Sensitivity and Specificity of Canine Pancreas‐Specific Lipase (cPL) and Other Markers for Pancreatitis in 70 Dogs with and without Histopathologic Evidence of Pancreatitis

Abstract

Background: Pancreatitis is a common disorder in dogs for which the antemortem diagnosis remains challenging. Objectives: To compare the sensitivity and specificity of serum markers for pancreatitis in dogs with histopathologic evidence of pancreatitis or lack thereof.Animals: 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.Methods: 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.Results: The sensitivity for the Spec cPL (cutoff value 400 lg/L) was 21 and 71% in dogs with mild (n = 56) or moderate-severe pancreatitis (n = 7), and 43 and 71% (cutoff value 200 lg/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 lg/ L, respectively), whereas the specificity for the cTLI, serum amylase, and lipase activity was 100, 100, and 43%, respectively.Conclusion and Clinical Importance: 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.

Canine Pancreatic‐Specific Lipase Concentrations in Clinically Healthy Dogs and Dogs with Naturally Occurring Hyperadrenocorticism

“…, 6 Specificity of the SPEC assay for pancreatitis ranges from 66 to 100% depending on the study population and cut‐off value used (200 and 400 μg/L) 4, 5, 6, 7. In 1 report, sensitivities and specificities of the SPEC assay for clinical acute pancreatitis were 86.5–93.6% and 66.3–77.0%, respectively, using a cut‐off value of 200 μg/L.…”

“…Increased canine cPLI concentrations currently are the most specific biomarkers for canine pancreatitis, with sensitivities ranging from 21 to 94% depending on disease severity 4, 6, 126 Specificity of the SPEC assay for pancreatitis ranges from 66 to 100% depending on the study population and cut‐off value used (200 and 400 μg/L) 4, 5, 6, 7.…”

“…Reported specificities for the cPLI assays range from 71 to 100% 4, 5, 6, 7. Concentrations of cPLI can be estimated using a semiquantitative point‐of‐care test (SNAP)1 or measured using a quantitative ELISA test (SPEC).…”

Diagnostic accuracy of the SNAP and Spec canine pancreatic lipase tests for pancreatitis in dogs presenting with clinical signs of acute abdominal disease

“…10 The reported sensitivity for cPLI/Spec cPL ranges from 21-82%, 4,5,9,11,13 while specificity for Spec cPL is reported to range from 86-100%. 5,9,12,13 All but 1 of these studies based the diagnosis of AP on histologic demonstration of pancreatic inflammation. As a result, the sensitivities and specificities may not be accurate as pancreatic inflammation was often very low or mild.…”

“…The sensitivity of Spec cPL (or cPLI) has been shown to be higher in dogs with increasing histologic severity. 4,5,13 A recent study reported the sensitivity and specificity of the SNAP cPL to be 94 and 77%, respectively, in dogs that presented both with suspicion and without suspicion of pancreatitis. 9 The true diagnostic accuracy of noninvasive methodologies for determining the presence of AP is unknown due to the difficulty in obtaining a gold standard.…”