Evaluation of the SNAP CPL and Spec CPL canine pancreatic lipase tests for acute pancreatitis in dogs presenting with clinical signs of acute abdominal disease
Haworth, Mark (2014) Evaluation of the SNAP CPL and Spec CPL canine pancreatic lipase tests for acute pancreatitis in dogs presenting with clinical signs of acute abdominal disease. Other thesis, Murdoch University.
Canine acute pancreatitis (AP) is commonly encountered in veterinary clinical practice. Acute pancreatitis can occur on its own as a primary disease or can be secondary to other diseases. Early recognition and appropriate management of dogs with AP can be hampered by difficulty in not only diagnosing the disease, but also differentiating primary versus secondary pancreatitis. Failure to recognise that AP is actually the result of another underlying disease may lead to inappropriate management of the patient. This is especially important in critically ill dogs that present to an emergency service.
Historically, catalytic assays have been used to diagnose AP but the tests have shown poor reliability. These tests have largely been criticised for lack of sensitivity and specificity, as pancreatic enzyme activity may not solely represent pancreatic leakage. Recently, a laboratory-based canine specific pancreatic lipase test (Spec cPL®) has been developed to aid diagnosis of AP, which is specific to the detection of pancreatic lipase leakage. To date, there are few studies evaluating the Spec cPL®, but it was developed in the hope it would provide a more definitive diagnosis of AP. Questions have been raised as to its accuracy as a diagnostic test, and it still does not differentiate between primary and secondary pancreatitis.
An in-house canine pancreatic lipase test (SNAP® cPL) has also become available to clinicians. The manufacturer has reported very good agreement between the Spec cPL® and SNAP® cPL, using recombinant canine pancreatic lipase (cPL), but this is yet to be tested clinically. The first aim of this study therefore was to measure agreement between these two tests in dogs presenting with clinical signs of acute abdominal disease. The second aim was to determine the degree of agreement (if any) between a clinical diagnosis of primary AP and increased cPL concentration, as measured by the above two tests. The third aim was to establish the sensitivity and specificity for these tests in dogs with clinically diagnosed primary AP.
The results of this study demonstrated that the SNAP® cPL and Spec cPL® tests had good agreement with each other for the entire cohort of dogs. However, there was poor agreement between each of these tests and a clinical diagnosis of pancreatitis. While sensitivity did not differ markedly from previous reports on Spec cPL®, specificity results were much lower. Therefore, it appears that these tests can detect the presence of cPL but cannot be used in isolation to diagnose primary pancreatitis.
|Publication Type:||Thesis (Other)|
|Murdoch Affiliation:||School of Veterinary and Life Sciences|
|Notes:||Research Masters with Training|
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