteria for lack of evidence of pancreatitis.
For all histologic characteristics except lymphocytic infiltration, the median MCS differed significantly between dogs with and without pancreatitis. Dogs were categorized as having no histologic evidence of pancreatitis when the MCSs for neutrophilic infiltration, pancreatic necrosis, peripancreatic fat necrosis, and edema were 0.0. On the basis of these criteria, 40 dogs were classified as having no evidence of pancreatitis. The cPSL concentration was within reference limits in 38 of these 40 dogs and was less than the cutoff value for diagnosing pancreatitis (400 μg/L) in 39 of the 40 dogs, resulting in a specificity of 97.5% (95% confidence interval, 86.8% to 99.9%).
The cutoff cPSL value used in this study may be useful for diagnosing pancreatitis in dogs with a lack of histologic lesions consistent with pancreatitis and for which pancreatitis is not considered a major differential diagnosis.
Available from: Stanley Marks
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ABSTRACT: Pancreatitis is a common disorder in dogs for which the antemortem diagnosis remains challenging.
To compare the sensitivity and specificity of serum markers for pancreatitis in dogs with histopathologic evidence of pancreatitis or lack thereof.
Seventy dogs necropsied for a variety of reasons in which the pancreas was removed within 4 hours of euthanasia and serological markers were evaluated within 24 hours of death.
Prospective study: Serum was analyzed for amylase and lipase activities, and concentrations of canine trypsin-like immunoreactivity (cTLI) and canine pancreas-specific lipase (cPL). Serial transverse sections of the pancreas were made every 2 cm throughout the entire pancreas and reviewed using a semiquantitative histopathologic grading scheme.
The sensitivity for the Spec cPL (cutoff value 400 μg/L) was 21 and 71% in dogs with mild (n = 56) or moderate-severe pancreatitis (n = 7), and 43 and 71% (cutoff value 200 μg/L), respectively. The sensitivity for the cTLI, serum amylase, and lipase in dogs with mild or moderate-severe pancreatitis was 30 and 29%; 7 and 14%; and 54 and 71%, respectively. The specificity for the Spec cPL based on 7 normal pancreata was 100 and 86% (cutoff value 400 and 200 μg/L, respectively), whereas the specificity for the cTLI, serum amylase, and lipase activity was 100, 100, and 43%, respectively.
The Spec cPL demonstrated the best overall performance characteristics (sensitivity and specificity) compared to other serum markers for diagnosing histopathologic lesions of pancreatitis in dogs.
Available from: John M Morton
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ABSTRACT: Hypertriglyceridemia has been proposed to contribute to the risk of developing pancreatitis in dogs.
To determine associations between postprandial serum triglyceride concentrations and canine pancreatic lipase immunoreactivity (cPLI) concentrations or pancreatic disease.
Thirty-five client-owned overweight (n = 25) or obese (n = 10) dogs weighing >10 kg.
Healthy dogs were prospectively recruited for a cross-sectional study. Serum triglyceride concentrations were measured before and hourly for 12 hours after a meal. Fasting cPLI and canine trypsin-like immunoreactivity (cTLI) concentrations were assayed. Cut-off values for hypertriglyceridemia were set a priori for fasting (≥ 88, ≥ 177, ≥ 354, ≥ 885 mg/dL) and peak postprandial (≥ 133, ≥ 442, ≥ 885 mg/dL) triglyceride concentrations. The association between hypertriglyceridemia and high cPLI concentrations was assessed by exact logistic regression. Follow-up was performed 4 years later to determine the incidence of pancreatic disease.
Eight dogs had peak postprandial triglycerides >442 mg/dL and 3 dogs had fasting serum cPLI concentrations ≥ 400 μg/L. Odds of high cPLI concentrations were 16.7 times higher in dogs with peak postprandial triglyceride concentrations ≥ 442 mg/dL relative to other dogs (P < .001). Fasting triglyceride concentration was not significantly associated with cPLI concentrations. None of the dogs with high triglyceride concentrations and one of the dogs with low fasting and peak postprandial triglyceride concentrations developed clinically important pancreatic disease.
Overweight and obese dogs with peak serum postprandial triglyceride concentrations ≥ 442 mg/dL after a standard meal are more likely to have serum cPLI concentrations ≥ 400 μg/L, but did not develop clinically important pancreatic disease.
Available from: Caroline S Mansfield
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ABSTRACT: The current study aimed to determine the specificity, and to a lesser extent the sensitivity, of canine pancreatic-specific lipase (cPL) concentration in dogs with various disease conditions. Dogs were presented for postmortem examination and had serum collected for cPL concentration within 6 hr preceding death or immediately postmortem. Pancreatic tissue was collected postmortem, and sections from the left lobe, right lobe, and body of the pancreas were examined histologically. Inflammation and fibrosis in each section were assessed to determine a total pancreatic inflammatory score and pancreatic fibrosis score in each dog. Correlations between these scores and the cPL concentration were made, as well as determination of specificity. A total of 32 dogs were included in the analysis, 20 of whom had no to minimal pancreatic inflammation. The specificity of cPL with a cutoff value of 200 µg/l was 80% (95% confidence interval [CI]: 56-94%), while with a cutoff of 400 µg/l, the specificity was 90% (95% CI: 68-99%). There was a significant but rather low correlation between cPL concentration and the pancreatic inflammation score, but not with the fibrosis score. Canine pancreatic-specific lipase concentration has good specificity overall in dogs without pancreatitis. This test is less useful in dogs with milder pancreatitis, and both false-positive and false-negative results occur. Results indicated that dogs with clinical signs suggestive of pancreatitis would require abdominal imaging in addition to serum cPL testing to evaluate the cause (or causes) of clinical signs.
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