You Are Here » Home » Posts » Magazine, Vet360, Vet360 Vol 03 Issue 02 » The Clinical Utility of Specific Canine Pancreatic Lipase (Spec cPL™)
Pancreatitis is a relatively common disease with very
non-specific clinical signs such as abdominal pain,
anorexia, vomiting and diarrhoea. Currently there is
no very specific and sensitive test available to use as
a gold standard for diagnosis. Pancreatitis may present
as acute and fulminant or be more low grade
and chronic in nature. These forms will present with
different clinical signs and also cause a different degree
of cell damage and resultant lipase release by
the affected organ, depending on the degree of inflammation,
amount of fibrosis and number of cells
remaining and affected.
In a case series of canine random consecutive post
mortems the most common pancreatic lesion was
hyperplastic nodules (80.2%), followed by lymphocytic
inflammation (52.5%), fibrosis (49.5%), atrophy
(46.5%), neutrophilic inflammation (31.7%), pancreatic
fat necrosis (25.7%), pancreatic necrosis (16.8%), and
oedema (9.9%). The most common lesion, lymphocytic
inflammation, was mild in most cases. This could
help explain why histologic lesions may be more prevalent
than clinical signs of pancreatic disease.5
Clinically normal dogs have low circulating concentrations
of pancreatic lipase in the blood. On the other
hand, dogs with acute pancreatitis typically show dramatic
elevations in serum pancreatic lipase concentrations,
which remain elevated for a prolonged period.
Animals with low-grade, histopathological disease
may not show any dramatic elevations in serum lipase
and may even exhibit no clinical signs.5 Pancreatitic
lipase can be determined by either the spec cPL or
SNAP cPL test. The former is a laboratory run test,
whereas the latter is a point-of-care in-house test.
Spec cPL is generally considered the most sensitive
and specific test currently available for pancreatitis as
the specific lipase only occurs within pancreatic tissue,
as it is an enzyme that is synthesized and released
only by the pancreatic acinar cell. Assays that measure
PLI are species-specific. However, no test is perfectand the spec cPL can give both false positives and
SNAP cPL should be performed in any dog with acute
signs of gastrointestinal disease which does not have
an obvious diagnosis such as intestinal parasites, foreign
body, Parvo-virus infection, etc. The SNAP test
only gives either a negative or positive result and is
slightly more sensitive but less specific than the Spec
cPL. If the test is negative then pancreatitis can essentially
be ruled out as the sensitivity of the SNAP
is 93% which gives a 7% chance of a false negative.4
A positive SNAP cPL indicates a lipase value of ≥
200ug/L. However, as a positive Snap cPL, is NOT
a 100% diagnostic positive diagnosis for pancreatitis,
it is still the responsibility of the clinician to perform
a full diagnostic workup. Ideally an abdominal ultrasound
should be performed to exclude other abdominal
conditions which could cause similar clinical signs
and also cause lipase release.
In addition, measurement of Spec cPL should be done
to help confirm diagnosis of pancreatitis. The Spec
cPL is a quantitative test with 3 diagnostic ranges: normal
reference range (< 200 ug/L), questionable range
(between 200-400 ug/L), and diagnostic cut-off for
pancreatitis (≥ 400 ug/L) (IDEXX package insert). The
magnitude of elevation of serum canine pancreatic
lipase concentration does, however, not establish a
prognosis for a patient with acute pancreatitis nor is
there evidence that changes in serum concentrations
correspond to clinical improvement.1
The sensitivity of Spec cPL in various studies ranges
from 21% in dogs with histopathologically confirmed
mild pancreatitis; 71% in dogs with severe pancreatitis;
and up to 87% in some cases.4 It would appear that
the greater the pancreatic inflammation the greater
the test sensitivity, which would make sense as more
lipase is release into the bloodstream and these dogs
have more severe clinical signs thus the prevalence
in the test population is higher. Thus there is about a
15-25% possibility of having a false negative diagnosis.
The Spec cPL sensitivity has also been measuredagainst an increase between > 200- 399 ug/L (90%)
and an increase > 400ug/L( 75%) thus it decreases as
the cutoff increases – but the specificity will increase
with an increased cutoff. The specificity is 74% for the
SNAP, 72% for Spec cPL cutoff between 200 -399ug/L
and 78% with a cutoff > 400ug/L.4
Spec cPL cannot differentiate between primary and
secondary pancreatitis — some dogs with an inflammatory
disease process in another organ in the region
of the pancreas (liver, gall bladder, mesentery, peritoneum)
may have secondary pancreatic inflammation
and animals with primary intestinal disease (foreign
body, inflammatory bowel disease, lymphoma) may
show elevated lipase values.1,2
Two recent studies investigating risk factors for pancreatitis
showed that many dogs had co-existing disease
and that there appeared to be an association
between the presence of Cushing’s disease and the
development of pancreatitis. Dogs with Cushing’s
disease and no clinically diagnosed pancreatitis had
a higher Spec cPL concentrations and more positive
SNAP cPL results than clinically healthy dogs with
normal ACTH stimulation test results. Spec cPL test
concentrations were significantly higher in dogs with
Cushing’s disease (491.1 ug/L) than in healthy dogs
(75.2 ug/L), with more abnormal Spec cPL results
in Cushing’s dogs. There were more positive SNAP
results in dogs with Cushing’s disease (55%) than in
healthy dogs (6%).3
In another study, SNAP cPL and Spec cPL was evaluated
in 3 groups of dogs: healthy dogs (n=20), those
with signs of Cushing’s disease but normal ACTH
stimulation test results (n=12), and dogs with confirmed
Cushing’s disease (n=20). Dogs were excluded
from the study if they had any clinical signs suggestive
of pancreatitis. Healthy dogs had one SNAP cPL positive
test and one Spec cPL in the 200-400g/L range.
In the second group, 3/12 dogs had a positive SNAP
cPL and 2 dogs had Spec cPL consistent with pancreatitis.
In dogs with confirmed Cushing’s disease,
11/20 had a positive SNAP cPL and 5 had a Spec cPLat the 200-400g/L range, and 7 had values >400g/L.
Yet none of the “positive” animals had clinical signs
consistent with pancreatitis.5 However, as it has been
reported that low grade pancreatitis can be present
as a post mortem histopathological diagnosis it is unknown
if these dogs had low grade clinical pancreatitis
(no biopsies were performed) or if something else
was causing the elevation in the lipase.3
Miniature Schnauzers with severe hypertriglyceridaemia
(> 9mmol/L, 900mg/dL) were 4.5x more likely
to have a Spec cPL value consistent with pancreatitis
(≥200 μg/L)4; however, these dogs did not show any
obvious clinical signs of pancreatitis.6
Pending further study, SNAP and Spec cPL test results
should be interpreted cautiously in dogs with Cushing’s
disease and hypertriglyceridaemia to avoid a
false diagnosis of concurrent pancreatitis.
In one study4, dogs were enrolled based on clinical
signs of pancreatitis and the study showed that the
SNAP test had a sensitivity of 91-94% and specificity
of 71 – 77%. Using a cutoff of 400ug/L the Spec cPL
had a sensitivity of 71-77% and a specificity of 80 –
85%.4 Another study also using a clinical diagnosis
(clinical, serum chemistry, abdominal ultrasound) ofacute pancreatitis in a group of dogs presenting with
acute abdomen, the sensitivity of the SNAP cPL was
82% (18% chance of false negative result) and specificity
59% (41% false positive results).1 The false positive
result dogs may have had pancreatic inflammation
due to diffuse abdominal inflammation due to the
underlying disease process such as septic peritonitis,
conditions causing hypo-perfusion or reperfusion injury,
acute gastroenteritis, duodenal reflux and intestinal
foreign bodies. In that study, the Spec cPL had a
sensitivity of 70% and a specificity of 77% (23% false
positives) with the accuracy of the SNAP and Spec
cPL in animals with clinically diagnosed pancreatitis
calculated at 65% and 75%, respectively.
It is thus evident that is it important to have a positive
SNAP confirmed by the Spec CPL test at a laboratory.
Other conditions where Spec cPL is elevated include
Babesia rossi where 28% of hospitalised cases had a
level >400ug/L, patients with more advanced mitral
valve disease and heart failure had minor increases
(200 – 400 ug/L) and in and a small percentage of
dogs on phenobarbitone and potassium bromide
treatment which had increases between 200-400ug/
L in 13/310 cases and increases >400ug/L in 9/310
Sensitivity of a test means “positivity in disease”, which means a sensitive test has no or few false negatives. The more
sensitive a test the more likely you are to get false positives if your test population is not properly selected.
Specificity means” negativity in health” – which means few or no false positive test results. The more specific a test is
the more likely you are to get a false positive in a poorly selected test population.
With the Spec cPL test: We know that histopathological pancreatic inflammation is present in many animals, which
have mild or no signs of disease. So if we use histopathological changes as the gold standard for pancreatitis the
test may be very specific (very few false positives) but if we were to use “clinically confirmed” pancreatitis using best
available clinical, biochemistry and abdominal ultrasound evidence as our gold standard the specificity will be lower,
more positives in the absence of clinical disease. This makes sense as we know some animals walk around with mild
inflammation and no clinical signs. These numbers are not written in stone as they vary depending on what they are
Take Home Message
• A negative SNAP test makes pancreatitis highly unlikely and thus consider other causes for the
• The Spec cPL and SNAP tests are more sensitive and specific in acute pancreatitis.
• Even if it is a true positive result and the dog does have pancreatitis, it does not mean that it is the
only condition present. Pancreatitis can be both primary and secondary and neither the SNAP
nor the Spec cPL can differentiate between the two. Secondary causes of pancreatitis such as
septic peritonitis or intestinal foreign body will need to be specifically addressed. These tests are
meant to be PART of the diagnostic evaluation and not the initial test to place the patient into a
pancreatitis positive/negative group.
• There are some other disease conditions which appear to cause false positive results and thus
decrease the specificity of the test. Cushing’s disease, chronic glucocorticoid treatment and
elevated triglycerides in Miniature Schnauzers have been shown to cause increased numbers of
positive Snap and Spec cPL results in the absence of clinical pancreatitis. Thus a positive SNAP
and Spec CPL is not diagnostic for pancreatitis.
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The Spec cPL Test is a revolutionary test that allows you to quickly and confidently assess pancreatic health in dogs.How accurate is the SNAP test for dogs? ›
The new SNAP® cPL™ (canine pancreas-specific lipase) Test is an ELISA assay that has a 95% correlation to the reference test method. The SNAP® cPL™ Test can be used pet-side with confidence when working up dogs presenting with vomiting, anorexia, abdominal pain, or other clinical signs of pancreatitis.What is a normal cPL in dogs? ›
Spec cPL was assayed by a monoclonal antibody sandwich ELISA as previously described. 5 According to the manufacturer, the assay has 3 ranges of interpretation: 0–200 μg/L is within the normal reference range; 201–399 μg/L is an equivocal zone; and ≥400 μg/L is consistent with pancreatitis.How much is a pancreatitis test for dogs? ›
First and foremost, your vet will administer a canine pancreatic lipase immunoreactivity test (cPLI) — costing $40-$80 per panel — which will use a small sample of blood to test for high levels of pancreatic enzymes.What level of lipase is concerning? ›
The normal range for adults younger than 60 is 10 to 140 U/L. Normal results for adults ages 60 and older is 24 to 151 U/L. Higher than normal levels of lipase mean that you have a problem with your pancreas. If your blood has 3 to 10 times the normal level of lipase, then it's likely that you have acute pancreatitis.What is abnormal dog cPL? ›
Spec cPL results ≤200 µg/L are consistent with an absence of pancreatic inflammation, while results ≥400 µg/L are consistent with a diagnosis of pancreatitis. Results of 200 to 399 µg/L are considered to be equivocal, and further testing using quantitative analysis is recommended in 2 to 3 weeks.What blood test shows pancreatitis in dogs? ›
A canine pancreatic lipase immunoreactivity (cPLI) test: The cPLI test is a highly accurate test in diagnosing pancreatitis, but the presence of an abnormal cPLI test does not definitely rule in pancreatitis as the sole cause of the clinical signs.What causes dog pancreatitis? ›
Pancreatitis in dogs is an inflammatory reaction within the pancreas that can result in abdominal pain, inappetence, and vomiting. The inflammation results from the inappropriate, early activation of an enzyme within the pancreas, which causes the pancreas to digest itself.How long does it take for a dog to recover from pancreatitis? ›
For milder cases, your dog will need to be in the hospital anywhere from 2 to 4 days. After your dog leaves the hospital you can expect them to have fully recovered after 1 to 2 weeks. For severe cases of pancreatitis, your dog may be hospitalized for up to 2 weeks.Will pancreatitis go away in dogs? ›
Most dogs recover without any long-term consequences. However, with severe or repeated episodes of pancreatitis, one or more of the following problems may develop: If a significant number of cells that produce digestive enzymes are destroyed, a lack of proper food digestion may follow.
Pancreatitis can be quite variable in severity with some dogs not even requiring hospitalization. Any combination of abdominal pain, severe vomiting and diarrhea, and complete loss of interest in eating for days to a week or more can be seen. Unfortunately, bad cases of necrotizing pancreatitis can be fatal.Can a dog live a long life with pancreatitis? ›
Dogs who have a mild bout of pancreatitis can recover fully without any long-term effects. If they remain safe and healthy, they should be able to live a long and full life. However, dogs with severe or chronic pancreatitis can be at risk for developing secondary conditions, such as digestive problems or diabetes.What is considered severe pancreatitis in dogs? ›
Dogs with severe pancreatitis are likely to suffer from symptoms including a loss of appetite, sickness, diarrhoea and lethargy. They may also show signs of abdominal pain and dehydration. In milder forms, symptoms aren't quite as obvious but may still include loss of appetite, lethargy, and diarrhoea.What is a good lipase number? ›
In general, normal results are 0 to 160 units per liter (U/L) or 0 to 2.67 microkat/L (µkat/L).What is abnormal lipase? ›
It's normal to have a small amount of lipase in your blood. But if the cells of your pancreas are damaged, they will release larger amounts of lipase. So high levels of lipase in your blood may mean you have pancreatitis, (an inflamed, swollen pancreas) or another type of pancreatic disease.What does a high lipase indicate? ›
Lipase is an enzyme produced by the pancreas that helps the body digest fats. An elevated amount of lipase in the blood can be a sign that the pancreas is swollen and inflamed, a condition called pancreatitis.What foods can cause pancreatitis in dogs? ›
Acute pancreatitis can occur after a dog eats a fatty food such as pork, beef, and some other human foods. Dogs that get into garbage can develop pancreatitis. Pancreatitis can also have other causes, including certain medications and some viral or bacterial infections.Can pancreatitis be cured? ›
There is no cure for chronic pancreatitis, but the related pain and symptoms may be managed or even prevented. Since chronic pancreatitis is most often caused by drinking, abstinence from alcohol is often one way to ease the pain.How can I treat my dogs pancreatitis at home? ›
When they get home, they'll need to give them lots of water to make sure they don't get dehydrated. They may need medication for pain, too. They may also get drugs to help ease nausea and vomiting. When your dog starts eating again, make sure it's a low-fat diet.What foods should dogs with pancreatitis avoid? ›
Meats high in fat such as lamb and pork should be avoided. Rice is a commonly used ingredient in homemade diets for pancreatic patients. Other ingredients include low fat beef, beef organs (kidney, heart, liver), egg whites, yogurt, barley and cooked vegetables.
- Pupper Chicken Topper.
- Royal Canin Veterinary Diet Canine Gastrointestinal LF Low Fat. ...
- Earthborn Holistic Weight Control Grain-Free Dry Dog Food. ...
- Natural Balance L.I.D.
In a dog with pancreatitis, however, the enzymes activate when they're released, inflaming and causing damage to the pancreas and its surrounding tissue and other organs. According to the Whole Dog Journal, the enzymes can actually begin to digest the pancreas itself, which causes extreme pain to your dog.What vegetables are good for dogs with pancreatitis? ›
There are a few vegetables that are safe for dogs with pancreatitis. These include carrots, green beans, and sweet potatoes. Avoid giving your dog raw vegetables as they may be hard to digest. Stick to cooked or canned vegetables that are soft and easily digestible.What meat causes pancreatitis in dogs? ›
One of the most common foods involved in the cause of pancreatitis is pork or pork products. Many dogs can tolerate and have digested ham, sausage, and pepperoni, but many others have died from the complications of pancreatitis after doing so. The fat in pork products seems to be very taxing on a dog's G.I.How likely is a dog to survive pancreatitis? ›
Prognosis. Most mild cases of pancreatitis recover after 2 to 3 days of therapy and have a good prognosis. The more severe cases have a guarded prognosis and often require a hospital stay of a week or longer.How often should you feed a dog recovering from pancreatitis? ›
How many times should you feed a dog with pancreatitis? If your dog has pancreatitis, you should feed your dog about 4-5 times a day in small quantities.Do dogs with pancreatitis drink a lot of water? ›
A pet with pancreatitis will exhibit some or all of the following signs: lack of appetite, frequent vomiting and diarrhea which may contain blood. A pet may also drink more water than usual and vomit it soon after consumption.Is chicken OK for dogs with pancreatitis? ›
For a dog with pancreatitis, it is best to avoid high fat diets. Protein sources such as lamb and beef are usually too high in fat and may cause problems for dogs with chronic pancreatitis. Instead, look for low fat proteins like chicken or turkey, non-oily fish, or even lean game meat.Can dogs recover from pancreatitis at home? ›
If your dog has a serious case of acute pancreatitis, he needs veterinary care early on. It's a very serious condition … so please don't try to manage severe acute pancreatitis yourself at home. Don't feel bad if your dog gets some emergency medications in the clinic.Should I euthanize my dog with chronic pancreatitis? ›
Some animals may be very severely ill with pancreatitis and will not recover despite treatment. Sadly in these cases euthanasia may be the kindest option to prevent suffering..
Treating a Dog's Pancreatitis. Mild cases of pancreatitis can be treated on an outpatient basis. As we said before, all you have to do is withhold food and water for 36 to 48 hours and then reintroduce food with a bland diet. “One of the key things is to make sure to feed a diet that's low fat,” says Dr.Is pancreatitis curable in older dogs? ›
There is no specific cure for pancreatitis, fortunately though most dogs recover with appropriate supportive treatment. Supportive measures include giving an intravenous drip (to provide the body with necessary fluid and salts) and the use of medications which combat nausea and pain.WHAT DOES Cpl measure? ›
CPL is a metric that marketers use to measure how cost-effective campaigns are at generating new leads. CPL helps marketers understand how much of their budget is spent on acquiring new leads for the business and gives them a ROI figure.WHAT DOES Cpl test stand for? ›
SNAP cPL Test for Canine Pancreatitis (canine pancreas-specific lipase) - IDEXX US.How is amyloidosis diagnosed in dogs? ›
- Blood Tests. ...
- Urinalysis. ...
A good CPL according to studies
As a rule, they consider that a good CPL for B2B companies would be below $75. Wordstream estimates the average CPL for B2B at $116.13 for Google Ads in 2021. VisitorQueue estimates CPL at $58 for B2B social media marketing, $75 for LinkedIn advertising, or $53 for email marketing.
Rice is a commonly used ingredient in both commercial and homemade diets for pancreatic patients. Boiled chicken, low fat beef, egg whites, yogurt, barley and cooked vegetables are also considered safe foods for pancreatitis patients.What does a high CPL mean? ›
CPL lets marketing teams know if they're spending an appropriate amount on different avenues of acquiring new leads, such as Google Ads or Facebook Ads. The higher the CPL compared to other businesses in your industry, the less effective the marketing campaign is. Naturally, a lower CPL is considered ideal.What can trigger pancreatitis in dogs? ›
- Diet, particularly high fat diets.
- Hereditary disorders associated with fat metabolism.
- Prior surgery.
- Toxins including chocolate, lilies, zinc and organophosphates.
For milder cases, your dog will need to be in the hospital anywhere from 2 to 4 days. After your dog leaves the hospital you can expect them to have fully recovered after 1 to 2 weeks. For severe cases of pancreatitis, your dog may be hospitalized for up to 2 weeks.
High-fat diets like red meat, organ meat, potato and starchy foods, sugary goods, table scraps, and dairy fats are all to be avoided when your dog is diagnosed with pancreatitis.What are the warning signs of amyloidosis? ›
- Severe fatigue and weakness.
- Shortness of breath.
- Numbness, tingling, or pain in the hands or feet.
- Swelling of the ankles and legs.
- Diarrhea, possibly with blood, or constipation.
- An enlarged tongue, which sometimes looks rippled around its edge.
Average life expectancy varies based on the type of cardiac amyloid (protein), how much the organs are involved and the stage at diagnosis. Based on these factors, the worst case scenario could be six months, while in some cases, life expectancy can be eight to 10 years after diagnosis.Can you survive amyloidosis? ›
Treatment. There is no cure for patients with AL amyloidosis but more frequently patients can go into remission with drug therapy. In our experience, the majority of patients surviving the first six months can often start recovering thereafter and can typically live normal or near normal lives for years to come.