Display options
Share it on

J Small Anim Pract. 2021 Dec;62(12):1092-1100. doi: 10.1111/jsap.13379. Epub 2021 Jul 07.

Retrospective study evaluation of DGGR lipase for diagnosis, agreement with pancreatic lipase and prognosis in dogs with suspected acute pancreatitis.

The Journal of small animal practice

A Hope, E L Bailen, R E Shiel, C T Mooney

Affiliations

  1. Small Animal Clinical Studies, School of Veterinary Medicine, University College Dublin, Dublin 4, Ireland.

PMID: 34233038 DOI: 10.1111/jsap.13379

Abstract

OBJECTIVES: Activity of 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6'-methylresorufin) ester (DGGR) lipase is considered to be more pancreas specific than traditional lipase assays. The aim of this study was to evaluate the diagnostic performance of DGGR lipase activity for suspected acute pancreatitis in dogs and to assess its prognostic usefulness.

METHODS: Retrospective study of case records for suspected acute pancreatitis based on clinician-stated diagnosis, point-of-care and quantitative canine pancreas-specific lipase (cPL) results and consistent ultrasonographic features. Diagnostic performance of DGGR lipase was assessed by receiver-operating characteristic curve analysis, agreement by Cohen's kappa (κ) and prognostic value by multiple regression analysis.

RESULTS: Median DGGR lipase activity was significantly (P < 0.001) higher in dogs with suspected acute pancreatitis [93.7 (range, 11.0-2853.0) U/L (n = 158)] compared to those with no evidence of pancreatitis [range, 20.9 (6.7-89.0) U/L (n = 356)]. A DGGR lipase activity >42.15 U/L had the best combined diagnostic sensitivity (81.0%) and specificity (92.1%). Previously established cut-offs (>130 and >80 U/L) had sensitivities of 40.5 and 43.0%, and specificities of 100 and 99.7%, respectively. There was near perfect (κ = 0.821) and substantial (κ = 0.751) agreement between DGGR lipase activity >42.15 U/L and quantitative cPL concentrations ≥200 and ≥400 μg/L, respectively. DGGR lipase activity but not quantitative cPL concentration was statistically (P = 0.043, odds ratio = 0.999) predictive of discharge but clinical utility is questionable.

CLINICAL SIGNIFICANCE: Using DGGR lipase at the lower cut-off could provide an additional test for supporting a diagnosis of acute pancreatitis in dogs particularly if cPL results are not available. Larger studies are required to more fully assess its value in prognostication.

© 2021 The Authors. Journal of Small Animal Practice published by John Wiley & Sons Ltd on behalf of British Small Animal Veterinary Association.

References

  1. Beall, M. J. , Cahill, R. , Pigeon, K. , et al. (2011) Performance validation and method comparison of an in-clinic enzyme-linked immunosorbent assay for the detection of canine pancreatic lipase. Journal of Veterinary Diagnostic Investigation 23, 115-119 - PubMed
  2. Bennaim, M. , Shiel, R. E. , Forde, C. , et al. (2018) Evaluation of individual low-dose dexamethasone suppression test patterns in naturally occurring hyperadrenocorticism in dogs. Journal of Veterinary Internal Medicine 32, 967-977 - PubMed
  3. Cridge, H. , MacLeod, A. G. , Pachtinger, G. E. , et al. (2018) Evaluation of SNAP cPL, Spec cPL, VetScan cPL rapid test, and precision PSL assays for the diagnosis of clinical pancreatitis in dogs. Journal of Veterinary Internal Medicine 32, 658-664 - PubMed
  4. Cridge, H. , Sulivan, A. M. , Wills, R. W. , et al. (2020) Association between abdominal ultrasound findings, the specific canine pancreatic lipase assay, clinical severity indices, and clincial diagnosis in dogs with pancreatitis. Journal of Veterinary Internal Medicine 34, 636-643 - PubMed
  5. Fabres, V. , Dossin, O. , Reif, C. , et al. (2019) Development and validation of a novel clinical scoring system for short-term prediction of death in dogs with acute pancreatitis. Journal of Veterinary Internal Medicine 33, 499-507 - PubMed
  6. Goodband, E. L. , Serrano, G. , Constantino-Casas, F. , et al. (2018) Validation of a commercial 1,2-o-dilauryl-rac-glycero glutaric acid-(6′-methylresorufin) ester lipase assay for diagnosis of canine pancreatitis. Veterinary Record Open 5, e000270 - PubMed
  7. Gori, E. , Pierini, A. , Lippi, I. , et al. (2020) Evaluation of asymmetric dimethylarginine as an inflammatory and prognostic marker in dogs with acute pancreatitis. Journal of Veterinary Internal Medicine 34, 1144-1149 - PubMed
  8. Graca, R. , Messick, J. , McCullough, S. , et al. (2005) Validation and diagnostic efficacy of a lipase assay using the substrate 1,2-o-dilauryl-rac-glycero glutaric acid-(6′ methyl resorufin)-ester for the diagnosis of acute pancreatitis in dogs. Veterinary Clinical Pathology 34, 39-43 - PubMed
  9. Haworth, M. D. , Hosgood, G. , Swindells, K. L. , et al. (2014) Diagnostic accuracy of the SNAP and Spec canine pancreatic lipase tests for pancreatitis in dogs presenting with clinical signs of acute abdominal disease. Journal of Veterinary Emergency and Critical Care 24, 135-143 - PubMed
  10. Hess, R. S. , Saunders, H. M. , Van Winkle, T. J. , et al. (1998) Clinical, clinicopathologic, radiographic, and ultrasonographic abnormalities in dogs with fatal acute pancreatitis: 70 cases (1986-1995). Journal of the American Veterinary Medical Association 213, 665-670 - PubMed
  11. Huth, S. P. , Relford, R. , Steiner, J. M. , et al. (2010) Analytical validation of an ELISA for measurement of canine pancreas-specific lipase. Veterinary Clinical Pathology 39, 346-353 - PubMed
  12. Kim, H. , Kang, J. H. , Heo, T. Y. , et al. (2019) Evaluation of hypertriglyceridemia as a mediator between endocrine diseases and pancreatitis in dogs. Journal of the American Animal Hospital Association 55, 92-100 - PubMed
  13. Kook, P. H. , Kohler, N. , Hartnack, S. , et al. (2014) Agreement of serum Spec cPL with the 1,2-o-dilauryl-rac-glycero glutaric acid-(6′-methylresorufin) ester (DGGR) lipase assay and with pancreatic ultrasonography in dogs with suspected pancreatitis. Journal of Veterinary Internal Medicine 28, 863-870 - PubMed
  14. Landis, J. R. & Koch, G. G. (1977) The measurement of observer agreement for categorical data. Biometrics 33, 159-174 - PubMed
  15. Linari, G. , Dondi, F. , Segatore, S. , et al. (2020) Evaluation of 1,2-O-dilauryl-rac-glycero glutaric acid - (6′-Methylresorufin) ester (DGGR) lipase assay in dogs with naturally occurring hypercortisolism. Journal of Veterinary Internal Medicine 34, 359 - PubMed
  16. Lucibello, T.J. , McGrath, C. , Papakonstantinou, S. et al., (2014) Novel lipase assay for a rapid, inexpensive, and reliable diagnosis of pancreatitis in dogs and cats. 29th Annual Meeting of the British Society of Toxicological Pathology and Association of Comparative Clinical Pathology. - PubMed
  17. Mansfield, C. (2012) Acute pancreatitis in dogs: advances in understanding, diagnostics and treatment. Topics in Companion Animal Medicine 27, 123-132 - PubMed
  18. McCord, K. , Morley, P. S. , Armstrong, J. , et al. (2012) A multi-institutional study evaluating the diagnostic utility of the spec cPL and SNAP(R) cPL in clinical acute pancreatitis in 84 dogs. Journal of Veterinary Internal Medicine 26, 888-896 - PubMed
  19. Newman, S. , Steiner, J. , Woosley, K. , et al. (2004) Localization of pancreatic inflammation and necrosis in dogs. Journal of Veterinary Internal Medicine 18, 488-493 - PubMed
  20. Okanishi, H. , Nagata, T. , Nakane, S. , et al. (2019) Comparison of initial treatment with and without corticosteroids for suspected acute pancreatitis in dogs. Journal of Small Animal Practice 60, 298-304 - PubMed
  21. Penninck, D. (2008) Pancreas. In: Atlas of Small Animal Ultrasonography. 1st edn. Eds D. Penninck and M.-A. D'Anjou . Blackwell Publishing, Iowa. pp 322-325 - PubMed
  22. Pratschke, K. M. , Ryan, J. , McAlinden, A. , et al. (2015) Pancreatic surgical biopsy in 24 dogs and 19 cats: postoperative complications and clinical relevance of histological findings. Journal of Small Animal Practice 56, 60-66 - PubMed
  23. Sato, T. , Ohno, K. , Tamamoto, T. , et al. (2017) Assesment of severity and changes in C-reactive protein concentration and various biomarkers in dogs with pancreatitis. Journal of Veterinary Medical Science 79, 35-40 - PubMed
  24. Steiner, J. M. , Newman, S. , Xenoulis, P. , et al. (2008) Sensitivity of serum markers for pancreatitis in dogs with macroscopic evidence of pancreatitis. Veterinary Therapeutics 9, 263-273 - PubMed
  25. Steiner, J.M. , Suchodolski, J.S. , Gomez, R. (2015) DGGR is not a specific substrate for pancreatic lipase, Proceedings of the World Small Animal Veterinary Association, Bangkok. p 71. - PubMed
  26. Thompson, L. J. , Seshadri, R. & Raffe, M. R. (2009) Characteristics and outcomes in surgical management of severe acute pancreatitis: 37 dogs (2001-2007). Journal of Veterinary Emergency and Critical Care 19, 165-173 - PubMed
  27. Trivedi, S. , Marks, S. L. , Kass, P. H. , et al. (2011) Sensitivity and specificity of canine pancreas-specific lipase (cPL) and other markers for pancreatitis in 70 dogs with and without histopathologic evidence of pancreatitis. Journal of Veterinary Internal Medicine 25, 1241-1247 - PubMed
  28. Watson, P. J. , Roulois, A. J. , Scase, T. , et al. (2007) Prevalence and breed distribution of chronic pancreatitis at post-mortem examination in first-opinion dogs. Journal of Small Animal Practice 48, 609-618 - PubMed
  29. Weatherton, L. K. & Streeter, E. M. (2009) Evaluation of fresh frozen plasma administration in dogs with pancreatitis: 77 cases (1995-2005). Journal of Veterinary Emergency and Critical Care 19, 617-622 - PubMed
  30. Xenoulis, P. G. (2015) Diagnosis of pancreatitis in dogs and cats. Journal of Small Animal Practice 56, 13-26 - PubMed

Publication Types