Chapter 137 The effects of acute pancreatitis on closely related organs and the peritoneum establish a localized peritonitis. This localized peritonitis is then the cause of most of the plain radiographic signs associated with acute pancreatitis in dogs, such as loss of contrast in the cranial abdomen, that is, the “ground glass appearance.” Plain radiographic findings are nonspecific and at best only supportive of a clinical diagnosis of acute pancreatitis. A retrospective survey of 70 fatal cases of acute pancreatitis in dogs reported radiographic findings consistent with acute pancreatitis in only 10 of 41 cases (24%) for which radiographs were available (Hess et al, 1998). Because these cases were all fatal they likely represent a biased selection toward high-severity disease (Ruaux and Atwell, 1998). The frequency of radiographic abnormalities in lower-severity cases of acute pancreatitis is likely to be low. This suggests that the negative predictive value, or the ability of negative findings on plain radiography to rule out the presence of acute pancreatitis, is low. The broad availability of immunoassays for canine pancreas-specific lipase, in the form of the quantitative Spec cPL assay and bedside Snap cPL tests, has advanced dramatically the ability to diagnose pancreatic disease in dogs (see Chapter 135). Canine pancreas-specific lipase as a diagnostic marker for pancreatitis has received a remarkable degree of investigation in the peer-reviewed literature and has been shown to have high sensitivity and specificity by several different groups and in a variety of contexts (Neilson-Carley et al, 2011; Trivedi et al, 2011). In an animal with compatible clinical signs, the presence of an elevated pancreas-specific lipase concentration provides strong evidence to support the clinical diagnosis of pancreatitis, whereas a normal concentration in a dog with similar signs is a strong indication that pancreatic disease is not present and should prompt investigation for other differential diagnoses.
Treatment of Canine Pancreatitis
Recognition of Acute Pancreatitis in the Canine Patient
Plain Radiography
Measurement of Pancreatic Lipase
Therapy of Acute Pancreatitis
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