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Diagnosing and treating a dog with pancreatitis can be a real clinical challenge. A pancreatic biopsy is the gold standard for diagnosis, but we know the issues and concerns with a pancreatic tissue sampling procedure. So, we rely on less-invasive diagnostic tests such as complete blood cell count, serum biochemistry profile, and abdominal ultrasonography. Yet, these tests show low specificity in the diagnosis of pancreatitis. Serum canine pancreatic lipase (cPL), a lipase that originates in the pancreas and increases in the event of pancreatic acinar cell damage, is far more specific and sensitive, and consequently an incredibly helpful biomarker for the diagnosis of canine pancreatitis.
Our featured study compares Vcheck cPL (Bionote), a more recently released assay, with 2 other commercially available serum cPL measurement assays: SNAP cPL (IDEXX) and Spec cPL (IDEXX).
Of the 50 cPL assays evaluated, most (94%) were in agreement; therefore, the 3 cPL assays show a significantly high correlation. The contention with SNAP cPL is the potential for reading error as color intensity indicates a qualitative “normal” or “abnormal.” The Spec cPL provides quantified data yet requires a large blood sample and for the sample to be sent to an external laboratory, taking several days for results to return. With the recent development of Vcheck cPL, a quantified concentration of cPL is displayed within 5 minutes of loading in a small serum sample.
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In this study, Spec cPL and Vcheck cPL showed similar increasing or decreasing results in serum cPL concentration during treatment. With their quantified data, those 2 tests are helpful diagnostic tools to monitor a patient over the course of treatment. The costliness of replacing existing laboratory equipment with an alternative assay method, Spec cPL or Vcheck cPL, may be justified by this additional capability of monitoring beyond the diagnosis of pancreatitis. It should also be noted that IDEXX recently announced—after the publication of this study—that it plans to release the Catalyst Pancreatic Lipase Test in September 2024. IDEXX says this new test will provide quantifiable results to diagnose pancreatitis in less than 10 minutes in-house, either as an add-on to a chemistry test or as a stand-alone test.
Unlike patients with acute pancreatitis, patients with chronic pancreatitis often show no clinical signs or elevation of serum cPL. Because of pancreatic fibrosis and atrophy, pancreatic lipase may not leak from the pancreas of those patients. Consequently, false negative tests are commonly observed in patients with chronic pancreatitis. Thus, the sensitivity of cPL assays in diagnosing chronic pancreatitis is lower than in acute pancreatitis. Additionally, despite mild or no clinical signs, serum cPL concentrations may increase in dogs with chronic pancreatitis. A treatment plan based solely on cPL measurement is not appropriate for the management of those cases; a long-term outpatient treatment plan based on history, clinical signs, CRP concentration, and abdominal ultrasonography may be necessary.
The Study:
A comparative analysis of canine pancreatic lipase tests for diagnosing pancreatitis in dogs.
Kim JK, Hwang SY, Kim SE, et al. J Vet Sci. doi.org/10.4142/jvs.24001