Clinical pathology: clinical chemistry-(v)Evaluation of the pancreas

Question 1

In dogs, where does serum amylase have the highest concentrations in the body?(2)

Answer 1

Serum amylase has the highest concentrations in the pancreas and the small intestinal mucosa.

Question 2

Give 4 different causes of increased serum amylase.

Answer 2

• Pancreatic injury
• Renal dysfunction
• GI disease
• Hepatic disease
• Neoplasia(lymphoma, haemangiosarcoma)

Question 3

What would be the most likely cause of increase if amylase was elevated more than three-fold greater than the upper reference range limit?

Answer 3

Pancreatic injury is strongly suggested.

Question 4

What are the different causes of increased serum lipase in dogs?

Answer 4

• Pancreatic injury
• Renal dysfunction
• Hepatic disease
• GI disease
• Corticosteroids (dexamethasone can increase lipase five-fold)
• Neoplasia (lymphoma, haemangiosarcoma)

Question 5

What does an elevation greater than two-fold suggest?

Answer 5

An elevation greater than two-fold is suggestive of pancreatic injury, except if the dog has received corticosteroids.

Question 6

Comment on the level of lipase activity in cats with pancreatic injury.

Answer 6

Cats with pancreatic injury typically have normal lipase activity.

Question 7

What is the most likely cause of the following:

-amylase or lipase activity being higher in peritoneal fluid than in serum

Answer 7

Pancreatic injury is more likely.

Question 8

What is TLI?

Answer 8

Serum trypsin-like immunoreactivity

Question 9

What is TLI activity proportional to?

Answer 9

TLI activity is proprotional to trypsinogen and trypsin. Trypsinogen is secreted only by the pancreas and is converted to trypsin in the small intestine.

Question 10

What does increased TLI indicate?

Answer 10

TLI is increased in pancreatitis and is a more sensitive indicator of early pancreatitis than are amylase or lipase determination.