What is pancreatitis?
Pancreatitis is a disease caused by inflammation of the pancreas. The pancreas is a small fleshy organ located between the stomach and small intestine. The pancreas has many functions related to digestion and the regulation of blood sugar levels.
Dogs with severe, sudden on-set pancreatitis are often very ill and show signs of vomiting, lethargy, loss of appetite, abdominal pain, and fever. Dogs with less severe forms of pancreatitis may show only mild signs of illness, and some dogs may have low-grade ongoing problems with recurring episodes of illness.
Can routine tests be used to diagnose pancreatitis?
Routine blood tests, including a Complete Blood Count and Biochemistry Profile (see handouts: "Complete Blood Count" and "Serum Biochemistry") typically reveal abnormalities that are suggestive of pancreatitis. However, the changes are not unique to the disease and do not give a definitive diagnosis.
In the past, the diagnosis of pancreatitis was based on finding high levels of two enzymes called serum amylase and serum lipase. While high values of these enzymes can be found in dogs with pancreatitis, the tests have not proven reliable and are no longer considered the tests of choice for diagnosing pancreatitis in the dog.
What is pancreas-specific lipase? How is it different from serum lipase?
"...blood values increase only when there is pancreatic inflammation."
Pancreas-specific lipase is a form of lipase produced only in the pancreas. It is highly specific to the pancreas, and blood values increase only when there is pancreatic inflammation. By comparison, serum lipase can come from tissues other than the pancreas, and high blood values can occur with conditions other than pancreatitis.
How is pancreas-specific lipase measured? What sample is required?
Pancreas-specific lipase is measured with a test called Canine Pancreatic Lipase Immunoreactivity, known simply as cPLI. The test requires only a small blood sample. A fasting sample is preferred, but it is not essential for the accuracy of the test.
Does the sample have to be sent away to a diagnostic laboratory?
There is a version of the cPLI test that can be used in-clinic (SNAP cPL© IDEXX). This rapid “pet-side” test takes only a few minutes and can give an indication of whether pancreatitis could be the cause of a pet’s illness. Ideally, the sample should also be sent to the laboratory to get an actual value of cPLI. This will help to confirm the diagnosis of pancreatitis and also provide a starting point or base line that can be used to monitor the pet’s progress after treatment has been started.
How reliable is cPLI?
Studies have demonstrated that cPLI has a high degree of accuracy in diagnosing canine pancreatitis. According to these studies, approximately 85% of dogs with pancreatitis will show high values of cPLI. If the cPLI is high there is a 96% certainty that the patient has pancreatitis and not another disease that causes similar signs. The cPLI is currently considered the best blood test available for diagnosing pancreatitis in dogs.
Can cPLI be used to monitor clinical pancreatitis?
Yes. Pancreas-specific lipase is cleared from the blood very quickly, which means that cPLI can be used to monitor changes in the pancreas in response to treatment. A rapidly falling cPLI value together with improvement in the dog's condition indicates a good response to treatment. The in-clinic test is not as versatile for monitoring pancreatitis, and samples should be sent to the laboratory.
Which dogs should be tested for pancreatitis using cPLI?
The cPLI test should be considered for:
Dogs with signs of sudden onset vomiting, abdominal pain, or loss of appetite.
Dogs with recurring episodes of vomiting or poor appetite.
Dogs at increased risk for pancreatitis, such as Miniature Schnauzers, or dogs receiving Potassium Bromide anticonvulsant therapy.