Abstract
BackgroundSerum feline pancreatic lipase immunoreactivity (fPL) commonly is used in the assessment of sick cats suspected to have pancreatitis but its diagnostic utility is debated.ObjectivesTo evaluate the diagnostic utility of the Spec fPL test and selected serum biochemistry tests in the diagnosis of pancreatitis in cats.AnimalsTwo hundred seventy‐four client‐owned cats presented to a university teaching hospital in the United Kingdom, from April 2013 to May 2017, in which Spec fPL was measured.MethodsCats were classified into 1 of 4 groups based on clinical signs (all cats), ultrasonographic findings (all cats) and histopathological or cytological assessment of the pancreas where available (9 cats) regardless of Spec fPL concentration. The groups were (a) definite pancreatitis (n = 9), (b) probable pancreatitis (n = 49), (c) possible pancreatitis (n = 139), and (d) unlikely pancreatitis (n = 77). Spec fPL and selected serum biochemistry test results were compared among groups.ResultsSerum fPL concentrations >5.3 μg/L were classified as positive and concentrations <3.5 μg/L were classified as negative. There was a significantly (P = .03) lower proportion of false‐positive results (cats unlikely to have pancreatitis, n = 77, with a positive fPL, n = 8, 10%) than false‐negative results (cats with definite or probable pancreatitis, n = 58, with a negative fPL result, n = 14, 24%). None of the selected biochemical tests were helpful diagnostically.Conclusion and Clinical ImportanceA positive Spec fPL result indicates that pancreatitis is a probable diagnosis, but the test cannot be used to rule the diagnosis out.
Highlights
Diagnosis of pancreatitis in cats usually involves a combination of clinical suspicion, evaluation of clinical pathology test results, ultrasonographic evidence of pancreatitis, and measurement of serum feline pancreatic lipase immunoreactivity.[1,5]
Because no gold standard to assess the diagnostic performance of Spec feline pancreatic lipase immunoreactivity (fPL) is available,[2] a combination of diagnostic findings was used to reach a diagnosis of definite, probable, possible, or unlikely pancreatitis
The Spec fPL results for 300 client-owned cats admitted to a referral teaching hospital in the United Kingdom between April 2014 and May 2017 were obtained from the records of the hospital's veterinary diagnostic laboratory
Summary
Reaching a definitive diagnosis is challenging because of the nonspecific clinical signs,[1,2] the variable sensitivity and specificity of the diagnostic tests available,[3] and the challenge of finding a gold standard diagnostic test. Diagnosis of pancreatitis in cats usually involves a combination of clinical suspicion, evaluation of clinical pathology test results, ultrasonographic evidence of pancreatitis, and measurement of serum feline pancreatic lipase immunoreactivity (fPL).[1,5] Because no gold standard diagnostic test is available, clinicians must assess test results critically in the context of the clinical presentation.[6]. Because no gold standard to assess the diagnostic performance of Spec fPL is available,[2] a combination of diagnostic findings (clinical signs and ultrasonography in all cats, histopathology and cytology in some cats) was used to reach a diagnosis of definite, probable, possible, or unlikely pancreatitis
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