Pancreatitis is an inflammatory condition of the pancreas. In a retrospective study on necropsy findings, 1.5% of 9342 dogs and 1.3% of 6504 cats had evidence of pancreatic disease. Dogs and cats with pancreatitis have nonspecific signs, making this disorder difficult to diagnose. Pancreatitis is either acute or chronic, and both types can vary from mild to severe. Clinical signs depend on the severity of the disease; mild cases are often subclinical. In a retrospective study of 70 dogs with fatal pancreatitis, the following were noted: anorexia (91%), vomiting (90%), weakness (79%), abdominal pain (58%), dehydration (46%), and diarrhea (33%). In a retrospective study of cats with pancreatitis, the following were reported: anorexia (87%), lethargy (81%), dehydration (54%), weight loss (47%), vomiting and hypothermia (46%), icterus (37%), fever (25%), abdominal pain (19%), diarrhea (12%), and a palpable mass (11%). Complete blood counts and serum chemistry panels often show mild, nonspecific findings. Imaging is commonly used to aid in the diagnosis. Abdominal radiography is nonspecific, and computed tomography is not sensitive in dogs and cats. Abdominal ultrasonography may be helpful depending on the criteria and skill of the user. Serum lipase and amylase levels may be increased, but such elevation is not sensitive or specific in dogs or cats. Serum trypsin-like immunoreactivity measures trypsinogen, and concentrations may be elevated; this finding is specific but not sensitive in dogs and cats. Trypsinogen-activation peptide, when present, suggests a diagnosis of pancreatitis, but it is labile in serum and urine and the test is not readily available. Biopsy of the pancreas has long been considered the most definitive diagnostic tool. The pancreas can be visualized, and biopsy specimens can be obtained; however, in a recent study, histologic findings of dogs with pancreatitis were localized, thereby suggesting that unless several biopsies are obtained, the diagnosis can be missed. Patients with pancreatitis are often poor anesthetic risks. Pancreatic lipase immunoreactivity assays have been developed recently and validated for dogs and cats. These tests are highly sensitive and specific for diagnosing pancreatitis.

COMMENTARY: This concise review discusses an important disease in dogs and cats. The low percentage of dogs reported with abdominal pain that had fatal pancreatitis is worrisome, as abdominal pain is one of the "hallmarks" of this disease. The author raises a key point in the article: Is abdominal pain less common, or are we misdiagnosing it? The low incidence of reported vomiting and abdominal pain in cats is also noteworthy. Currently, pancreatic lipase immunoreactivity concentrations are available via the Gastrointestinal Laboratory of Texas A&M University's Department of Small Animal Clinical Sciences (www.cvm.tamu.edu/gilab). A commercial assay (Spec cPL, Idexx Laboratories) has just been released.

Is it pancreatitis? Steiner JM. VET MED 101:158-167, 2006.