Pathological evidence of pancreatitis in 43 horses (1986-2011)

Diagnostic utility and validity of 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6'-methylresorufin) ester (DGGR) lipase activity in horses with colic

Little is known about the clinical usefulness in horses of the 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6'-methylresorufin) ester (DGGR) lipase assay, a biomarker used in other species for the detection of pancreatitis. The main objectives of this study were to evaluate the prevalence of increased DGGR-lipase activity in horses with signs of colic and investigate its association with, and validity to diagnose, underlying gastrointestinal diseases, treatment method (medical or surgical), and outcome (survival or non-survival). Clinical data from 192 horses presented for colic to a teaching hospital were analysed retrospectively. DGGR-lipase activity was measured in frozen plasma collected within 24 h of presentation. Non-parametric tests and Chi-squared or Fisher's exact tests were used to evaluate differences and associations between DGGR-lipase activity and continuous and categorical variables or outcomes, respectively. Measures of the validity of DGGR-lipase as a diagnostic test were also calculated. Increased DGGR-lipase activity above published reference limits was demonstrated in 30.2% of horses with signs of colic, and was above 2x the upper reference limit (URL) in 15.6%. The median DGGR-lipase activity in horses with large bowel displacement or torsion was significantly higher than the median activity for large bowel impaction and for gastric impaction, dilation, or ulceration. DGGR-lipase activity > 2x URL was significantly associated with surgical treatment, strangulating disease, and non-survival. However, as a diagnostic or screening test for these target outcomes, DGGR-lipase activity was poor to fair consequent to poor sensitivity, poor negative likelihood ratio, and an area under the receiver operating characteristic curve, with optimal cut-offs based on the Youden Index, within reference limits.

Chronic Pancreatitis with Acinar-Ductal Metaplasia and Ductal Dysplasia in a Horse

A 16-year-old Friesian gelding with relapsing colic was humanely destroyed during diagnostic laparotomy due to suspected abdominal neoplasia. On post-mortem examination, the pancreas appeared as a firm mass (20 × 8 × 8 cm). The cut surface had a lobular structure with multiple cavities. Histological examination revealed severe chronic fibrosing pancreatitis with acinar-ductal metaplasia and duct dysplasia, which was considered to be the cause of the recurrent colic. Formation of tubular complexes within a background of acinar-ductal metaplasia is similar to the regressive lesions detected in the human pancreas in the context of inflammation, duct obstruction, cystic fibrosis and neoplasia. Pancreatic acinar-ductal metaplasia and ductal dysplasia are considered to be preneoplastic conditions in man and in the mouse.

Equine pancreatic disease

Equine pancreatic disease is considered rare, and successful treatment is limited. Additionally, antemortem diagnosis of equine pancreatitis is difficult because of the lack of definitive diagnostic tests. Although a paucity of information exists on this entity in the horse, pancreatic disease has typically been shown to be secondary to other gastrointestinal, hepatic, and endocrine conditions. No predisposition based on age, sex, or breed appears to exist, but several conditions predispose a horse to pancreatitis, including grain overload, endocrine disease, and parasite migration. A retrospective search of cases within the archive of the University of Tennessee necropsy database revealed only 4 cases during a 9-year period (2005–2014). In only 1 case was pancreatic disease considered primary, and in the other 3, pathologies often seen concurrently with pancreatic lesions were identified. These included cecal rupture, colonic displacement, neoplasia (lymphocytic leukemia), and pituitary adenoma. A review of available historical data and associated laboratory results are included with the gross and histologic characteristics of pancreatic lesions, in these 4 newly reported cases.