Pearls
- Acute pancreatitis is common in dogs and is generally easily diagnosed based on history, clinical findings, inflammatory leukogram, imaging studies and increased activities of amylase and lipase.
- Pancreatitis in the cat can be difficult to diagnose as it is more often chronic and “low-grade”. Leukogram changes are inconsistent and evidence of inflammation may be very subtle. Amylase and lipase are not useful. Hypocalcemia and hyperbilirubinemia may be detected on the biochemical panel and serum fPLI has proven to be a useful diagnostic test. Ultrasound findings are often useful in making the diagnosis; exploratory laparotomy and biopsy may be required to confirm the diagnosis.
- Amylase and lipase activities can be elevated due to decreased renal excretion or inactivation of these enzymes with prerenal azotemia or renal disease.
- DO NOT DIAGNOSE PANCREATITIS SOLELY BASED ON AMYLASE AND LIPASE RESULTS.
- DO NOT EXCLUDE A DIAGNOSIS OF PANCREATITIS BECAUSE AMYLASE AND LIPASE ACTIVITY ARE NOT INCREASED.
- Amylase and lipase activities can change dramatically in a short period; following these over time can be useful in prognostication of pancreatitis in dogs.
- Hepatic enzyme activities and bilirubin are often elevated in pancreatitis, presumably from local inflammation and perihepatitis, as well as ascending inflammation from the pancreatic duct. Cholangitis/cholecystitis can be a complication of pancreatitis in dogs and cats.
- The diagnosis of EPI (maldigestion) is usually easily made using the TLI test.
- We have seen a few older dogs with extremely high lipase activities, without amylase elevations, that have had pancreatic or hepatic tumors.
- Malabsorptive disorders often require intestinal biopsy to make a definitive diagnosis.
- PLE often requires intestinal biopsies to identify the cause of the protein loss.
- The hypoproteinemia with PLE generally involves both albumin and globulins and the albumin to globulin ratio is normal. Animals with PLE may be presented for ascites and dependent edema if the albumin is approximately 10 g/L (1 g/dL) or less.
- Enteric diseases resulting in acute, severe vomiting and/or diarrhea can result in marked abnormalities in electrolyte and acid-base status.
- Abdominocentesis and cytology are extremely important prognostic aids (in addition to CBC) in cases of colic in horses. These procedures should be done in any species in which there is excess abdominal fluid with or without intestinal signs.
- Abomasal disorders are very common in cattle. They can be primary or secondary to other illness which results in anorexia and abomasal stasis. Hypochloremic metabolic alkalosis is the typical electrolyte and acid-base abnormality seen with abomasal disorders.
- Small animals with this same biochemical change may have a GI foreign body, upper GI tumor or other lesion resulting in functional obstruction of the upper GI tract.
definition
Technique used to obtain small pieces of tissue for histologic examination.
Azotemia due to extracellular fluid volume depletion (dehydration).
Break-down product of hemoglobin.
Process of obtaining abdominal fluid for cytologic evaluation.
