Is it pancreatitis? - Veterinary Medicine
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Is it pancreatitis?
Diagnosing this condition in dogs and cats is challenging. Here is a rundown of the tests at your disposal if you suspect pancreatitis, including a promising new serum assay.


VETERINARY MEDICINE


PANCREATIC BIOPSY

Traditionally, a pancreatic biopsy has been viewed as the most definitive diagnostic tool for pancreatitis. The presence of pancreatitis can sometimes be easily determined by the gross appearance of the pancreas. However, the absence of pancreatitis can be difficult to prove. In a recent study, histopathologic findings in dogs with pancreatitis were highly localized, suggesting that even if multiple biopsy samples are being collected, pancreatic inflammation, especially in cases of chronic pancreatitis, may be easily missed.2 And although a pancreatic biopsy itself is not associated with many complications, many patients with pancreatitis are poor anesthetic risks. In some patients, a pancreatic biopsy may help differentiate pancreatitis and exocrine pancreatic neoplasia.

Editors' note: Dr. Steiner is a paid consultant for Idexx Laboratories and is director of the Gastrointestinal Laboratory at Texas A&M University College of Veterinary Medicine.

Jörg M. Steiner, med.vet., Dr.med.vet., PhD, DACVIM, DECVIM-CA
Department of Small Animal Clinical Sciences
College of Veterinary Medicine and Biomedical Sciences
Texas A&M University
College Station, TX 77843

REFERENCES

1. Hänichen T, Minkus G. Retrospektive Studie zur Pathologie der Erkrankungen des exokrinen Pankreas bei Hund und Katze. Tierärztliche Umschau 1990;45:363-368.

2. Newman S, Steiner J, Woosley K, et al. Localization of pancreatic inflammation and necrosis in dogs. J Vet Intern Med 2004;18:488-493.

3. Isler D. Übersicht über die wichtigsten Erkrankungen bzw. Todesursachen der Katze. Sektionsstatistik 1965-1976. PhD dissertation. Universität Zürich 1978.

4. Bradley EL 3rd. A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992. Arch Surg 1993;128:586-590.

5. Ferreri JA, Hardam E, Kimmel SE, et al. Clinical differentiation of acute necrotizing from chronic nonsuppurative pancreatitis in cats: 63 cases (1996-2001). J Am Vet Med Assoc 2003;223:469-474.

6. Hill RC, Van Winkle TJ. Acute necrotizing pancreatitis and acute suppurative pancreatitis in the cat. A retrospective study of 40 cases (1976-1989). J Vet Intern Med 1993;7:25-33.

7. Hess RS, Saunders HM, Van Winkle TJ, et al. Clinical, clinicopathologic, radiographic, and ultrasonographic abnormalities in dogs with fatal acute pancreatitis: 70 cases (1986-1995). J Am Vet Med Assoc 1998;213:665-670.

8. Forman MA, Marks SL, De Cock HEV, et al. Evaluation of serum feline pancreatic lipase immunoreactivity and helical computed tomography versus conventional testing for the diagnosis of feline pancreatitis. J Vet Intern Med 2004;18:807-815.

9. Washabau RJ. Acute necrotizing pancreatitis. In: August JR. ed. Consultations in feline internal medicine. St. Louis, Mo: Elsevier Saunders, 2006;109-119.

10. Steer ML. How and where does acute pancreatitis begin? Arch Surg 1992;127:1350-1353.

11. Norman J. The role of cytokines in the pathogenesis of acute pancreatitis. Am J Surg 1998;175:76-83.

12. Kimmel SE, Washabau RJ, Drobatz KJ. Incidence and prognostic value of low plasma ionized calcium concentration in cats with acute pancreatitis: 46 cases (1996-1998). J Am Vet Med Assoc 2001;219:1105-1109.

13. Saunders HM, VanWinkle TJ, Drobatz K, et al. Ultrasonographic findings in cats with clinical, gross pathologic, and histologic evidence of acute pancreatic necrosis: 20 cases (1994-2001). J Am Vet Med Assoc 2002;221:1724-1730.

14. Gerhardt A, Steiner JM, Williams DA, et al. Comparison of the sensitivity of different diagnostic tests for pancreatitis in cats. J Vet Intern Med 2001;15:329-333.


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