Lipase/Amylase in cats

RE: Lipase/Amylase in cats

Lucy Fleming — Tue, 10 Sep 2019 12:41:05 GMT

[quote user="Beats"]

[quote user="Lucy Fleming"]For me, the main benefit of knowing - or perhaps we should say strongly suspecting - the cat has pancreatitis is more for managing owner expectations going forward.[/quote]

I'd like £60 to manage your expectations please

I would need a stronger sales pitch than this, based on saying that a blood test may increase or decrease your level of suspicion that a cat will show vague signs of illness again in the future, but you're not advocating anything to lessen that chance, just to let you know that it may or may not happen, you think, probably, well maybe, OK dunno, well no it's common anyway so I'll stick with probably...

[/quote]

Too true, that! Without better understanding of the cause, hard to give preventative advice. Even more so when the providers of the test tell you on the one hand, the numerical test result doesn't necessarily correlate with the severity, but on the other hand, it can be used to track changes....

I don't run it very often, unless I feel that a profile that includes it suits other aspects of the case. I did have a chronic pancreatitis cat who's owner used to like to check his fPL every time we bled him for other reasons (he had many, many problems) and I can't say that the result was very useful! Feels about as useful as SDMA sometimes....

RE: Lipase/Amylase in cats

Kate Richardson — Mon, 09 Sep 2019 19:01:26 GMT

Given there is no specific treatment for pancreatitis, other than giving the owners a diagnosis, they are not helpful tests in my opinion. Might support your clinical suspicions, equally, if test result not consistent with pancreatitis, if clinically I suspected it, I am still likely to think it does have it and the test result is a false negative! But I do run them if funds allow, as it can be helpful to be able to give the owners a 'definitive' diagnosis (or as near to definitive as one can be) in terms on them staying on board with treatment, especially in the worst cases that require hosp and lots of supportive treatments such fluids and feeding tubes. Having a 'diagnosis' might also help persuade the owners of an overweight cat that loss of pancreatic cells in an overweight cat will increase the risks of diabetes in the future for example. Maybe more useful in chronic recurrent cases, as Lucy alluded to in terms of managing expectations.

But I certainly don't lose any sleep if I am not able to run this test.

RE: Lipase/Amylase in cats

Beats — Mon, 09 Sep 2019 09:14:23 GMT

[quote user="Lucy Fleming"]For me, the main benefit of knowing - or perhaps we should say strongly suspecting - the cat has pancreatitis is more for managing owner expectations going forward.[/quote]

I'd like £60 to manage your expectations please

RE: Lipase/Amylase in cats

Lucy Fleming — Mon, 09 Sep 2019 08:46:51 GMT

[quote user="Beats"]how does the "diagnosis" of "clinical pancreatitis" in a cat help it[/quote]

For me, the main benefit of knowing - or perhaps we should say strongly suspecting - the cat has pancreatitis is more for managing owner expectations going forward. Given that we suspect chronic pancreatitis to be fairly common in cats (based on evidence at necropsy) then it's a good chance to discuss with the owners the likelihood of recurrent flare-ups causing clinical signs, and the need for repeated treatment (though as you mentioned, that's largely symptomatic at the moment!)

RE: Lipase/Amylase in cats

Beats — Thu, 05 Sep 2019 21:15:32 GMT

[quote user="robloxley"]There's some good discussion of various pancreatitis blood tests at http://www.cvm.tamu.edu/gilab/research/pancreatitis-information [/quote]

I'm not quite sure I consider anything from Dr Steiner to be truly objective and free from bias on the topic of pancreatic blood tests...

but even going from that link:

" Specificity of Spec fPL® has been as high as 100% when tested against a healthy control group." [irrelevant surely?]

"More importantly, specificity of Spec fPL® reached 67% in cats with clinical signs mimicking pancreatitis but with normal pancreatic histopathology." [can be interpreted a number of ways, but probably also still meaning Spec fPL result of extremely limited clinical relevance? translated = of 100 cats with vague digestive signs, presumably bad enough to warrant biopsy, which had "high" Spec fPL results consistent with "pancreatitis", only two-thirds had pancreatic inflammation found on biopsy]

RE: Lipase/Amylase in cats

Beats — Thu, 05 Sep 2019 20:57:22 GMT

I am highly skeptical, potentially cynical(?), of blood tests to "diagnose clinical pancreatitis" in cats (even more so than in dogs).

But setting my skepticism aside, and acknowledging the need not to divorce diagnostics from therapeutics, how does the "diagnosis" of "clinical pancreatitis" in a cat help it? Genuine question, not rhetorical. Are the treatment choices clear and unequivocally beneficial? If so, do they differ from the non-specific treatment of the "clinical signs" [apparent without blood tests] associated with the "pancreatitis"? If so, then what are the differences? If I don't understand this, then I'll not be able to muster the energy to take a fresh objective look at the diagnostic utility of such blood tests.

RE: Lipase/Amylase in cats

Rob Loxley — Tue, 03 Sep 2019 21:28:25 GMT

[quote user="bob lehner"]DGGR Lipase - which apparently correlates pretty well with F PLi[/quote]

Which correlates how well with an actual diagnosis of pancreatitis?

[quote user="bob lehner"]Fuji lipase... ...this correlates pretty well with the DGGR lipase[/quote]

but maybe not with specFPL for diagnosing pancreatitis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4667670/ FDC-v-lip did not show a strong correlation with Spec fPL in cats with various diseases, which resulted in the low sensitivity and positive predictive value. However, the relatively high (>90%) specificity and negative predictive value indicated that FDC-v-LIP could be a useful patient-side screening test for the exclusion of feline pancreatitis

[quote user="bob lehner"]However the pathologist did stress that diagnosing pancreatitis in cats should not rely on blood tests alone[/quote] agree

There's some good discussion of various pancreatitis blood tests at http://www.cvm.tamu.edu/gilab/research/pancreatitis-information

RE: Lipase/Amylase in cats

bob lehner — Tue, 03 Sep 2019 10:32:56 GMT

A bit more to add on this topic - having spoken to one of the pathologists at Axiom.

They do indeed use the new(ish) DGGR Lipase - which apparently correlates pretty well with F PLi.

'Old fashioned' Lipase, as others have said, is of little value in cats.

If they get a high DGGR Lipase they won't bother with doing a F Pli, and ditto if a low lipase. There is a grey area where lipase may be equivocal - and here they would recommend doing an F Pli.

The Mi Lab machines used in many practices (marketed by CVS./Axiom) apparently use yet another type of lipase -'Fuji lipase' - and this correlates pretty well with the DGGR lipase - so the same reasoning as to whether to do an F PLi would apply.

However the pathologist did stress that diagnosing pancreatitis in cats should not rely on blood tests alone - but include U/S etc - as it often involves liver and s.i. issues as well.

RE: Lipase/Amylase in cats

Rob Davis — Sun, 01 Sep 2019 19:59:43 GMT

[quote user="Anthony Todd"]

[quote user="Rob Davis"]Feline lipase and amylase are as useful as "cracking off the tartar" with your thumbnail.... This could get fun![/quote]

The relief to the cat [alway!] at no cost was. IMHO, probably, no certainly, more beneficial to the cat.

That's if the owner was not frightened by the fee...., that is the [£200 +?] full "dental! [couched in a more expensive name] etc now obligatory in this modvet day when simple things, without the bells and whistles, which are of dubious, and certainly substantiated value, are NOT de rigeur.......

[/quote]

And he bites...

RE: Lipase/Amylase in cats

Anthony Todd — Sun, 01 Sep 2019 19:28:58 GMT

[quote user="Rob Davis"]Feline lipase and amylase are as useful as "cracking off the tartar" with your thumbnail.... This could get fun![/quote]

The relief to the cat [alway!] at no cost was. IMHO, probably, no certainly, more beneficial to the cat.

RE: Lipase/Amylase in cats

bob lehner — Sun, 01 Sep 2019 17:52:21 GMT

[quote user="Luke Bam"]

As far as I‘m aware, Axiom uses DGGR lipase. This has a higher sensitivity and specificity than your regular garden variety lipase, even in cats. Amylase is of course still as useful as a chocolate tea-pot.

I will try and and dig up some numbers to substantiate this though.

[/quote]

Thanks Luke - that could well be the answer to my conundrum.

If you do have any more info please let us know.

RE: Lipase/Amylase in cats

Marni Miller — Sun, 01 Sep 2019 12:20:28 GMT

Although I've always found cracking the tartar off to be very satisfying

RE: Lipase/Amylase in cats

Luke Bam — Sun, 01 Sep 2019 10:55:54 GMT

I will try and and dig up some numbers to substantiate this though.

RE: Lipase/Amylase in cats

Rob Davis — Sat, 31 Aug 2019 17:14:58 GMT

[quote user="Sarah Keir"]

Feline lipase and amylase as useful as a leukocyte reading on a urine dipstick.

[/quote]

Feline lipase and amylase are as useful as "cracking off the tartar" with your thumbnail.... This could get fun!

RE: Lipase/Amylase in cats

Sarah Keir — Fri, 30 Aug 2019 16:14:18 GMT

Feline lipase and amylase as useful as a leukocyte reading on a urine dipstick.

RE: Lipase/Amylase in cats

Bob Russell — Fri, 30 Aug 2019 13:38:58 GMT

Amylase is on our in house profile. I do note it with caution.

Lipase does concern me but as 'non' or 'sub' clinical pancreatitis seems to be considered almost the norm I wonder if this is the reason it is of limited value. cPLi's are far from perfect either!!