Risk Factors and Clinical Presentation in Dogs with Increased Serum Pancreatic Lipase Concentrations—A Descriptive Analysis

Abstract

Limited data exist regarding the full array of clinical signs seen in dogs with pancreatitis and potential risk factors for the disease. Laboratory submissions from the Gastrointestinal Laboratory at Texas A&M University were retrospectively reviewed for dogs with an increased serum pancreatic lipase immunoreactivity (cPLI) concentration (≥400 µg/L), and an internet-based survey was distributed to the attending veterinarian and/or technician on each case. The survey contained questions related to (i) clinical signs, (ii) prior gastrointestinal upset, (iii) comorbidities, (iv) pre-existing medical therapies, and (v) dietary history. One hundred and seventy (170) survey responses were recorded. The top three clinical signs reported were inappetence (62%), diarrhea (53%), and vomiting (49%). Abdominal pain was noted in only 32% of dogs, likely associated with poor pain detection. Additionally, the majority of dogs (71%) had prior episodes of gastrointestinal upset within the past 12 months, lending support for the commonality of recurrent acute pancreatitis, or acute on chronic disease. Hepatobiliary abnormalities (24%) were the most common concurrent disease, and endocrine disorders were seen in a low proportion of respondents (5–8%). Adult maintenance diets (65%), dog treats (40%), and human foods (29%) were commonly consumed by dogs prior to the discovery of increased cPLI concentration.

Progression of lipase activity and pancreatic lipase immunoreactivity in dogs hospitalized for acute pancreatitis and correlation with clinical features

“…Disease duration before presentation often is not described in dogs with pancreatitis. Most publications do not mention duration of clinical signs before the presentation 1,3,5,9,12,15,16,29‐40 . Some studies included dogs with a predefined disease duration, but did not report the actual duration of clinical signs 6,41,42 .…”

“…Most publications do not mention duration of clinical signs before the presentation. 1 , 3 , 5 , 9 , 12 , 15 , 16 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 Some studies included dogs with a predefined disease duration, but did not report the actual duration of clinical signs. 6 , 41 , 42 Some studies consider acute as short as 2 days, 43 others consider 10 days, 6 2 weeks, 41 or 3 weeks 44 as acute.…”

Fuzapladib in a randomized controlled multicenter masked study in dogs with presumptive acute onset pancreatitis

“…The most common clinical signs reported in dogs with AP are anorexia, vomiting, lethargy, abdominal pain, and diarrhea 4,6,9,26 . The use of the MCAI scoring system, which includes these clinical signs, proved valuable in our study to allow for objective assessment of the clinical response of dogs with AP to treatment with fuzapladib.…”

“…The most common clinical signs reported in dogs with AP are anorexia, vomiting, lethargy, abdominal pain, and diarrhea. 4,6,9,26 The use of the MCAI scoring system, which includes these clinical signs, proved valuable in our study to allow for objective assessment of the clinical response of dogs with AP to treatment with fuzapladib. A new score, the MCAI5, was constructed by including the most relevant combination of clinical signs in dogs with AP (ie, activity, appetite, abdominal pain, vomiting, and dehydration), thereby increasing the clinical relevance.…”

“…Acute pancreatitis (AP) is an inflammatory disease characterized by polymorphonuclear inflammatory cell infiltration of the exocrine pancreas, edema, and necrosis associated with acute onset of a wide range of clinical signs, potential for multiple organ failure, and high mortality rate (23%‐58%) in dogs 1‐6 . Although the etiology of pancreatitis remains unknown in most cases, risk factors have been identified, including dietary indiscretion, hypertriglyceridemia, hypercalcemia, drugs and toxins, endocrinopathies or other comorbidities, hereditary or breed predilections (eg, miniature schnauzers), advanced age (>7 years old), and being overweight 6‐9 …”