Cridge et al (2023) performed a study to examine whether there was a relationship between ionised calcium and pancreatic lipase in dogs, and to ascertain whether there was a correlation between improving hypercalcaemia and pancreatic lipase concentrations in dogs that had received treatment for primary hyperparathyroidism. In the first part of the trial, 44 serum samples were analysed for pancreatic lipase levels, and in the second part, 24 serum samples from dogs with primary hyperparathyroidism were tested before and after correction of calcium levels. The initial results showed a negative correlation between ionised calcium and pancreatic lipase levels. In the second part of the trial, pancreatic lipase levels were higher before treatment of hypercalcaemia than after, although this was not statistically significant. The authors conclude that there is an inverse relationship between pancreatic lipase and ionised calcium in dogs in which there was an indication for pancreatic lipase to be measured, and that hypercalcaemia may cause an elevation in levels of pancreatic lipase.
As well as calcium concentration changes, pancreatitis may be associated with hyperglycaemia. Kim et al (2023) performed a retrospective cohort study to evaluate the relationship between hyperglycaemia and pancreatic lipase in diabetic dogs. In total, 26 dogs were included in the study and were grouped according to well-controlled or poorly-controlled diabetic status by fructosamine levels. Around 20% of the dogs had pancreatic lipase levels suggestive of pancreatitis, two of which had ultrasonographic findings consistent with pancreatitis. Pancreatic lipase levels were higher in the poorly-controlled group than in the well-controlled group. A positive correlation between fructosamine concentration and pancreatic lipase was found. The authors concluded that chronic hyperglycaemia may cause pancreatitic inflammation, but the clinical significance of this is uncertain.
Treatment of acute pancreatitis currently consists of supportive treatment to manage the signs of pain and vomiting, and the physiological derangements such as shock. Steiner et al (2023) report a randomised, blinded, placebo-controlled trial to assess the safety and efficacy of fuzapladib in the treatment of acute pancre-atitis. Fuzapladib is a novel leukocyte function-associated antigen type-1 activation inhibitor which may reduce the progression of pancreatitis by blocking the activation, adhesion and migration of neutrophils. The study included 61 dogs with presumed acute pancreatitis. The drug was well tolerated in all cases, and improvement in clinical activity index was significantly higher in the treatment group than the placebo group. No difference was found in other parameters measured, such as pancreatic lipase concentration and C-reactive protein. The authors concluded that fuzapladib appears to be safe in dogs, and that it showed evidence of a positive response in clinical activity score. Further studies are needed to evaluate survival and duration of hospitalisation after treatment with fuzapladib.