Page 630 - Clinical Small Animal Internal Medicine

598 Section 6 Gastrointestinal Disease

VetBooks.ir Dog presents with clinical signs of acute pancreatitis

Routine clinical pathology (biochemistry, hematology, electrolytes) and
if possible blood gas analysis and urine analysis

Results consistent with specific Results NOT consistent with
metabolic disease specific metabolic disease

Further diagnostic testing Abdominal radiographs
and treatment as required

Evidence of intestinal No specific
obstruction Suggestion of abnormalities
free fluid

Abdominocentesis and fluid
analysis

SNAP cPL or Specific canine
pancreatic lipase or serum
pancreatic elastase-1 or total
Septic Sterile lipase
exudate exudate

Surgical exploration of abdomen
once animal is considered stable Abdominal
enough for anesthesia. ultrasound
Evidence of
surgical abdominal
disease

Abnormal pancreas with
No identifiable abnormalities on remainder abdomen normal on
abdominal ultrasound abdominal ultrasound

Abnormal SNAP cPL or increased
Normal SNAP cPL/cPLI/cPE-1 cPLI/cPE-1 Normal SNAP cPL/cPLI/cPE-1

Unlikely primary pancreatitis. Treat for non-
specific gastrointestinal disease and re-evaluate Likely primary pancreatitis. Confirm with pancreatic
if poor response. cytology if discordant results or repeat ultrasound
examination.

Figure 55.5 A diagnostic algorithm for the diagnosis of acute pancreatitis in the dog. Source: Mansfield (2013). Reproduced with
permission of Elsevier.