Acute pancreatitis can be a challenging disease to manage in dogs and may be associated with high morbidity and mortality rates. Part of the traditional treatment recommendation in the management of this disease has been to withhold food from dogs followed by feeding an ultra–low-fat diet. Results of recent studies1–3 in humans and experimental studies in dogs indicate that provision of enteral nutrition early in the course of the disease improves survival and decreases complication rates, but the ideal diet has never been determined.
Serum cTLI concentration is a specific marker of exocrine pancreatic function; assessment of this variable has a relatively low sensitivity for detection of pancreatitis, yet is the most sensitive and specific test for the diagnosis of exocrine pancreatic insufficiency in dogs.4–6 Because measurement of serum cTLI concentration includes all circulating cationic trypsinogen and approximately 80% of cationic trypsin, it may also be used to assess pancreatic adaptation or function.7 Compared with total serum lipase activity, assessment of serum cPLI concentration appears to have improved sensitivity and specificity as a commercially available laboratory test for diagnosis of pancreatitis in dogs; moreover, serum cPLI concentration is unaffected by prednisolone administration or concurrent renal failure.8,9,a Serum cPLI concentration is reduced in dogs with exocrine pancreatic insufficiency and may also be a useful marker for indirect determination of the degree of pancreatic adaptation or response within an individual dog.10
In the gastric antrum, G-type cells secrete gastrin in response to gastric distension and ingestion of protein.11 The main forms of gastrin secreted in dogs are gastrin 34, 17, and 14; collectively, they have a short circulating half-life of 3 to 9 minutes.11 The presence of gastrin, other gastrointestinal hormones such as CCK, and enteric neuropeptides stimulates pancreatic acinar cells to release lysosomes and zymogens in response to food.11 This response occurs both through the anticipation and smell of food (mediated via neural pathways) and as a result of the presence of food in the stomach and small intestine (mediated via hormonal pathways).11 Thus, assessment of serum gastrin concentration may serve as an indirect measure of one aspect of pancreatic stimulation. The purpose of the study reported was to determine whether amounts of dietary fat or addition of pancreatic enzymes and MCTs to diets alters concentrations of cTLI, cPLI, and gastrin in healthy dogs.
Canine pancreatic lipase immunoreactivity
Canine trypsin–like immunoreactivity
Coefficient of variation
Steiner J M, Lees GE, Willard MD, et al. Serum canine pancreatic lipase immunoreactivity (cPLI) concentration is not altered by oral prednisone administration (abstr). 21st Annu Meet Am Coll Vet Intern Med J Vet Intern Med 2003;17:444.
Immunolite 2000, Diagnostic Products Corp, Los Angeles, Calif.
PurinaONE, adult dog, chicken and rice formula, Nestlé Purina PetCare Co, St Louis, Mo.
Royal Canin, Canine Veterinary Diet, digestive low fat, Royal Canin, Aimargues, France.
CREON 5000, CREON 10000, and CREON FORTE, Solvay Pharmaceuticals, Pymble, NSW, Australia.
SHS international Ltd, Liverpool, England.
Commercial radioimmunoassay, canine TLI assay, Siemens Healthcare Diagnostics, Deerfield, Ill. Testing was performed at the Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Tex.
Enzyme-linked immunosorbent assay, Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Tex.
Testing was performed at Royal Perth Hospital, Perth, WA, Australia.
SPSS, version 14.0, SPSS Inc, Chicago, Ill.
Qin HL, Su ZD, Gao Q, et al.Early intrajejunal nutrition: bacterial translocation and gut barrier function of severe acute pancreatitis in dogs. Hepatobiliary Pancreat Dis Int 2002;1:150–154.
Hess RS, Saunders HM, Van Winkle TJ, et al.Clinical, clinico-pathologic, radiographic, and ultrasonographic abnormalities in dogs with fatal acute pancreatitis: 70 cases (1986–1995). J Am Vet Med Assoc 1998;213:665–670.
Mansfield CS, Jones BR. Plasma and urinary trypsinogen activation peptide in healthy dogs, dogs with pancreatitis and dogs with other systemic diseases. Aust Vet J 2000;78:416–422.
Williams DA, Batt RM. Sensitivity and specificity of radioimmunoassay of serum trypsin-like immunoreactivity for the diagnosis of canine exocrine pancreatic insufficiency. J Am Vet Med Assoc 1988;192:195–201.
Steiner JM, Teague SR, Williams DA. Development and analytic validation of an enzyme-linked immunosorbent assay for the measurement of canine pancreatic lipase immunoreactivity in serum. Can J Vet Res 2003;67:175–182.
Steiner JM, Rutz GM, Williams DA. Serum lipase activities and pancreatic lipase immunoreactivity concentrations in dogs with exocrine pancreatic insufficiency. Am J Vet Res 2006;67:84–87.
Williams DA. The pancreas. In: Guilford WG, Center S, Strombeck D, et al, eds. Strombeck's small animal gastroenterology. 3rd ed. Philadelphia: WB Saunders Co, 1996;381–410.
IMMULITE 2000 Gastrin [package insert]. Los Angeles: Diagnostic Products Corp, 2005.
Williams DA, Steiner JM. Canine exocrine pancreatic disease. In: Ettinger SJ, Feldman EC, eds. Textbook of veterinary internal medicine. St Louis: Elsevier Saunders, 2005;1482–1488.
Shea JC, Bishop MD, Parker EM, et al.An enteral therapy containing medium-chain triglycerides and hydrolyzed peptides reduces postprandial pain associated with chronic pancreatitis. Pancreatology 2003;3:36–40.