Clinical Chemistries: Pancreatic Function Flashcards
What are the two types of glands the pancreas has functions for?
Endocrine
Exocrine
Endocrine glands
uses chemical messengers to regulate organs
low concentrations of hormones have powerful effects
What feedback loop is the most common in the Endocrine glands?
Negative feedback
Exocrine glands
Secrete digestive enzymes into ducts
Empty into body cavities or body surface
What are the Endocrine Function tests?
Glucose
Fructosamine
Glucose Tolerance
Insulin Tolerance
What are the Exocrine Pancreatic Function tests?
Amylase Lipase Amylase and Lipase in Peritoneal Fluid Trypsin Serum Trypsinlike Immunoreactivity Serum Pancreatic Lipase Immunoreactivity
Endocrine Portion: Alpha Cells
Secrete glucagon
20% of cells
Endocrine Portion: Beta Cells
Secrete insulin
70% of cells
Endocrine Portion: Delta, Gamma, Epsilon
Other jobs
Exocrine Portion
Majority of pancreas size
Secretes enzymes needed for digestion into the GI tract
What are the digestive enzymes?
Trypsin
Amylase
Lipase
Why do we run Exocrine Pancreas Test: Amylase?
Breaks down starches and glycogen in sugars
Why do we run Exocrine Pancreas Test: Lipase?
Breaks down long-chain fatty acids of lipids
Pancreatitis
High-fat diets
Can be life-threatening
What are the symptoms in dogs?
Often overweight Painful abdomen (praying position) Anorexia Fever Lethargy Vomiting Hemorrhagic diarrhea
What are the symptoms in cats?
Maybe no vomiting
ADR
Anorexic
Weight loss
Where does Amylase come from?
Pancreas
Salivary glands
Small intestine
What is an increase in serum amylase almost always due to?
Pancreatitis
What serum levels are normal in the early stage of pancreatitis?
Lipase
What happens to lipase cells as pancreatitis progresses?
The cells are replaced with connective tissue and cannot produce lipase
What does a higher level of amylase and lipase in the peritoneal fluid suggest?
Pancreatitis
Serum Trypsinlike Immunoreactivity
Detects both trypsinogen and trypsin
Test only available for dogs and cats
An important indicator of pancreatic mass
What is only produced in the pancreas?
Trypsinogen
What happens when the pancreas is injured?
Trypsinogen is released in the extracellular space and converted to trypsin, which diffuses into the bloodstream
Serum Pancreatic Lipase Immunoreactivity
SNAP tests in-house needs serum
Available for dogs and cats
fPLi and cPLi
Glucagon from alpha cells
Raises blood glucose levels
How does glucagon raise glucose levels?
By stimulating the liver to convert glycogen to glucose and by stimulating gluconeogenesis
How does insulin from beta cells lower blood glucose levels?
By causing glucose, amino acids, and fatty acids to be absorbed into cells
What stimulates the release of insulin?
High blood glucose
What stimulates the release of glucagon?
Low blood glucose
What regulates the secretion of insulin and glucagon?
Negative feedback mechanism
What happens if the pancreas not producing enough insulin?
Glucose can not get into the cells so will be high in the blood
What happens if there is too much insulin?
Hypoglycemia
What is a common issue with cats that can be caused by a trip to a clinic, waiting to be seen, or having blood drawn?
Stress hyperglycemia
What do you need for an accurate glucose level?
Need to separate plasma or serum from the red blood cells
What happens if the plasma or serum are not separated?
The red blood cells continue to metabolize glucose and cause a 10% glucose drop per hour at room temperature
What do glucagon, thyroxine, growth hormone, epinephrine, and glucocorticoids all influence?
Hyperglycemia
Boost blood glucose levels
What does insulin promote?
Glucose influx into its target cells
What are the normal levels of glucose?
80-120 mg/dL
What happens at 250 mg/dL?
Glucosuria, PU/PD
Diabetes Mellitus
The inability to produce or use insulin
What are the two types of diabetes mellitus?
- Insulin-dependent diabetes
2. Non-Insulin dependent diabetes
Insulin-dependent diabetes
Dogs and Cats
Require insulin injections to survive
Non-Insulin dependent diabetes
Cats and very rare in dogs
Some cats may have transient diabetes
Diet-controlled
What are the clinical signs of diabetes
PU/PD
Polyphagia
Hyperglycemia
Glucosuria
What are the treatments for diabetes mellitus?
Insulin injections
Diet changes
