Journal Scan: How effective is cPL testing for diagnosing pancreatitis in dogs?

Journal Scan: How effective is cPL testing for diagnosing pancreatitis in dogs?

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Sep 24, 2012

What they did

Clinicians from 14 institutions enrolled dogs suspected of having acute pancreatitis based on history and physical examination findings before any diagnostic testing. All dogs enrolled in the study were tested with two different canine pancreatic-specific lipase (cPL) tests—a SNAP cPL Test (IDEXX) performed in-house as well as a Spec cPL Test (IDEXX) performed at a commercial laboratory.

A panel of four boarded internists retrospectively categorized the patients into one of five groups based on the likelihood of having acute pancreatitis based on all clinical, imaging, and laboratory data but were blinded to the cPL results. Statistical analysis was then used to estimate the sensitivity and specificity of Spec cPL and SNAP cPL tests and measurement of amylase and lipase activities for the diagnosis of acute pancreatitis.

What they found

Among the 84 dogs enrolled, SNAP cPL and Spec cPL test results had a significantly higher sensitivity and specificity than did amylase and lipase activity measurement.

Take-home message

An in-house SNAP cPL is a good screening test for ruling out acute pancreatitis (good negative predictive value) in dogs. A positive cPL (SNAP or Spec) test result in a dog suspected of having acute pancreatitis has a good positive predictive value when assessed in conjunction with a full clinical evaluation. Measurements of serum amylase and total lipase activities lack both sensitivity and specificity and are of limited use in diagnosing acute pancreatitis.

McCord K, Morley PS, Armstrong J, et al. A multi-institutional study evaluating the diagnostic utility of the Spec cPL and the SNAP cPL in clinical acute pancreatitis is 84 dogs. J Vet Intern Med 2012;26(4):888-896.

Link to abstract: http://onlinelibrary.wiley.com/doi/10.1111/j.1939-1676.2012.00951.x/abstract