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1370 Pancreatic Lipase Parathyroid Hormone

• Daily variation may occur secondary to with heart murmurs due to cardiomyopathy cardiomyopathy. Echocardiography and EKG
physical exertion, fluid intake, and (likely) (increased NT-proBNP): 71% sensitivity, or Holter monitor recommended.
100% specificity in one study.
circadian rhythm.
VetBooks.ir • NT-proBNP shows promise for distinguish- • Dobermans with NT-proBNP > 735 pmol/L AUTHOR: Carrie L. Flint, DVM, DACVP
EDITOR: Lois Roth-Johnson, DVM, PhD, DACVP
may be at increased risk of occult dilated
ing cats with physiologic heart murmurs
(result within reference interval) from cats

Pancreatic Lipase

Definition • Higher values (>400 mcg/L in dogs, cPL; unknown if drug effect or due to
Lipase produced only by the pancreas. Species- >5.4 mcg/L in cats) are consistent with pancreatitis.
specific assays for canine pancreatic lipase (cPL) pancreatitis.
or feline pancreatic lipase (fPL) include rapid Specimen Collection and Handling
semiquantitative point-of-care tests (SNAP Causes of Abnormally High Levels Serum, 1 mL minimum (red top tube). Unless
cPL, SNAP fPL, IDEXX Laboratories) or a Pancreatitis, especially if acute. Potentially also fasting is clinically contraindicated, fast for 12
quantitative test (Spec cPL, Spec fPL, IDEXX pancreatic neoplasia, hypoperfusion, or trauma. hours, collect blood and remove serum from
Laboratories or Gastrointestinal Laboratory, Animals with the following conditions may clot. Store refrigerated up to 8 days or frozen.
Texas A&M University). These two tests corre- have high values with or without concurrent SNAP test is performed on serum.
late well in dogs; the manufacturer reports high pancreatitis: miniature schnauzers with hyper-
agreement for the feline assay, but independent triglyceridemia; overweight/obese dogs; dogs Relative Cost: $$
evaluation is pending. with heart failure, acute abdominal disease,
hyperadrenocorticism or parvoviral enteritis; Pearls
Synonyms cats with diabetes mellitus or inflammatory • Currently the most sensitive and specific
Pancreatic lipase immunoreactivity (PLI), bowel disease. Intraindividual variability exists blood test for pancreatitis in both dogs and
pancreatic-specific lipase (PSL), canine pan- in healthy dogs, accounting for gray zone or cats.
creatic lipase (cPL), feline pancreatic lipase (fPL) up to 6% false-positive results. • Sensitivity is higher than specificity. Nega-
tive SNAP cPL or normal Spec cPL results
Physiology Next Diagnostic Steps to Consider typically rule out pancreatitis. When results
Leakage from pancreatic exocrine cells occurs if Levels are High are positive, clinical signs, routine laboratory
with pancreatitis and likely neoplasia, hypo- Assess clinical signs, routine laboratory tests tests, and ultrasonography should help dif-
perfusion and trauma. In individual healthy and abdominal ultrasonography. Consider ferentiate pancreatitis from other conditions.
dogs there is considerable biologic variation, quantitative Spec test or DGGR lipase activity • Lipemia, bilirubin, or hemolysis does not
so only increases of ≈5-fold or greater are measurement. interfere with the assay.
considered clinically significant. cPL is cleared
rapidly (<24 hours), so values reflect current Causes of Abnormally Low Levels AUTHOR: Shelley Burton, DVM, MSc, DACVP
EDITOR: Lois Roth-Johnson, DVM, PhD, DACVP
exocrine pancreatic cell leakage. Exocrine pancreatic insufficiency in dogs
(trypsin-like immunoreactivity is a superior
Reference Interval test; p. 1390). Chronic pancreatitis (decreased
• Canine Spec cPL: 0-200 mcg/L; feline Spec exocrine tissue).
fPL: 0-3.5 mcg/L
• Gray zone values (201-399 mcg/L in dogs, Drug Effects
3.6-5.3 mcg/L in cats) suggest pancreatitis; Dogs treated with phenobarbital, potassium
retesting is recommended. bromide, or prednisolone may have increased

Parathyroid Hormone

Definition gastrointestinal (GI) tract to increase serum Reference Interval
Hormone produced by parathyroid glands in calcium levels. In the kidney, renal excretion Dogs and cats: 2-13 pmol/L (approximate; exact
response to low blood calcium levels; important of phosphate increases, tubular resorption of range is laboratory specific)
in the rapid and precise regulation of calcium calcium increases, and vitamin D precursors
are converted to active vitamin D (which, Causes of Abnormally High Levels
Synonyms along with PTH, increases calcium absorption Hyperparathyroidism: primary hyper-
Parathormone, PTH from the GI tract). PTH mobilizes calcium parathyroidism (parathyroid adenoma/
and phosphate from bone. Ultimately, these hyperplasia); multiple endocrine neo-
Physiology actions increase blood calcium and reduce plasia, chronic kidney disease (renal
Parathyroid hormone (PTH) acts directly phosphate. secondary hyperparathyroidism); pseudohy-
on bone and kidney and indirectly on the perparathyroidism (decreased PTH-receptor

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