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12 Cards in this Set
- Front
- Back
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What are tests used to help detect pancreatic injury?
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Serum amylase
Serum lipase Peritoneal Fluid amylase/lipase Trypsin-like immunoreactivity (TLI) -only for cats and dogs Pancreatic lipase immunoreactivity |
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What are problems with amylase?
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not specific for pancreatic injury
not particularly sensitive magnitude of increase may not correlate with degree of same - if amylase activity is greater than 3-4 times the upper end of normal there is suggestion of pancreatic injury |
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What are problems with lipase?
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not specific for pancreatic injury
not particularly sensitive (cats have normal lipase with pancretitis) Lipase greater than 2 times the upper end of normal suggests pancreatic injury can be high with dogs receiving steroids -amylase may decrease -dexamethasone up to 5 times normal limit Prednisone - generally less of an increase |
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What does it suggest when there is increase amylase and lipase?
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renal failure
50 - 60% of dogs with renal failure have increase amylase and/or lipase prerenal azotemia frequently see increases |
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What are peritoneal fluid amylase/lipase?
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local leakage of enzymes into the peritoneal cavity usually larger than reflux into serum
-peritoneal levels > serum levels -highly suggestive of pancreatitis -can also be increased with intestinal perforation |
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Which enzyme is more sensitive, amylase or lipase?
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lipase
although both enzymes have poor sensitivity and specificity |
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What is trypsin like immunoreactivity assay (TLI)?
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measure both trypsinogen and trypsin (pancreas specific)
leaks from injured pancrease converted to trypsin, diffuses into blood (bound to serum protease inhibitors) species specific assay (dogs and cats) |
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What is pancreatic lipase immunoreactivity assay?
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antibody based assay specific for pancreatic lipase
species specific for dog and cat preliminary results suggest good sensitivity and specificity in dogs not better than TLI |
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What are some abnormalities seen with pancreatitis?
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hyperglycemia - stress, excitment, glucagon
hypoglycemia increased liver enzymes - cholestasis bile duct obstruction, inflammation -hepatic necrosis -ishchemic, toxic damage ascending inflammation |
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What do we see with pancreatitis in horses?
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amylase is slightly elevated with acute necrosis
lipase nit rigorously explored common inrestinal disease can result in increase amylase |
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What do we see with pancreatitis in cats?
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difficult to diagnose: cats are stoic and usually do not vomit
amylase is normal or decreased lipase generally normal peritoneal fluid may help PLI is the best likely test |
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What are associated diseases with feline pancreatitis?
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cholangitis
inflammatory bowel disease can be predisposed to hepatic lipidosis, obstructive jaundice, pulmonary thrombosis and exocrine pancreatic insufficiency |
