Diagnosing canine pancreatitis: The latest research into pancreatitis tests and how to use them

Pancreatitis is implicated in up to 40 % of acute-abdomen ICU admissions and carries reported case-fatality rates of at least 8.8%. Its clinical picture — vomiting, lethargy, vague abdominal pain — overlaps dozens of differentials, so under- and over-diagnosis is easy. That makes objective testing the keystone of a sound pancreatitis diagnosis. But testing for canine pancreatitis isn’t simple, and there’s a whole range of tests available. So let’s see what we’ve got… 

 Presentation of the acute pancreatitis case 

Whether it’s truly acute or acute-on-chronic, pancreatitis cases often come in with vague – though serious – signs, such as vomiting, anorexia, abdominal pain, lethargy, and dehydration. Your history taking should focus particularly on medical history (prior episodes, concurrent diseases, current medications) as well as diet (high-fat diet, or recent access to high-fat foods) to tease out contributing factors. 

Your pancreatitis diagnostic toolbox at a glance 

– Spec cPL® (reference-lab ELISA) 

Measures pancreatic lipase immunoreactivity (PLI). Still the benchmark assay. Sensitivity 71–85 %, specificity 90–100 % when a ≥400 µg/L cut-off is used. Samples ship chilled; results typically next day. Downside: no rapid clinical decisions at 2 a.m. 

– SNAP cPL® (qualitative point-of-care) 

Patient-side lateral-flow device; results in 10 min. A negative test has a high negative predictive value — helpful for ruling out pancreatitis during triage. Specificity is lower (70 – 80 %), so confirm positives with Spec cPL. 

– Quantitative POCT slides (Catalyst-cPL, Vcheck-cPL) 

Generate a numeric cPL within 8–15 min from whole blood or serum. A 2024 head-to-head study compared SNAP cPL, Spec cPL and the newer Vcheck cPL (fluorescence immunoassay). Agreement between the three tests was impressive (0.88-0.96) and highlighted the ability of the Vcheck cPL to be used to monitor progression,  

– General lipase 

Cheap and quick, but less pancreas-specific; renal or GI disease and glucocorticoids can raise values. Use as a screen—if elevated, reflex to a cPL assay. Recent JVIM work found only 62 % specificity when DGGR was used alone. 

– Imaging 

Ultrasonography of the pancreas, abdominal radiography, and contrast CT can help to diagnose pancreatitis by ruling out conditions that present similarly, as well as identify damaged pancreas tissue and complications. 

Key take-home messages for the general practitioner 

• Never use general lipase from a biochemistry analyser (eg in-house or laboratory biochemistry panels) as the sole diagnostic tool – it has low specificity and false-positives are common 

• SNAP cPL similarly has low specificity, so positive results should always be followed with further tests to confirm 

• Newer patient-side tests are available (eg VCheck cPL) which provide a quantitative result with high agreement with the laboratory ELISA, but with faster results. 

• VCheck cPL can also be used to monitor progression by repeating every 24 hours.  

Conclusion 

Pancreatitis is still difficult to diagnose, and clinicians should take care to combine the clinical picture and history with any test results to help reduce false positives. But new innovations in pancreatitis diagnostics – like the VCheck cPL – are making fast decision making, and prompt treatment, easier than ever.  

Whether you love internal medicine or find it a bit tricky, decision making under pressure is key. That’s why we included training techniques from some of the world’s most high-pressure jobs in our new Small Animal Internal Medicine Certificate program. In our world-leading online learning platform, you’ll cover pancreatitis and other internal medicine conundrums through case-based learning and problem-oriented medicine, helping you take cases from presentation to discharge without breaking a sweat.  

Find out more about the Small Animal Medicine Certificate program 

Author – Dr Joanna Woodnutt, MRCVS