New Tests for Pancreatitis - IDEXX Laboratories

INDICATIONSSNAP cPLA SNAP cPL should be performed in any dogwith acute signs of gastrointestinal disease anddoes not have an obvious diagnosis. If the SNAPcPL is negative, pancreatitis can essentially beruled out.If the SNAP cPL is positive, an abdominal ultrasoundshould be performed. In addition, serumfor measurement of Spec cPL should be sent outto help confirm diagnosis of pancreatitis. This isimportant because the SNAP test provides onlya negative or positive result, while the Spec cPLis a quantitative test with 3 diagnostic ranges—a reference range (< 200 mcg/L), questionablerange (≥ 200 mcg/L, but < 400 mcg/L), anddiagnostic cut-off for pancreatitis (≥ 400 mcg/L).If the SNAP cPL is positive, Spec cPL will fallin the questionable or diagnostic ranges. In addition,Spec cPL assays help monitor disease progressionin patients with pancreatitis.Spec cPL & fPLIndications for the measurement of Spec cPLand Spec fPL depend on the goal of the clinician:In patients with classic clinical signs—acuteonset of vomiting and abdominal discomfort—orthose with less specific clinical signs that cannotbe explained by another diagnosis, these tests canhelp confirm or exclude pancreatitis.If the goal is to identify even subclinical pancreatitis,these tests should be added to any serumbiochemical profile. At first thought this recommendationmay seem extreme; however, few clinicianswould argue against measuring serumcreatinine concentrations as part of every serumbiochemical profile to diagnose subclinical renalinsufficiency. It would appear to be just as reasonableto routinely measure serum PLI concentrationsto diagnose subclinical pancreaticinflammation.2SNAP cPL, negative: The testspot is lighter in color than thecontrol spot, which indicates aserum cPL concentration withinthe reference range and suggeststhat pancreatitis is highlyunlikely.3SNAP cPL, positive: The testspot is darker in color than thecontrol spot, suggesting thatserum cPL is above the referencerange and that further teststo confirm pancreatitis areindicated.Figures 2 and 3. Reprinted from Small Animal Gastroenterology. Steiner JM (ed). Hannover: Schlütersche Verlagsgesellschaft, 2008, with permission.CONTINUESDiagnostics / NAVC Clinician’s Brief / April 2010 ...................................................................................................................................................................................77