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

Abstract

Objectives -To (i) assess the clinical diagnostic accuracy of SNAP canine pancreatic lipase (cPL) and specific canine pancreatic lipase (Spec cPL) and (ii) assess the agreement of an abnormal test result between SNAP cPL and Spec cPL in dogs presenting with acute abdominal disease. Design -Prospective observational cohort study. Setting -University teaching hospital emergency center. Animals -Thirty-eight client-owned dogs that presented with acute abdominal disease, with a known final diagnosis between March 2009 and April 2010. Dogs were retrospectively assigned into 2 groups, dogs with acute pancreatitis (AP) (Group 1) and dogs without AP (Group 2). Interventions -Paired serum samples obtained within 24 hours of presentation were analyzed using the SNAP cPL test and Spec cPL assay. Measurements and Results -SNAP cPL clinical sensitivity and specificity was 82% (9/11 dogs of group 1) and 59% (16/27 dogs of group 2), respectively. Spec cPL clinical sensitivity and specificity was 70% (7/10 dogs of group 1) and 77% (20/26 dogs of group 2), respectively. Accuracy of the SNAP and Spec cPL for a clinical diagnosis of pancreatitis was found to be 66% and 75%, respectively. Agreement between a positive SNAP (cPL ≥ 200 g/L) and a clinical diagnosis pancreatitis resulted in = 0.33. Agreement between an increased Spec (cPL ≥ 400 g/L) and a clinical diagnosis of pancreatitis resulted in a = 0.43. The agreement between SNAP and Spec cPL (cPL ≥ 200 g/L) for the entire cohort resulted in = 0.78. Conclusion -SNAP cPL and Spec cPL results may provide a "false positive" diagnosis of pancreatitis in up to 40% of dogs presenting with acute abdominal disease. There is good overall agreement between SNAP cPL and Spec cPL; however, there were 4/38 dogs with positive SNAP cPL and "normal" Spec cPL. (J Vet Emerg Crit Care 2014; 24(2): 135-143)

Cytologic findings and diagnostic yield in 92 dogs undergoing fine-needle aspiration of the pancreas

“…10 Canine-specific pancreatic lipase (cPL) has been reported to have high sensitivity and specificity; however, there is the potential for a false-positive diagnosis in up to 40% of dogs presenting with acute abdominal signs. 9 Laparoscopy and contrast enhancing ultrasonography techniques may improve visualization of lesions. 11,16 Even histologic diagnosis is problematic in canine pancreatitis because focal and randomly distributed lesions can be present in apparently healthy dogs.…”

Practical Interpretation and Application of Exocrine Pancreatic Testing in Small Animals

“…36 This correlation is also demonstrated in a multicenter study that used Bayesian statistics to overcome the need for pancreatic histology as a gold standard, which also determined that dogs with Spec-cPL of 200 mg/L or less and/or a negative SNAP-cPL were unlikely to have clinical acute pancreatitis. 32…”

“…36 This study assessed dogs presenting to an emergency center with signs of acute abdominal disease and found a sensitivity of 82% but a specificity of 59% for SNAP-cPL. Another way of interpreting this is that approximately 40% of dogs with a positive SNAP-cPL had disease other than pancreatitis as their primary presenting problem.…”

“…Summary of sensitivity and specificity for various laboratory testing in dogs from various studiesAbbreviations: AP, acute pancreatitis; CP, chronic pancreatitis; cPE-1, serum canine pancreatic-elastase-1; cPL, canine pancreatic lipase (or canine pancreatic lipase immunoreactivity in earlier studies); NA, not assessed; RI, reference interval.Data from Refs 10,[29][30][31][32][33][34]36,45. …”

Patologias Pancreáticas Em Cães: Revisão De Literatura

“…Não obstante, outros marcadores específicos de inflamação e dano oxidativo como a paraoxanase sérica tem sido utilizados (TVARIJONAVICIUTE et al, 2015), já que a lipase pancreática canina pode apresentar resultados falso-positivos em 40% dos cães com doença abdominal aguda (HAWORTH et al, 2014).…”