Evaluation of Canine Pancreas‐Specific Lipase Activity, Lipase Activity, and Trypsin‐Like Immunoreactivity in an Experimental Model of Acute Kidney Injury in Dogs

Self Cite

BackgroundRenal replacement therapies can be life‐saving for dogs with severe acute kidney injury (AKI), however, comorbidities including pancreatitis might affect outcome.Hypothesis/ObjectivesTo investigate the prevalence of pancreas‐specific lipase (Spec cPL) measurements consistent with pancreatitis (≥400 μg/L) in dogs undergoing intermittent hemodialysis (IHD) for treatment of AKI and to determine whether there were associations between 30‐days outcomes and Spec cPL measurements.AnimalsFifty‐three client‐owned dogs presented to teaching hospitals between November 2008 and September 2016 that underwent IHD.MethodsRetrospective medical record review from dogs that received IHD for management of AKI and also had a Spec cPL measurement. Association between survival, dialysis‐dependency, and Spec cPL measurements was assessed.ResultsForty of 53 (76%) dogs were alive at 30‐days and 33/53(62%) had a Spec cPL result ≥400 μg/L. Spec cPL was not significantly different either between surviving (635.5 μg/L, range 29–1,001) and nonsurviving dogs (860 μg/L, range 56–1,001; P = 0.75) or between dialysis‐dependent (1,001 μg/L, range 177–1,001) and nondialysis‐dependent dogs (520 μg/L, range 29–1,001; P = 0.08). Spec cPL ≥400 μg/L was not significantly associated either with survival (P = 0.74) or dialysis‐dependency (P = 0.33).Conclusions and Clinical ImportanceResults revealed a high prevalence of Spec cPL ≥400 μg/L in dogs with AKI treated with IHD. No significant associations between Spec cPL and survival or dialysis‐dependency in dogs with AKI at 30 days were identified in the current study, however, the latter could be due to lack of power in this study.

Section: Discussionmentioning

confidence: 96%

Assessment of Canine Pancreas‐Specific Lipase and Outcomes in Dogs with Hemodialysis‐Dependent Acute Kidney Injury

Takada

Palm

Epstein

et al. 2018

Self Cite

“…[1][2][3][4][5] The most common nonpancreatic disorder associated with an increased lipase activity in our study was renal disease, despite poor correlation between DGGR-lipase activity and plasma creatinine concentration. The effect of decreased GFR, because of naturally occurring or experimentally induced acute kidney injury and chronic kidney disease on lipase activity has been variably reported in the literature, with older reports suggesting that lipase activity is increased in renal disease, 32 but newer studies not documenting significant effects of experimentally induced acute kidney injury 33 and chronic renal failure 34 on lipase activity and cPL. The kidneys are considered to be a major site for lipase metabolism, likely through a combination of glomerular filtration, tubular reabsorption, and enzyme inactivation, 35 which would explain why hyperlipasemia cannot be accounted for by decreased GFR alone.…”

Section: Discussionmentioning

confidence: 99%

Hyperlipasemia in critically ill dogs with and without acute pancreatitis: Prevalence, underlying diseases, predictors, and outcome

Prümmer

Howard

Grandt

et al. 2020

Background: Hyperlipasemia is frequent in critically ill people without evidence of acute pancreatitis (AP), and has been associated with increased morbidity and mortality. Objective: To evaluate the prevalence of hyperlipasemia at admission and development of hyperlipasemia during hospitalization in critically ill dogs, explore factors associated with hyperlipasemia, and evaluate association with outcome. Animals: Critically ill, client owned dogs (n = 1360), presented on emergency and admitted to the intensive care unit, that had 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6 0-methylresorufin) ester (DGGR) lipase activity measured within 24 hours of admission. Methods: Retrospective cross-sectional study of clinical and laboratory records. Results: The DGGR lipase activity was increased >3× the upper reference limit at admission in 216/1360 (16%) dogs, of which 70/216 (32%) had a clinical diagnosis of AP. Other primary conditions associated with hyperlipasemia were renal, endocrine, and immune-mediated diseases, and upper airway obstruction. Predictors of hyperlipasemia at admission were prior glucocorticoid administration, vomiting and abdominal pain, increased age, plasma bilirubin and creatinine concentrations, and decreased hematocrit. Of dogs with repeat measurements, 78/345 (23%) had significantly increased lipase during hospitalization, of which 13/78 (17%) had a clinical diagnosis of AP. Other primary conditions associated with in-hospital hyperlipasemia were renal and immune-mediated disorders.

“…Azotemia was more frequent in nonsurvivors. Pancreatitis and AKI are common comorbidities in humans and dogs, each can potentially precipitate the other . Azotemia at presentation and development of AKI also are associated with worse prognosis in other diseases of cats, especially as AKI itself carries a guarded prognosis…”

Section: Discussionmentioning

confidence: 99%

A retrospective study of 157 hospitalized cats with pancreatitis in a tertiary care center: Clinical, imaging and laboratory findings, potential prognostic markers and outcome

Nivy

Kaplanov

Kuzi

et al. 2018

BackgroundPancreatitis in cats (FP) has been increasingly diagnosed in recent years, but clinical studies of large numbers of affected cats are scarce.ObjectivesTo describe a large cohort of cats with FP requiring hospitalization.AnimalsOne hundred and fifty‐seven client‐owned cats.MethodsRetrospective study, including cats diagnosed with pancreatitis based on sonographic evidence, positive SNAP feline pancreatic lipase immunoreactivity test results, increased 1,2‐o‐dilauryl‐rac‐glycerol‐glutaric Acid‐(6′‐methylresorufin ester)‐lipase activity, histopathology, or some combination of these.ResultsOne‐hundred and twenty‐two cats (77.7%) survived to discharge.Median time from onset of clinical signs to presentation was longer (P = .003) in nonsurvivors. Causes of FP included recent general anesthesia, trauma, hemodynamic compromise, and organophosphate intoxication, but most cases (86.6%) were idiopathic. Ultrasonographic findings consistent with pancreatitis were documented in 134 cats, including pancreatomegaly (81.3%), decreased (31.3%), or increased (14.9%) pancreatic echogenicity, extra‐hepatic biliary tract dilatation (24%), and increased peri‐pancreatic echogenicity (13%). Lethargy (P = .003), pleural effusion (P = .003), hypoglycemia (P = .007), ionized hypocalcemia (P = .016), azotemia (P = .014), parenteral nutrition administration (P = .013), and persistent anorexia during hospitalization (P = .001) were more frequent in nonsurvivors, whereas antibiotics were more frequently administered to survivors (P = .023). Nevertheless, when Bonferroni's correction for multiple comparisons was applied, none of the variables was statistically significant.Conclusions and Clinical ImportancePreviously unreported, clinically relevant, potential prognostic factors, including hypoglycemia, azotemia, parenteral nutrition, and withholding antibacterial treatment were identified in this exploratory study. These preliminary results should be examined further in confirmatory studies.