Acute pancreatitis in dogs can present with vague clinical signs that overlap with many gastrointestinal conditions, making rapid, accurate diagnosis challenging in general practice. This case study, provided by Dr. Deborah Greco, demonstrates how point-of-care pancreatic lipase testing using the TRUFORMA® diagnostic system enabled immediate diagnosis and successful outpatient management of acute pancreatitis in a 12-year-old Yorkshire Terrier, avoiding costly emergency referral while providing excellent patient care.
Case Presentation: Complex Medical History with Acute GI Signs
Patient Background
Signalment: 12-year-old spayed female Yorkshire Terrier named Lola
Presenting Complaints: Large bowel diarrhea with mucus, vomiting, anorexia, lethargy
Relevant Medical History:
- Hypothyroidism (1 year duration) – managed with levothyroxine 0.2 mg BID
- Hyperadrenocorticism (8 months duration) – treated with trilostane 20 mg BID
- Atopic dermatitis – managed with monthly Cytopoint injections and topical therapy
- Chronic GI sensitivity – maintained on hydrolyzed protein diet
Initial Clinical Course
Timeline of Events:
- Day 1: Normal eating, then midnight vomiting followed by four episodes of mucoid diarrhea
- Weekend: Owner initiated metronidazole, but patient stopped eating and drinking
- Urgent care visit: Received maropitant, B12 injection, and Entyce
- Presentation day: Continued anorexia, lethargy, weakness, and stumbling
Physical Examination Findings:
- Dehydration: 5-6% based on tacky mucous membranes
- Dermatologic lesions: Pyoderma on ventral abdomen and left neck
- General condition: Lethargic and weak with unsteady gait
- Otherwise unremarkable physical examination
Diagnostic Approach: Point-of-Care Testing Strategy
Laboratory Testing Protocol
Minimum Database Collected:
- Complete blood count (CBC)
- Comprehensive serum chemistry profile
- TRUFORMA cPL (canine pancreatic lipase) – point-of-care testing
Key Laboratory Results
Hematology Findings (Suggesting Inflammation):
- WBC: 11.60 K/µL (elevated, reference 5.05-16.76)
- Monocytes: 1.18 K/µL (elevated, reference 0.16-1.12) – indicating inflammatory response
- Platelets: 89 K/µL (thrombocytopenia, reference 148-484) – possible consumption
- Neutrophils: 68.8% suggesting inflammatory process
Chemistry Profile Abnormalities:
- ALT: 136 U/L (elevated, reference 10-125)
- ALP: 399 U/L (elevated, reference 23-212)
- BUN: 41 mg/dL (elevated, reference 7-27) – likely dehydration-related
- Globulin: 5.0 g/dL (elevated, reference 2.5-4.5)
- Cholesterol: 334 mg/dL (elevated, reference 110-320)
Critical Finding – TRUFORMA cPL Result:
- Initial cPL: 1190 µg/L (significantly elevated)
- Reference range: <200 µg/L normal, >400 µg/L consistent with pancreatitis
TRUFORMA Diagnostic System: Enabling Rapid Decision-Making
Point-of-Care Testing Advantages
Immediate Clinical Benefits:
- 15-minute results allowed same-visit treatment planning
- Quantitative measurement provided baseline for monitoring therapy
- Avoided referral delay and expense of emergency hospitalization
- Enabled confident outpatient management with appropriate monitoring
Technology Advantages:
- High accuracy correlating with Texas A&M Spec® cPL
- User-friendly operation requiring minimal training
- Consistent results allowing precise monitoring and unaffected by sample quality
- Multi-test platform for comprehensive point-of-care diagnostics
Clinical Decision Impact
Immediate Treatment Decisions Based on Results:
- Confirmed pancreatitis diagnosis justified specific dietary and medical management
- Baseline cPL value established for therapeutic monitoring
- Outpatient management deemed appropriate based on clinical status and owner compliance
- Referral avoided saving client significant expense while maintaining quality care
Treatment Protocol and Monitoring Strategy
Initial Management Plan
Immediate Interventions:
- Subcutaneous fluid therapy: 100 mL administered in-clinic
- Home fluid therapy: Owner-administered SQ fluids for continued hydration
- Dietary modification: Switched to Purina ProPlan EN gastroenteric low-fat diet
- Medication adjustments: Discontinued metronidazole, continued trilostane and levothyroxine
- Symptomatic support: Fortiflora prescribed for diarrhea management
Monitoring Protocol:
- Serial cPL testing using TRUFORMA diagnostic system
- Clinical assessment for appetite, hydration, and energy level
- Owner communication for home monitoring and compliance
Treatment Response Monitoring
Day 3 Follow-up:
- TRUFORMA cPL: Decreased to 900 µg/L (25% reduction)
- Clinical improvement: Some appetite return, better hydration
- Continued management: SQ fluids and dietary therapy
One Week Follow-up:
- TRUFORMA cPL: Further decreased to 600 µg/L (50% reduction from initial)
- Complications addressed: Worsening dermatitis managed with Cytopoint injection
- Additional treatments: Enrofloxacin for pyoderma, Claro for otitis externa
- Laboratory normalization: Liver enzymes and WBC returning to normal ranges
Eight Days Later:
- TRUFORMA cPL: 314 µg/L (74% reduction from initial value)
- Clinical resolution: Normal appetite, voluntary water consumption, excellent energy
- Laboratory normalization: Complete resolution of liver enzyme elevation and leukocytosis
- Full recovery: Patient returned to normal activity and demeanor
Case Study Analysis: Clinical Lessons
Diagnostic Value of Serial cPL Monitoring
Quantitative Trend Analysis:
- Initial diagnosis: cPL 1190 µg/L confirmed acute pancreatitis
- Early response: cPL 900 µg/L (Day 3) showed treatment effectiveness
- Continued improvement: cPL 600 µg/L (Day 7) supported ongoing management
- Near resolution: cPL 314 µg/L (Day 15) indicated successful treatment
Clinical Correlation: The consistent correlation between decreasing cPL values and clinical improvement validated the treatment approach and provided objective evidence of recovery progress.
Benefits of Point-of-Care Testing
Practice Management Advantages:
- Immediate results enabled same-visit treatment planning
- Cost-effective care avoided expensive emergency referral
- Client confidence improved through rapid diagnosis and monitoring
- Quality outcomes achieved through appropriate treatment and monitoring
Patient Care Benefits:
- Rapid diagnosis prevented delayed treatment
- Appropriate therapy initiated immediately based on objective data
- Successful monitoring ensured treatment effectiveness
- Outpatient management reduced stress and maintained quality of life
TRUFORMA Diagnostic System: Advanced Point-of-Care Technology
The TRUFORMA diagnostic system brings laboratory-quality pancreatic testing directly into veterinary clinics using innovative bulk acoustic wave technology. This advanced system provides quantitative cPL results in 15 minutes, enabling immediate diagnosis and treatment decisions for optimal patient care.
Key Technology Features:
- 15-minute turnaround time for immediate clinical decision-making
- Bulk acoustic wave technology eliminates interference from hemolysis or lipemia
- Quantitative results enable precise treatment monitoring and trend analysis
- Reference laboratory correlation >0.95 for reliable accuracy
- Multi-analyte platform supporting comprehensive diagnostic testing
- Simple operation requiring minimal training for consistent results
Transform your practice’s diagnostic capabilities with rapid, accurate pancreatic testing that enables successful outpatient management of pancreatitis cases like demonstrated in this real-world case study provided by Dr. Deborah Greco.
Visit zomedica.com to discover how the TRUFORMA diagnostic system can revolutionize your approach to gastrointestinal disease diagnosis and management.
