Ultrasonography & Diagnosis of Pancreatitis in Dogs

In the Literature

Gori E, Pierini A, Lippi I, Citi S, Mannucci T, Marchetti V. Evaluation of diagnostic and prognostic usefulness of abdominal ultrasonography in dogs with clinical signs of acute pancreatitis. J Am Vet Med Assoc. 2021;259(6):631-636.

The Research …

Diagnosing acute pancreatitis in dogs can be challenging, and although abdominal ultrasonography can be useful in these patients, studies reporting sensitivity and specificity are limited.^1,2

This study evaluated ultrasonographic changes in dogs with acute pancreatitis and assessed whether findings changed over the first 2 days of hospitalization, as well as possible prognostic use of stratifying ultrasonographic findings as mild, moderate, or severe.

On admission, 24 (64.8%) of 37 dogs with acute pancreatitis had ultrasonographic evidence of pancreatitis; this sensitivity is similar to a previous report of 68%.³ Within 2 days of hospitalization, an additional 10 (27%) dogs had ultrasonographic evidence; 3 (8%) dogs had no ultrasonographic evidence during this period. The sensitivity of abdominal ultrasonography may be significantly increased from 65% to 92% by repeating ultrasonography during hospitalization. This study evaluated a period of 2 days after hospitalization, but a longer period may be more beneficial. 

Stratification of ultrasonographic findings as mild, moderate, or severe had prognostic use; severe findings suggested an increased risk for death. 

Nine of the 10 dogs that did not show ultrasonographic evidence of acute pancreatitis at presentation, but did so within 2 days of presentation, had a serum canine pancreatic lipase immunoreactivity (cPLI) concentration >400 µg/L at presentation, suggesting pancreatitis. Serum cPLI concentrations may increase earlier than abdominal ultrasonographic findings for diagnosis of acute pancreatitis at presentation.

... The Takeaways

Key pearls to put into practice:

• Dogs suspected of having acute pancreatitis with no ultrasonographic evidence at presentation may benefit from repeated ultrasonography within 2 days of hospitalization.

• Although abdominal ultrasound findings of acute pancreatitis alone are not associated with mortality, increase in the ultrasound severity index (ie, mild, presence of a hypoechoic–heterogeneous enlarged pancreas alone; moderate, pancreatic alterations and peripancreatic free fluid; severe, pancreatic alterations and diffuse abdominal hyperechogenicity with free fluid) is associated with increased mortality.

• Serum cPLI concentration may increase before development of ultrasonographic abnormalities in dogs with acute pancreatitis.