Pancreatitis in Cats: Pancreas-Specific Lipase

What is pancreatitis?

Pancreatitis is a disease caused by inflammation of the pancreas. The pancreas is a small, vital organ on the right side of the abdomen, between the stomach and the small intestine. The pancreas has many functions related to digestion and the regulation of blood sugar levels.

In cats, inflammation of the pancreas is often part of a more extensive inflammatory condition that typically involves the liver and intestine, as well as the pancreas. Clinical signs are often vague and non-specific, including lethargy, poor appetite, weight loss, and dehydration. Some cats may have intermittent vomiting or diarrhea and may show signs of abdominal pain.

Can routine tests be used to diagnose pancreatitis?

Routine blood tests such as the complete blood count (CBC) and biochemistry profile usually reveal a variety of changes. These changes are not specific for pancreatitis, and most indicate the involvement of other organ systems. Two enzymes that have a small role in diagnosing pancreatitis in the dog, serum amylase and serum lipase, do not help diagnose pancreatitis in the cat.

What is pancreas-specific lipase?

Pancreas-specific lipase is a digestive enzyme that is only produced in the pancreas. When the pancreas is inflamed, levels of pancreatic-specific lipase often increase.

How is pancreas-specific lipase measured?

Pancreas-specific lipase is measured with a test called feline pancreatic lipase immunoreactivity (fPLI). The test requires only a simple blood test. In specific cases, your vet may recommend fasting (not eating for 12 hours) before the blood sample is taken. There are several versions of the fPLI test that can be used in-clinic. The SNAP fPL© from IDEXX is a rapid “pet-side” test that takes only a few minutes and can give a positive or negative result, while newer in-clinic tests such as the Catalyst® pancreatic lipase test give a number value. These results help confirm the diagnosis of pancreatitis and provide a starting point or baseline that can be used to monitor the pet’s progress after treatment is started.

How reliable is the fPLI test?

Studies show that the fPLI test is highly reliable for diagnosing pancreatitis in cats with moderate to severe pancreatitis. Cats with mild disease are more difficult to diagnose reliably. However, fPLI outperforms all other blood tests and is considered the best for diagnosing pancreatitis in cats.

Can fPLI be used to monitor cats receiving treatment for pancreatitis?

Yes, fPLI may be useful in monitoring response to treatment. Pancreas-specific lipase is cleared from the blood very quickly in healthy pets. A rapidly falling fPLI, together with improvement in the cat's condition and improvement in ultrasound findings, may indicate a good response to treatment.

When should fPLI be used?

The fPLI test should be considered for the following:

• Cats with signs of illness consistent with pancreatitis (e.g., lethargy, poor appetite, weight loss, vomiting)
• Cats with liver or intestinal disease, which often accompanies pancreatitis in cats
• Cats recently diagnosed as diabetic or diabetic cats with poorly controlled disease (these cats may have underlying pancreatitis, making diabetes harder to control)