Recent years have seen significant advancements in the laboratory diagnosis of pancreatic diseases in dogs and cats. With the development of more sensitive and specific tests, veterinarians are now better equipped to detect conditions such as Exocrine Pancreatic Insufficiency (EPI) and pancreatitis, leading to improved treatment outcomes for our furry friends.
EPI is a condition recognized in both dogs and cats, characterized by the pancreas' inability to produce sufficient digestive enzymes. This can lead to malnutrition and weight loss despite normal food intake. While EPI is more commonly diagnosed in younger animals, it does not exclusively affect them; older pets can also suffer from this condition.
For dogs, the Trypsin-Like Immunoreactivity (TLI) test is a cornerstone in diagnosing EPI. It is both sensitive and specific, and it is included in the canine intestinal profile along with folate and cobalamin assays. In cats, the feline TLI test has proven to be an excellent diagnostic tool for EPI. However, it is currently only available in the United States. Despite this limitation, it is recommended to add this test for cats presenting with steatorrheic feces or those that are underweight despite a healthy appetite, once other causes have been excluded.
Diagnosing pancreatitis in dogs is challenging due to the transient nature of amylase and lipase enzyme elevations following the onset of clinical signs. Normal levels of these enzymes do not necessarily rule out pancreatitis. Furthermore, mild increases in amylase and lipase can be associated with intestinal and hepatic diseases, as well as reduced renal function, making these tests less reliable.
Pancreatic Lipase Immunoreactivity (PLI) has emerged as a promising diagnostic marker for pancreatitis in both dogs and cats. In dogs, PLI levels tend to remain elevated for a longer period, making it a valuable test for chronic pancreatitis. In cats, PLI has shown greater sensitivity compared to TLI (70% vs. 30%), which is particularly beneficial given the often non-specific clinical signs in felines, such as lethargy, anorexia, and dehydration. Only a minority of cats with pancreatitis exhibit vomiting (35%) or abdominal pain (25%).
Currently, the PLI assay is only available in the USA, with a turnaround time of about 10 days. However, there is optimism that this assay will become more accessible in the future. To request a PLI test for dogs or cats, veterinarians can indicate this on the request form (B33) and submit an additional 0.75 ml of non-lipaemic serum.
In conclusion, the diagnosis of pancreatic diseases in pets has greatly improved with the advent of more specific tests such as TLI and PLI. These advancements allow for earlier detection and better management of conditions like EPI and pancreatitis, contributing to the overall health and well-being of our canine and feline companions.
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