Abstract
BackgroundFeline pancreatitis (FP) is an important health problem of cats. Its diagnostics is based on the combination of quantification of serum pancreatic lipase immunoreactivity (fPLI) and abdominal ultrasonography (AUS). These modalities allow for establishing highly specific diagnosis, however they are relatively expensive and time-consuming. On the other hand, a screening test of high sensitivity which would allow to rule out FP on the first visit without a considerable increase of costs would be clinically useful. To evaluate accuracy of nonspecific inflammatory biomarkers based on complete blood count (CBC) in diagnosing FP 73 client-owned cats with signs of lethargy and reduced appetite lasting for at least 2 days before presentation were enrolled in the cross-sectional study. They were examined with fPLI assay and AUS and classified as cats with very low risk of FP when fPLI ≤3.5 μg/L and AUS negative for FP, or as cats with increased risk of FP in the case of any other combination of results. Then, 7 various CBC measurements were measured in each cat and linked to the risk of FP using the multivariable logistic regression.ResultsFive CBC measurements turned out to be significantly associated with the risk of FP – total leukocyte count (WBC; crude odds ratio(ORcrude) = 12.2; CI 95%: 1.52, 98.5), total neutrophil count (ORcrude = 5.84; CI 95%: 1.22, 27.9), band neutrophil count (BNC; ORcrude = 6.67; CI 95%: 1.98, 22.4), neutrophil-to-lymphocyte ratio (ORcrude = 3.68; CI 95%: 1.25, 10.9), and eosinophil count (EC; ORcrude = 0.34; CI 95%: 0.12, 0.96). The model based on WBC, BNC, and EC proved to have at least fair diagnostic potential (area under ROC curve 82.7%; CI 95%: 72.8%, 92.5%). When WBC < 18 G/L, BNC < 0.27 G/L, and EC > 0.3 G/L was considered as a negative result, and any other combination as the positive result, the CBC model had high sensitivity (91.8%; CI 95%: 80.8%, 96.8%) at a relatively low specificity (58.3%; CI 95%: 38.8%, 75.5%).ConclusionThe combination of three CBC measurements is an immediately available and fairly accurate screening method for identification of lethargic and anorectic cats with increased risk of FP.
Highlights
Feline pancreatitis (FP) is an important health problem of cats
We evaluated the accuracy of a handful of complete blood count (CBC) measurements in making the first-line decision whether a cat with lethargy and reduced appetite was at increased risk of FP
On the basis of those two diagnostic tests the risk of FP was determined as very low in 24 cats (32.9%) and increased in 49 cats (67.1%)
Summary
The study enrolled 73 adult castrated cats, 45 males (61.6%) and 28 females (38.4%), aged from 2 to 18 years with the median (IQR) of 10 (8 to 12) years. On the basis of those two diagnostic tests the risk of FP was determined as very low (fPLI ≤3.5 μg/L and normal appearance of the pancreas in AUS) in 24 cats (32.9%) and increased (fPLI > 3.5 μg/L and/or abnormal appearance of the pancreas in AUS) in 49 cats (67.1%). From among 49 cats with increased risk of FP only 17 cats (34.7%) had both elevated fPLI and abnormal appearance of the pancreas in AUS. The univariable analysis yielded 5 CBC measurements significantly linked to an increased risk of FP – four positively associated: WBC, total neutrophil count (TNC), band neutrophil count (BNC), NLR, and one negatively associated: eosinophil count (EC) (Table 2). Three CBC measurements proved to be significantly associated with increased risk of FP in the multivariable analysis (Table 3).
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