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Effect of Chronic Glucocorticoids on Serum Pancreatic Lipase Activity in Dogs

Jennifer E. Stokes, DVM, DACVIM (SAIM), University of Tennessee

Internal Medicine

|July 2022

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In the literature

Cocker SE, Lawrence YA, Lidbury JA, Suchodolski JS, Steiner JM, Richter KP. Serum pancreatic lipase immunoreactivity in sick dogs after chronic administration of supraphysiologic doses of glucocorticoids. Vet Clin Pathol. 2022;50(Suppl 1):63-69. doi:10.1111/vcp.12943


FROM THE PAGE...

Pancreatitis is often difficult to diagnose antemortem in dogs and can cause clinical signs that overlap with nonpancreatic diseases. Measurement of canine pancreatic lipase immunoreactivity (cPLI) concentration is the most sensitive (71.7%-77.8%) and specific (80.5%-88%) laboratory test for acute pancreatitis.1 Data on the effects of exogenous glucocorticoids on cPLI concentrations in clinically ill dogs are conflicting; glucocorticoids are often administered for treatment of immune-mediated, inflammatory, and neoplastic diseases.2-4

This study assessed fasting serum cPLI concentration before (T0) and after (T1) chronic glucocorticoid (prednisone ± dexamethasone) administration in 35 dogs with diseases other than pancreatitis. Prednisone (≥0.5 mg/kg/day [0.5-3 mg/kg/day]) was administered for ≥3 weeks. 

cPLI increase (absolute median change, 31 µg/L) following glucocorticoid administration was significant enough to change the clinical interpretation of cPLI results from T0 to T1 in 6 dogs (from within the reference interval [0-200 µg/L] to consistent with pancreatitis [>400 µg/L] in 3 dogs; from equivocal [200-400 µg/L] to consistent with pancreatitis in 1 dog; from consistent with pancreatitis to equivocal in 2 dogs). 

There was no clinical suspicion of pancreatitis in any dogs regardless of change in cPLI concentration after chronic prednisone therapy in clinically ill dogs. The cause of increased cPLI in this population is unclear.

...TO YOUR PATIENTS

Key pearls to put into practice:

1

Chronic prednisone administration in dogs can cause an increase in cPLI concentration that can lead to a laboratory interpretation consistent with pancreatitis.

2

Chronic glucocorticoid administration is not associated with clinical signs of acute pancreatitis.

 

3

Routine measurement of cPLI concentration in dogs receiving prednisone is not recommended unless clinical signs consistent with acute pancreatitis develop.

 

4

Additional or alternate testing (eg, abdominal ultrasonography) for acute pancreatitis is recommended if signs of acute pancreatitis develop after chronic administration of prednisone.

 

References

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