If the goal is to identify even subclinical pancreatitis, these tests should be added to any serum biochemical profile. At first thought this recommendation may seem extreme; however, few clinicians would argue against measuring serum creatinine concentrations as part of every serum biochemical profile to diagnose subclinical renal insufficiency. It would appear to be just as reasonable to routinely measure serum PLI concentrations to diagnose subclinical pancreatic inflammation.
Figure 3: SNAP cPL, positive: The test spot is darker in color than the control spot, suggesting that serum cPL is above the reference range and that further tests to confirm pancreatitis are indicated.
Advantages
The SNAP cPL allows clinicians to rule out pancreatitis in dogs with acute gastrointestinal signs and also to strengthen a suspicion of pancreatitis within minutes. Many dogs with acute gastritis, hypoadrenocorticism, renal failure, or other diseases may present with similar clinical signs. A negative SNAP cPL helps the clinician quickly shift the focus of the clinical investigation to other conditions. Measurement of Spec cPL or Spec fPL often allows diagnosis even in animals with mild or chronic disease (Figure 4).
Figure 4: Serum trypsin-like immunoreactivity (cTLI) concentration, abdominal ultrasound, and serum pancreatic lipase immunoreactivity (cPLI) concentration have high specificity for canine pancreatitis, whereas only approximately 50% of dogs with an increased serum lipase activity have pancreatitis.5,7
Disadvantages
While a positive SNAP cPL test helps strengthen a suspicion of pancreatitis, it does not definitively diagnose it. Other diagnostic tests, including abdominal ultrasound and measurement of Spec cPL, are necessary. In addition, no diagnostic test is 100% sensitive and specific. Thus, it is crucial to integrate all clinical data available during the diagnostic process.