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Szkopek D, Pierzynowski SG, Pierzynowska K, Zaworski K, Kondej A, Wychowański P, Konieczka P, Seklecka B, Donaldson J, Jank M, Woliński J. A review: Pancreatic enzymes in the treatment of chronic pancreatic insufficiency in companion animals. J Vet Intern Med 2024; 38:2026-2033. [PMID: 38721836 PMCID: PMC11256127 DOI: 10.1111/jvim.17096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 04/18/2024] [Indexed: 07/19/2024] Open
Abstract
The purpose of this review was to analyze the scientific literature on exocrine pancreatic insufficiency (EPI) in dogs and cats and our own research on porcine model to compare animal- and microbial-derived enzymes in the treatment of animals with this disease. Clinical signs of EPI occur when more than 85% of the pancreatic parenchyma is non-functional. EPI can be a consequence of various diseases. The insufficient activity or deficiency of pancreatic enzymes leads to impaired digestion and absorption, and consequently, to malnutrition. The primary treatment for enzyme insufficiency is pancreatic enzyme replacement therapy (PERT). PERT in animals with EPI is a lifetime therapy. Most commercially available products are of animal origin (processed pancreata obtained from a slaughter house) and contain lipases, alpha-amylase, and proteases. Enzymes of microbial and plant origin seem to be a promising alternative to animal-derived enzymes, but to date there are no registered preparations containing all enzymes simultaneously for use in clinical practice to treat EPI. Results from some previous studies have highlighted the "extra-digestive" functions of pancreatic enzymes, as well as the actions of pancreatic-like microbial enzymes. For example, trypsin activates protease-activated receptor and provokes maturation of enterocytes and enterostatin inhibits fat absorption. It has been postulated that intrapancreatic amylase is the main component of the acini-islet-acinar axis-the reflex which down regulates insulin release, while gut and blood amylase exhibit anti-incretin actions "per se." Additionally, high but still physiological blood amylase activity coincide with physiological glucose homeostasis and a lack of obesity.
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Affiliation(s)
- Dominika Szkopek
- Laboratory of Large Animal Models, The Kielanowski Institute of Animal Physiology and NutritionPolish Academy of Sciences, Instytucka 3JabłonnaPoland
| | - Stefan G. Pierzynowski
- Anara ABTrelleborgSweden
- Department of Medical BiologyWitold Chodźka Institute of Rural MedicineLublinPoland
- Department of BiologyLund UniversityLundSweden
| | - Kateryna Pierzynowska
- Department of BiologyLund UniversityLundSweden
- Department of Animal Physiology, The Kielanowski Institute of Animal Physiology and NutritionPolish Academy of Sciences, Instytucka 3JabłonnaPoland
| | - Kamil Zaworski
- Department of Animal Physiology, The Kielanowski Institute of Animal Physiology and NutritionPolish Academy of Sciences, Instytucka 3JabłonnaPoland
| | - Agata Kondej
- Laboratory of Large Animal Models, The Kielanowski Institute of Animal Physiology and NutritionPolish Academy of Sciences, Instytucka 3JabłonnaPoland
| | - Piotr Wychowański
- Oral Surgery and Implantology Unit, Division of Oral Surgery and Implantology, Department of Head and Neck, Institute of Clinical DentistryFondazione Policlinico Universitario A. Gemelli IRCCS, Universita Cattolica del Sacro CoureRomeItaly
| | - Paweł Konieczka
- Department of Animal Nutrition, The Kielanowski Institute of Animal Physiology and NutritionPolish Academy of Sciences, Instytucka 3JabłonnaPoland
- Department of Poultry Science and ApicultureUniversity of Warmia and Mazury, Oczapowskiego 5OlsztynPoland
| | | | - Janine Donaldson
- School of Physiology, Faculty of Health SciencesUniversity of the WitwatersrandParktown, Johannesburg 2193South Africa
| | - Michał Jank
- Department of Pre‐Clinical Sciences and Infectious Diseases, Faculty of Veterinary Medicine and Animal SciencePoznan University of Life SciencesPoznańPoland
| | - Jarosław Woliński
- Laboratory of Large Animal Models, The Kielanowski Institute of Animal Physiology and NutritionPolish Academy of Sciences, Instytucka 3JabłonnaPoland
- Department of Animal Physiology, The Kielanowski Institute of Animal Physiology and NutritionPolish Academy of Sciences, Instytucka 3JabłonnaPoland
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Todd A, Bennett-Huntley E, Rosendahl J, Schnekenburger J, Uhl W. Comparative Investigation of pH-Dependent Availability of Pancreatic Enzyme Preparations In Vitro. Pharmaceuticals (Basel) 2024; 17:552. [PMID: 38794123 PMCID: PMC11123882 DOI: 10.3390/ph17050552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/13/2024] [Accepted: 04/18/2024] [Indexed: 05/26/2024] Open
Abstract
This study aimed to compare different pancreatic enzyme preparations (PEPs) available in Germany regarding particle geometry and size, and to evaluate enzyme activity under physiologically relevant conditions in vitro. Pancreatic endocrine insufficiency is characterized by deficiency of pancreatic enzymes resulting in maldigestion. It is orally treated by pancreatic enzyme replacement therapy. The formulations differ in their physical properties and enzyme release behavior, potentially resulting in inconsistent dosages and poor interchangeability of products. A total of 25 products were analyzed for particle size and number of particles per capsule. Enzyme activities of lipase, amylase, and protease were measured by digestion of olive oil emulsion, starch, and casein, respectively. To analyze enzyme release, gastric environments were simulated by incubating PEPs at pH 1, 4, or 5. Duodenal conditions were simulated by subsequent incubation at pH 6. Regarding physical properties and enzyme release kinetics, considerable differences between different PEPs were found. Furthermore, compared to the label claim, excess lipase activity was observed for most products, reaching up to 148%. These in vitro results suggest poor interchangeability of PEPs, potentially explained by physical and release characteristics. Physicians and patients should be aware of the potential gap between label claims and the real-life performance of different PEPs.
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Affiliation(s)
- Amy Todd
- Viatris/Mylan Pharma UK Ltd., Sandwich CT13 9ND, UK
| | | | - Jonas Rosendahl
- Department of Internal Medicine I, University Hospital Halle (Saale), 06120 Halle, Germany
| | - Jürgen Schnekenburger
- Biomedizinisches Technologiezentrum (BMTZ), Faculty of Medicine, University of Münster, 48149 Münster, Germany
| | - Waldemar Uhl
- Department of General and Visceral Surgery, St.-Josef-Hospital, Clinic of Ruhr-University Bochum, 44791 Bochum, Germany
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Remmel P, Gros L, Mortier J, Freiche V. Congenital Partial Colonic Agenesis in Dogs and Cats: Clinical, Biological, Diagnostic Imaging, Endoscopic and Histopathologic Characterization, a Retrospective Study. Vet Sci 2023; 10:577. [PMID: 37756099 PMCID: PMC10536647 DOI: 10.3390/vetsci10090577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/28/2023] [Accepted: 09/07/2023] [Indexed: 09/28/2023] Open
Abstract
Congenital diseases of the large intestine of dogs and cats have scarcely been reported and mostly include fistula, atresia or colonic duplication. Cases of partial colonic agenesis have rarely been described. The purpose of this study was to report a cohort of dogs and cats diagnosed with partial colonic agenesis. The colon was measured during colonoscopy or contrast-radiography and compared to the average length described in the literature. Six dogs and 17 cats were retrospectively included. Depending on the case, partial colonic agenesis could represent an incidental finding or the likeliest cause of clinical signs. Diarrhea was reported in most cases, and no specific clinical or biological abnormality was observed. Median age of presentation was variable and long asymptomatic periods were common. Abdominal ultrasound was useful and identified a short colon in 14/17 cats but only in one dog. Endoscopy was useful to confirm the diagnosis and to identify associated lesions and complications. Among others, colonic stenosis was reported in 8/9 cases that had lifelong clinical signs and the shortest colon length. This anatomical abnormality could promote chronic inflammation that might generate fibrosis and ultimately stenosis.
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Affiliation(s)
- Paul Remmel
- Unité de Médecine Interne, Centre Hospitalier Universitaire Vétérinaire d’Alfort (CHUVA), École Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France;
| | - Lucile Gros
- Service d’imagerie Médicale, Département d’Élevage et Pathologie des Équidés et Carnivores (DEPEC), Centre Hospitalier Universitaire Vétérinaire d’Alfort (CHUVA), École Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France
| | - Jérémy Mortier
- Service d’imagerie Médicale, Département d’Élevage et Pathologie des Équidés et Carnivores (DEPEC), Centre Hospitalier Universitaire Vétérinaire d’Alfort (CHUVA), École Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France
| | - Valérie Freiche
- Unité de Médecine Interne, Centre Hospitalier Universitaire Vétérinaire d’Alfort (CHUVA), École Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France;
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Karra DA, Chadwick CC, Stavroulaki EM, Pitropaki MN, Flouraki E, Allenspach K, Lidbury JA, Steiner JM, Xenoulis PG. Fecal acute phase proteins in cats with chronic enteropathies. J Vet Intern Med 2023; 37:1750-1759. [PMID: 37401847 PMCID: PMC10473003 DOI: 10.1111/jvim.16802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 06/21/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Chronic enteropathies (CE) are common in cats and reliable biomarkers that can distinguish different causes and predict or monitor response to treatment are currently lacking. HYPOTHESIS To evaluate certain acute phase proteins in feces that could potentially be used as biomarkers in cats with CE. ANIMALS Twenty-eight cats with either inflammatory bowel disease (IBD; n = 13), food-responsive enteropathy (FRE; n = 3) or small cell gastrointestinal lymphoma (SCGL; n = 12) and 29 healthy control cats were prospectively enrolled. METHODS Fecal concentrations of haptoglobin, alpha-1-acid-glycoprotein (AGP), pancreatitis-associated protein-1 (PAP-1), ceruloplasmin, and C-reactive protein (CRP) were measured using Spatial Proximity Analyte Reagent Capture Luminescence (SPARCL) immunoassays before and after initiation of treatment. Cats were treated with diet and/or prednisolone (IBD cats), plus chlorambucil (SCGL cats). RESULTS Compared with controls, median fecal AGP concentrations were significantly lower (25.1 vs 1.8 μg/g; P = .003) and median fecal haptoglobin (0.17 vs 0.5 μg/g), PAP-1 (0.04 vs 0.4 μg/g) and ceruloplasmin (0.15 vs 4.2 μg/g) concentrations were significantly higher (P < .001) in cats with CE. Median fecal AGP concentrations were significantly lower (P = .01) in cats with IBD and FRE (0.6 μg/g) compared with cats with SCGL (10.75 μg/g). A significant reduction was found in CE cats after treatment for median fecal ceruloplasmin concentrations (6.36 vs 1.16 μg/g; P = .04). CONCLUSIONS Fecal AGP concentration shows promise to differentiate cats with SCGL from cats with IBD and FRE. Fecal ceruloplasmin concentrations may be useful to objectively monitor response to treatment in cats with CE.
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Affiliation(s)
| | | | | | | | | | - Karin Allenspach
- Iowa State UniversityCollege of Veterinary Medicine, Veterinary Clinical SciencesAmesIowaUSA
| | - Jonathan A. Lidbury
- Texas A&M University – Gastrointestinal LaboratoryCollege of Veterinary Medicine & Biomedical SciencesCollege StationTexasUSA
| | - Joerg M. Steiner
- Texas A&M UniversityGastrointestinal LaboratoryCollege StationTexasUSA
| | - Panagiotis G. Xenoulis
- University of ThessalySmall Animal ClinicKarditsaGreece
- Texas A&M UniversityGastrointestinal LaboratoryCollege StationTexasUSA
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Marsilio S, Freiche V, Johnson E, Leo C, Langerak AW, Peters I, Ackermann MR. ACVIM consensus statement guidelines on diagnosing and distinguishing low-grade neoplastic from inflammatory lymphocytic chronic enteropathies in cats. J Vet Intern Med 2023; 37:794-816. [PMID: 37130034 PMCID: PMC10229359 DOI: 10.1111/jvim.16690] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 03/10/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Lymphoplasmacytic enteritis (LPE) and low-grade intestinal T cell lymphoma (LGITL) are common diseases in older cats, but their diagnosis and differentiation remain challenging. OBJECTIVES To summarize the current literature on etiopathogenesis and diagnosis of LPE and LGITL in cats and provide guidance on the differentiation between LPE and LGITL in cats. To provide statements established using evidence-based approaches or where such evidence is lacking, statements based on consensus of experts in the field. ANIMALS None. METHODS A panel of 6 experts in the field (2 internists, 1 radiologist, 1 anatomic pathologist, 1 clonality expert, 1 oncologist) with the support of a human medical immunologist, was formed to assess and summarize evidence in the peer-reviewed literature and complement it with consensus recommendations. RESULTS Despite increasing interest on the topic for clinicians and pathologists, few prospective studies were available, and interpretation of the pertinent literature often was challenging because of the heterogeneity of the cases. Most recommendations by the panel were supported by a moderate or low level of evidence. Several understudied areas were identified, including cellular markers using immunohistochemistry, genomics, and transcriptomic studies. CONCLUSIONS AND CLINICAL IMPORTANCE To date, no single diagnostic criterion or known biomarker reliably differentiates inflammatory lesions from neoplastic lymphoproliferations in the intestinal tract of cats and a diagnosis currently is established by integrating all available clinical and diagnostic data. Histopathology remains the mainstay to better differentiate LPE from LGITL in cats with chronic enteropathy.
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Affiliation(s)
- Sina Marsilio
- Department of Veterinary Medicine and EpidemiologyUC Davis School of Veterinary MedicineDavisCaliforniaUSA
| | - Valerie Freiche
- Ecole Nationale Vétérinaire d'AlfortCHUVA, Unité de Médecine InterneMaisons‐AlfortFrance
| | - Eric Johnson
- Department of Surgical & Radiological SciencesUC Davis School of Veterinary MedicineDavisCaliforniaUSA
| | - Chiara Leo
- Anicura Istituto Veterinario NovaraNovaraItaly
| | | | | | - Mark R. Ackermann
- Oregon Veterinary Diagnostic Laboratory, Oregon State UniversityCorvallisOregonUSA
- Present address:
US Department of AgricultureNational Animal Disease CenterAmesIowaUSA
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Siani G, Mercaldo B, Alterisio MC, Di Loria A. Vitamin B12 in Cats: Nutrition, Metabolism, and Disease. Animals (Basel) 2023; 13:ani13091474. [PMID: 37174511 PMCID: PMC10177498 DOI: 10.3390/ani13091474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/18/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
Cobalamin is a water-soluble molecule that has an important role in cellular metabolism, especially in DNA synthesis, methylation, and mitochondrial metabolism. Cobalamin is bound by intrinsic factor (IF) and absorbed in the ileal tract. The IF in cats is synthesized exclusively by pancreatic tissue. About 75% of the total plasma cobalamin in cats is associated with transcobalamin II, while in this species, transcobalamin I is not present. In cats, the half-life of cobalamin is 11-14 days. Diagnostic biomarkers for B12 status in cats include decreased levels of circulating total cobalamin and increased levels of methylmalonic acid. The reference interval for serum cobalamin concentrations in cats is 290-1500 ng/L, and for the serum methylmalonic acid concentration, it is 139-897 nmol/L. Therapy for hypocobalaminemia mainly depends on the underlying disease. In some cases, subcutaneous or intramuscular injection of 250 μg/cat is empirically administered. In recent years, it has been demonstrated that oral cobalamin supplementation can also be used successfully in dogs and cats as a less invasive alternative to parental administration. This review describes the current knowledge regarding B12 requirements and highlights improvements in diagnostic methods as well as the role of hypocobalaminemia in its associated diseases.
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Affiliation(s)
| | - Beatrice Mercaldo
- Department of Veterinary Medicine and Animal Productions, University Federico II of Napoli, Via F. Delpino 1, 80137 Napoli, Italy
| | - Maria Chiara Alterisio
- Department of Veterinary Medicine and Animal Productions, University Federico II of Napoli, Via F. Delpino 1, 80137 Napoli, Italy
| | - Antonio Di Loria
- Department of Veterinary Medicine and Animal Productions, University Federico II of Napoli, Via F. Delpino 1, 80137 Napoli, Italy
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Roberts E, Dobromylskyj MJ. Histopathological evaluation of the adrenal glands in a cat with primary hypoadrenocorticism and multiple endocrine disease. JFMS Open Rep 2022; 8:20551169221125207. [PMID: 36226303 PMCID: PMC9549196 DOI: 10.1177/20551169221125207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Case summary A 6-year-old male neutered domestic longhair cat was referred for investigation of weight loss, hyporexia, vomiting and diarrhoea. The cat was diagnosed with primary hypoadrenocorticism, exocrine pancreatic insufficiency, cobalamin deficiency and a chronic enteropathy, and started on therapeutic treatment. Diabetes mellitus developed 4.5 months later, and the cat was started on insulin therapy. The cat was euthanased 10 months following the diagnosis of hypoadrenocorticism due to the development of status epilepticus, which was not associated with glucose or electrolyte abnormalities. Histopathological assessment of the adrenal glands at post-mortem examination documented lymphoplasmacytic adrenalitis, with the lymphocytic population being predominant. Immunohistochemical staining classified the lymphocytic infiltrate as T-cell rich, supportive of the cat's hypoadrenocorticism being due to autoimmune disease. Relevance and novel information This case documents the novel use of immunohistochemical staining in combination with histopathology to further assess the adrenal glands in non-neoplastic-associated primary hypoadrenocorticism in a cat. This identified similar pathological changes to those previously described in dogs with autoimmune primary hypoadrenocorticism. Additionally, this is the first report of a cat with multiple endocrine disease that included primary hypoadrenocorticism and highlights that monitoring for the development of additional endocrine disease should be advised in these cases.
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Affiliation(s)
- Emma Roberts
- Highcroft Veterinary Referrals,
Bristol, UK
- Emma Roberts BVetMed (Hons), MVM,
DipECVIM-CA, Highcroft Veterinary Referrals, 615 Wells Road, Bristol BS14 9BE,
UK
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Serial Measurement of Serum Pancreatic Lipase Immunoreactivity, Feline Trypsin-like Immunoreactivity, and Cobalamin Concentrations in Kittens. Vet Sci 2022; 9:vetsci9090469. [PMID: 36136684 PMCID: PMC9501717 DOI: 10.3390/vetsci9090469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022] Open
Abstract
Serum concentrations of feline pancreatic lipase immunoreactivity (fPLI), feline trypsin-like immunoreactivity (fTLI), and cobalamin are commonly used for the diagnostic investigation of cats with gastrointestinal signs. No information on these parameters in healthy cats less than 1 year of age exists. We aimed to evaluate serum concentrations of fPLI, fTLI, and cobalamin in healthy cats at different time-points during their first 12 months of life. Fourteen healthy 2-month-old kittens were included. Blood was collected at 2, 3, 4, 6, and 12 months of age, and serum concentrations of fPLI, fTLI, and cobalamin were measured. While there was a statistically significant difference in serum fPLI concentrations over time, there was no statistically significant difference between individual time-points. There was no significant difference in serum fTLI concentrations over time. Serum cobalamin concentrations were below the reference interval in 3/13 cats at 2 months of age and were significantly lower by 3 months, when 13/14 had hypocobalaminemia. By 12 months, serum cobalamin had significantly increased, yet 4/12 cats still had hypocobalaminemia. Serum fPLI and fTLI concentrations did not show any statistically or clinically significant differences in young kittens. In contrast, serum cobalamin concentrations were commonly below the reference interval in kittens. Serum fPLI and fTLI concentrations are not practically affected by age in kittens as young as 2 months of age and could be used for the investigation of pancreatic diseases.
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Konishi K, Okazaki S, Kono S, Nakamura T, Ushigusa T. Successful treatment of pyruvate kinase deficiency and inflammatory bowel disease comorbid with exocrine pancreatic insufficiency and hypocobalaminaemia in a cat. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Keisuke Konishi
- Yokohama Animal Medical Center Kannai Animal Clinic Yokohama Japan
| | - Seiji Okazaki
- Yokohama Animal Medical Center Kannai Animal Clinic Yokohama Japan
| | - Shota Kono
- Yokohama Animal Medical Center Kannai Animal Clinic Yokohama Japan
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Xenoulis PG, Moraiti KT, R Finco D, Suchodolski JS, Steiner JM. Serum feline pancreatic lipase immunoreactivity and trypsin-like immunoreactivity concentrations in cats with experimentally induced chronic kidney disease. J Vet Intern Med 2021; 35:2821-2827. [PMID: 34738673 PMCID: PMC8692220 DOI: 10.1111/jvim.16296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 10/06/2021] [Accepted: 10/12/2021] [Indexed: 12/29/2022] Open
Abstract
Background Serum feline pancreatic lipase immunoreactivity (fPLI) and trypsin‐like immunoreactivity (fTLI) concentrations are commonly used in cats for the evaluation of pancreatic disease. The effect of kidney disease on these tests in cats are unknown. Objective To investigate the effect of experimentally induced chronic kidney disease (CKD) on serum fPLI and fTLI concentrations. Animals Surplus serum samples from 20 cats with CKD experimentally induced for an unrelated project and a group of healthy control cats. Methods Serum fTLI and fPLI concentrations were compared between groups. Results Mean (±SD) serum fTLI concentrations in 20 cats with CKD (117.8 ± 63.6 μg/L) were significantly higher than those in healthy cats (n = 32; 46.9 ± 17.5 μg/L; P < .0001). Serum fTLI concentrations in cats with CKD were above the upper limit of the reference interval in 13 of 20 cats (65%). Serum fPLI concentrations were not significantly different between cats with induced CKD (n = 18; 8.6 μg/L; range, 5.4‐9.9 μg/L) and healthy cats (n = 41; 7.4 μg/L; range, 5.0‐15.2 μg/L; P = .12). All cats with experimentally induced CKD had serum fPLI concentrations within the reference interval. Conclusions and Clinical Importance Decreased renal function has a clinically relevant impact on serum fTLI concentrations and potentially could interfere with a diagnosis of exocrine pancreatic insufficiency (EPI). Serum fPLI concentration was not affected by experimentally induced CKD and thus serum fPLI may be used for the diagnosis of pancreatitis in cats with kidney disease. Additional studies are needed to verify these results in cats with naturally occurring CKD.
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Affiliation(s)
- Panagiotis G Xenoulis
- Texas A&M University, College of Veterinary Medicine and Biomedical Sciences, Gastrointestinal Laboratory, College Station, Texas, USA.,Small Animal Clinic, University of Thessaly, Karditsa, Greece
| | | | - Delmar R Finco
- Department of Physiology and Pharmacology, University of Georgia, Athens, Georgia, USA
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EXOCRINE PANCREATIC INSUFFICIENCY-LIKE SYNDROME IN FOUR CAPTIVE TIGERS ( PANTHERA TIGRIS). J Zoo Wildl Med 2021; 52:1079-1083. [PMID: 34687527 DOI: 10.1638/2019-0195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2021] [Indexed: 11/21/2022] Open
Abstract
Exocrine pancreatic insufficiency (EPI) is a condition characterized by a decreased synthesis and secretion of pancreatic enzymes, which results in weight loss, poor hair coat, and diarrhea. The diagnostic test of choice for EPI in domestic cats is feline serum trypsin-like immunoreactivity (fTLI). This paper details four tigers (Panthera tigris) with clinical signs compatible with EPI. On the basis of domestic cat reference ranges, fTLI assays for all four clinically affected tigers were diagnostic for EPI (median 1.0 µg/L; range 0.5-1.2 µg/L). All four tigers had a rapid clinical response to pancreatic enzyme supplementation. Serum from 10 clinically healthy tigers was submitted for the fTLI assay, for comparative purposes. The healthy tigers' fTLI assays were also within range for a diagnosis of EPI in domestic cats (median 3.1 µg/L; range 1.9-4.5 µg/L); however, clinically affected tigers had significantly lower serum fTLI concentrations than healthy tigers (P = 0.0058). Serum cobalamin was below the detection limit in both the affected and healthy tigers (<150 ng/L). Measuring fTLI appears to be a useful tool in the diagnosis of EPI-like syndrome in tigers. As in other species, EPI-like syndrome in tigers may also be associated with cobalamin deficiency.
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12
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Ewald N, Rödler F, Heilmann RM. [Chronic enteropathies in cats - diagnostic and therapeutic approach]. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2021; 49:363-376. [PMID: 34670312 DOI: 10.1055/a-1584-9705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Chronic enteropathies are characterized by persistent or recurrent gastrointestinal signs including vomiting, diarrhoea, weight loss, anorexia and lethargy for a minimum duration of 3 weeks. Diagnosis is by excluding other disease processes and includes faecal examinations, blood screenings (e. g., thyroidal, pancreatic, liver dysfunctions, investigation for infectious diseases, vitamin B12 status), diagnostic imaging, histopathological evaluation using biopsies from several different gastrointestinal segments and the response to therapeutic trials. Chronic inflammatory enteropathies are classified as food-responsive enteropathy (FRE), antibiotic-responsive enteropathy (ARE), immunosuppressant-responsive or, similarly -refractory enteropathy (IRE). Small-cell (low-grade) alimentary lymphoma (LGAL), a crucial differential diagnosis, is predominantly seen in older cats. The feline chronic enteropathy activity index (FCEAI), a clinical scoring system, was established to objectively assess the severity of clinical illness and to evaluate the response to treatment. In general, the prognosis depends on the underlying aetiology. Cats diagnosed with FRE typically have a good long-term prognosis with adequate dietary management. The response to treatment varies in cats with IRE, with same cats experiencing frequent relapses of clinical signs and still others being non-responsive to treatment. Prognosis for LGAL, with adequate treatment, is usually fair to good (median survival time 510-704 days).
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Affiliation(s)
- Nicole Ewald
- Kleintierzentrum am Schmelzbach, Fachpraxis für Kleintiermedizin
| | - Frauke Rödler
- Klinik für Kleintiere, Veterinärmedizinische Fakultät, Universität Leipzig
| | - Romy M Heilmann
- Klinik für Kleintiere, Veterinärmedizinische Fakultät, Universität Leipzig
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Cyclosporine Treatment in Cats with Presumed Chronic Pancreatitis-A Retrospective Study. Animals (Basel) 2021; 11:ani11102993. [PMID: 34680012 PMCID: PMC8532754 DOI: 10.3390/ani11102993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/10/2021] [Accepted: 10/12/2021] [Indexed: 12/03/2022] Open
Abstract
Simple Summary Chronic pancreatitis (CP) is a common disease in middle-aged to older cats. Cyclosporine, an immunosuppressive drug, has been suggested as an alternative treatment when other drugs that suppress inflammation are ineffective or unsuitable. However, no published studies have investigated its efficacy in cats with CP. The aim of this retrospective study was to evaluate the efficacy of cyclosporine as a treatment for pancreatitis in cats with presumed CP. All cats had a history and clinical signs suggestive of CP and blood samples showed abnormally high concentrations of feline pancreas-specific lipase (Spec fPL) on at least two occasions. This is common in CP. All cats were treated with cyclosporine for at least three weeks. Nineteen cats, aged 6.9–17.5 years, were included. Daily treatment with cyclosporine resulted in an improvement of serum Spec fPL concentrations which indicates that the pancreatic inflammation likely had improved. The study has several limitations, including different treatment durations and doses, lack of biopsies to confirm CP and the treatment effect was not compared with an untreated control group. Despite the limitations, our results suggest that cyclosporine treatment decreases serum Spec fPL concentrations and may be effective in the management of feline chronic pancreatitis. Abstract Chronic pancreatitis (CP) is a common disease in middle-aged to older cats. Cyclosporine has been suggested as an alternative treatment when other immunosuppressive treatments are insufficient or contraindicated. However, no published studies have investigated its efficacy on feline CP. The aim of this retrospective study was to evaluate the efficacy of cyclosporine on supranormal serum feline pancreas-specific lipase (Spec fPL) concentrations in cats with presumed CP. Inclusion criteria were history and clinical signs suggestive of CP, serum Spec fPL concentrations above 5.3 μg/L (reference range 0–3.5 μg/L, equivocal range 3.6–5.3 μg/L) on at least two occasions and treatment with cyclosporine for at least three weeks. Serum Spec fPL was analyzed at Idexx Laboratories, Kornwestheim, Germany. Nineteen cats, aged 6.9–17.5 years (median 11.6), were included. No pancreatic biopsies were available. Median (range) serum Spec fPL concentration was 14.2 μg/L (6.1–43.3) at baseline and 6.7 μg/L (0.9–23.6) at follow-up. Cyclosporine treatment (5.0–7.9 mg/kg orally SID) was associated with a significant reduction in serum Spec fPL concentrations (p < 0.001) at follow-up after 23–206 days (median 35). Body weight decreased significantly between inclusion and follow-up (p = 0.013). Significant improvement of clinical signs could not be measured (p = 0.781). This study has several limitations, including unstandardized treatment length and dose, no control group and lack of pancreatic biopsies. Despite the limitations, our results suggest that cyclosporine treatment reduces supranormal serum Spec fPL concentrations in cats with presumed CP.
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Auger M, Fazio C, Steiner JM, Penninck DG, Levine GJ, Griffin JF, Springer CM. Abdominal ultrasound and clinicopathologic findings in 22 cats with exocrine pancreatic insufficiency. J Vet Intern Med 2021; 35:2652-2661. [PMID: 34596279 PMCID: PMC8692186 DOI: 10.1111/jvim.16267] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/04/2021] [Accepted: 09/10/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Awareness of exocrine pancreatic insufficiency (EPI) in cats has increased since the development of an assay for feline trypsin-like immunoreactivity (fTLI). Ultrasound findings in cats with EPI have only been reported rarely and described as nonspecific. HYPOTHESIS/OBJECTIVES To describe the ultrasonographic findings, clinical signs, and concurrent diseases in cats with EPI. ANIMALS Twenty-two client-owned cats with EPI. METHODS Multicenter retrospective descriptive study including cats with serum fTLI concentration ≤8 μg/L and an abdominal ultrasound examination performed within 6 weeks of fTLI measurement. Sonographic measurements of maximal pancreatic thickness and maximal pancreatic duct diameter as well as ratios of pancreatic duct diameter to pancreatic thickness were obtained. Additional sonographic findings, concurrent conditions, and clinical signs were recorded. RESULTS The most common clinical sign was weight loss (15/22 cats). Chronic enteropathy was the most common concurrent disease (13/22 cats). In 39% of cats, the pancreas had minimal or no sonographic alterations. Pancreatic duct dilatation (>2.5 mm), pancreatic duct tortuosity with variable diameter, or both were seen in 6/13 cats. The pancreatic parenchyma was subjectively thin in 6 cats. A significant relationship was found between subjectively thin pancreatic parenchyma and increased pancreatic duct size : pancreatic thickness ratio (P = .004). Diffuse gastrointestinal dilatation with echogenic content was observed in 8/22 cats. CONCLUSION Exocrine pancreatic insufficiency often causes minimal to no sonographic pancreatic changes. Nonetheless, the findings of thin pancreatic parenchyma, pancreatic duct dilatation, or diffuse small intestinal dilatation with echogenic contents in cats with unexplained weight loss or unformed feces should raise clinical suspicion for EPI.
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Affiliation(s)
- Mylène Auger
- Animages, Longueuil, Quebec, Canada.,Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee, USA
| | - Constance Fazio
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee, USA
| | - Joerg M Steiner
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Dominique G Penninck
- Foster Hospital for Small Animals, Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
| | - Gwendolyn J Levine
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - John F Griffin
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Cary M Springer
- Research Computing Support, University of Tennessee, Knoxville, Tennessee, USA
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15
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Barko PC, Williams DA. Untargeted analysis of the serum metabolome in cats with exocrine pancreatic insufficiency. PLoS One 2021; 16:e0257856. [PMID: 34591942 PMCID: PMC8483406 DOI: 10.1371/journal.pone.0257856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/12/2021] [Indexed: 11/18/2022] Open
Abstract
Exocrine pancreatic insufficiency (EPI) causes chronic digestive dysfunction in cats, but its pathogenesis and pathophysiology are poorly understood. Untargeted metabolomics is a promising analytic methodology that can reveal novel metabolic features and biomarkers of clinical disease syndromes. The purpose of this preliminary study was to use untargeted analysis of the serum metabolome to discover novel aspects of the pathobiology of EPI in cats. Serum samples were collected from 5 cats with EPI and 8 healthy controls. The diagnosis of EPI was confirmed by measurement of subnormal serum feline trypsin-like immunoreactivity (fTLI). Untargeted quantification of serum metabolite utilized ultra-high-performance liquid chromatography-tandem mass spectroscopy. Cats with EPI had significantly increased serum quantities of long-chain fatty acids, polyunsaturated fatty acids, mevalonate pathway intermediates, and endocannabinoids compared with healthy controls. Diacylglycerols, phosphatidylethanolamines, amino acid derivatives, and microbial metabolites were significantly decreased in cats with EPI compared to healthy controls. Diacyclglycerols and amino acid metabolites were positively correlated, and sphingolipids and long-chain fatty acids were negatively correlated with serum fTLI, respectively. These results suggest that EPI in cats is associated with increased lipolysis of peripheral adipose stores, dysfunction of the mevalonate pathway, and altered amino acid metabolism. Differences in microbial metabolites indicate that feline EPI is also associated with enteric microbial dysbiosis. Targeted studies of the metabolome of cats with EPI are warranted to further elucidate the mechanisms of these metabolic derangements and their influence on the pathogenesis and pathophysiology of EPI in cats.
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Affiliation(s)
- Patrick C. Barko
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
- * E-mail:
| | - David A. Williams
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
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16
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Sorrell S. Diagnosing and treating chronic vomiting in cats. IN PRACTICE 2021. [DOI: 10.1002/inpr.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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17
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Signalment and Clinical Data of Cats with Exocrine Pancreatic Insufficiency Diagnosed Using Feline Trypsin-like Immunoreactivity in Routine Diagnostics. Vet Sci 2021; 8:vetsci8080155. [PMID: 34437477 PMCID: PMC8402856 DOI: 10.3390/vetsci8080155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/21/2021] [Accepted: 07/30/2021] [Indexed: 11/16/2022] Open
Abstract
Serum feline trypsin-like immunoreactivity (fTLI) is commonly used to diagnose feline exocrine pancreatic insufficiency (EPI). This study aimed to describe signalment and clinical data of cats with EPI. Determination of TLI was performed using an in-house ELISA; the reference interval was defined using a Reference Limit Estimator. Groups were formed from 4813 cats (2019-2020), based on their fTLI concentration: 1 (<8 µg/L; decreased; n = 275), 2 (8-88 µg/L; reference interval; n = 4256), and 3 (>88 µg/L; increased; n = 282). Males and Domestic Shorthairs were most common in all groups. Group 3 had the highest (13 years), and group 1 had the lowest (9 years), median age. Clinical information was available for 200 cats (decreased fTLI: n = 87, lower reference interval (8-12 µg/L): n = 113). Treatment response was observed in 83% (decreased fTLI) and 66% (lower reference interval). EPI cats displayed weight loss (69%), diarrhoea (68%), vomiting (41%), anorexia (39%), poor hair coat (35%), lethargy (33%), and/or polyphagia (21%). The lower the serum fTLI concentration, the more often good treatment response was reported (p = 0.022) but there were no statistically significant clinical signs. In conclusion, fTLI is a helpful parameter to diagnose EPI but predicting treatment response based on signalment or clinical signs is not possible.
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Marsilio S. Differentiating Inflammatory Bowel Disease from Alimentary Lymphoma in Cats: Does It Matter? Vet Clin North Am Small Anim Pract 2021; 51:93-109. [PMID: 33187624 DOI: 10.1016/j.cvsm.2020.09.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Differentiation of feline inflammatory bowel disease and intestinal small cell lymphoma can be challenging, and some clinicians argue that it is unnecessary because prognosis and treatment are similar. Differentiation of feline inflammatory bowel disease and intestinal small cell lymphoma can be challenging and some clinicians argue that it is unnecessary since prognosis and treatment are similar. Altough the body of research on this topic has increased over time, we still know little about etiopathogenesis, progression, alternative treatment modalities and prognosis of the different forms of FCE. While differentiating IBD from SCL might not alter a single patients' disease course, further research efforts are required to alter the disease course for our feline patient population as a whole.
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Affiliation(s)
- Sina Marsilio
- Department of Veterinary Medicine and Epidemiology, UC Davis School of Veterinary Medicine, Tupper Hall, 1275 Med Science Drive, Davis, CA 95616, USA.
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19
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Marsilio S. Feline chronic enteropathy. J Small Anim Pract 2021; 62:409-419. [PMID: 33821508 DOI: 10.1111/jsap.13332] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/24/2021] [Accepted: 03/05/2021] [Indexed: 01/22/2023]
Abstract
Feline chronic enteropathy is a common disorder, especially in the senior cat population, with rising incidence over the past decade. Feline chronic enteropathy is considered an umbrella term comprising different diseases including food-responsive enteropathy, idiopathic inflammatory bowel disease and alimentary small cell lymphoma. However, differentiation between those diseases is often difficult in practice. This review will discuss the clinical approach to cats with chronic enteropathy, state-of-the-art diagnostic tests and pitfalls thereof as well as current therapeutic approaches. Although, much of the etiopathogenesis is still unknown, increased research efforts in this field have brought new insights into diagnostic and therapeutic options for these cats.
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Affiliation(s)
- S Marsilio
- School of Veterinary Medicine, Department of Medicine and Epidemiology, University of California, One Shields Avenue, Davis, CA, 95616, USA
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20
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Allan F, Peschard AL, Schiavo L, Bayton W, Corbetta D, McCallum KE. Obstructive pancreatolithiasis in a cat with triaditis and concurrent hypercalcaemia. JFMS Open Rep 2021; 7:2055116921998494. [PMID: 35154801 PMCID: PMC8825244 DOI: 10.1177/2055116921998494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Case summary A 7-year-old neutered female domestic longhair cat was presented for further investigation of suspected hepatobiliary disease. Increases in serum 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6'-methylresorufin) ester lipase and hepatobiliary enzymes, with concurrent hypoalbuminaemia, were documented on blood biochemistry. Abdominal ultrasonography findings were consistent with acute pancreatitis with multiple pancreatoliths visualised within the pancreatic duct. Treatment for suspected triaditis was initiated with a hydrolysed protein diet, amoxicillin-clavulanate, hepatoprotectants and buprenorphine. Fifty-three days later, the patient presented with hypercalcaemia and obstructive pancreatolithiasis, and was euthanased. Post-mortem examination revealed severe chronic active pancreatitis with moderate chronic lymphocytic, plasmacytic cholangiohepatitis and mild chronic lymphocytic-plasmacytic duodenal enteritis (triaditis). Multiple calcium carbonate pancreatoliths present within the pancreatic ducts had resulted in pancreatic duct obstruction. Relevance and novel information Pancreatolithiasis is a very rare condition in cats, with only five reports to date. In human medicine, pancreatolithiasis is often a sequala to chronic pancreatitis, seen in up to 50-90% of patients. However, in cats the aetiology of pancreatolithiasis, and indeed chronic pancreatitis, is poorly understood. This report describes a case of obstructive pancreatolithiasis in a cat with histopathological confirmation of triaditis and is the first report of hypercalcaemia in a cat with obstructive pancreatolithiasis. This further adds to the evidence base that pancreatolithiasis may have a similar pathogenesis to humans and can develop secondarily to chronic pancreatitis in cats.
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Affiliation(s)
- Frederik Allan
- Frederik Allan BVMedSci (Hons), BVM, BVS (Hons), MRCVS, Queen’s Veterinary School Hospital, Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, UK
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Abstract
In recent years, increased awareness of feline pancreatitis by the veterinary profession and improved diagnostic modalities have led to an increased frequency of diagnosis of pancreatitis in this species. Consequently, pancreatic diseases, especially chronic pancreatitis, are considered highly prevalent, even in populations of apparently healthy individuals. This prevalence has led to the suspicion that the condition may be overdiagnosed. This article summarizes the difficulties of diagnosis of acute and chronic pancreatitis, assesses the reasons why this is a challenging disease to recognize, and considers whether these difficulties could result in either overdiagnosis or underdiagnosis.
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22
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Lester S. New Tests in Feline Veterinary Medicine: When to Use Them and When to Stick with Tried-and-True Tests. Vet Clin North Am Small Anim Pract 2020; 50:883-898. [PMID: 32360014 DOI: 10.1016/j.cvsm.2020.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The focus of this article is on how interpretations of laboratory data can utilize both population and individual reference intervals, while making the most of routine testing procedures coupled with some of the newer laboratory tests, which can complement the existing tests in diagnosing disease.
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Affiliation(s)
- Sally Lester
- True North Veterinary Diagnostics, Langley, British Columbia, Canada; Pilchuck Veterinary Hospital, Snohomish, WA, USA.
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23
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Abstract
When an owner notices a behavior change in their cat that concerns them enough to present the cat to the vet, there are 3 possibilities: the behavior change reflects a change in behavioral health (a change in psychological state), a change in medical health (a change in physical state), or a combination (comorbid medical and behavioral pathologies). Because many behavioral pathologies are diagnoses of exclusion, it is important that the veterinarian rule out all of the likely medical differentials for the changed behavior. This article is a behavior-by-behavior guide to the more common differentials for the most common problem behaviors.
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Affiliation(s)
- Elizabeth Stelow
- University of California, Davis, 1 Shields Avenue, Davis, CA 95616, USA.
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24
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Barnes AJ, Gates K, Kuntz J. Fat‐soluble vitamin deficiency and subsequent coagulopathy in a cat with exocrine pancreatic insufficiency. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2019-001019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Alexander James Barnes
- Department of Emergency and Critical CareACCESS Specialty Animal HospitalCulver CityCaliforniaUSA
| | - Kathryn Gates
- Department of Emergency and Critical CareACCESS Specialty Animal HospitalCulver CityCaliforniaUSA
| | - Jodi Kuntz
- Department of Internal MedicineACCESS Specialty Animal HospitalCulver CityCaliforniaUSA
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Parambeth JC, Ross CN, Miller AD, Austad SN, Lidbury JA, Suchodolski JS, Steiner JM. Serum Cobalamin and Folate Concentrations in Common Marmosets ( Callithrix jacchus) with Chronic Lymphocytic Enteritis. Comp Med 2019; 69:135-143. [PMID: 30902119 PMCID: PMC6464084 DOI: 10.30802/aalas-cm-18-000045] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/06/2018] [Accepted: 08/23/2018] [Indexed: 12/24/2022]
Abstract
Serum cobalamin and folate concentrations can serve as surrogate markers of gastrointestinal disease in dogs and cats, where they can have diagnostic, therapeutic, and prognostic implications. Chronic disease of the gastrointestinal tract, particularly chronic lymphocytic enteritis (CLE), occurs frequently in captive common marmosets. The aims of this study were to validate a commercially available assay for measuring serum cobalamin and folate concentrations in common marmosets, to establish reference intervals for these analytes in healthy marmosets, and to measure serum concentrations in common marmosets with CLE. The commercial assay was linear, accurate, precise, and reproducible for the measurement of serum cobalamin and folate concentrations in common marmosets. In healthy marmosets, the serum cobalamin concentration ranged from 322 to 2642 pg/mL (n = 35) and serum folate concentration from 54.8 to 786.4 ng/mL (n = 37). Low serum folate concentrations were moderately sensitive (greater than 70%) for CLE, and low serum cobalamin concentrations were moderately (greater than 70%) specific for CLE. Both serum cobalamin and folate concentrations were relatively unchanged in marmosets during 120 to 220 d. Serum cobalamin and folate concentrations were stable for approximately 7 y when samples were stored at -80 °C. Additional studies are warranted to further study the clinical implications of low serum cobalamin and folate concentrations in common marmosets.
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Affiliation(s)
- Joseph Cyrus Parambeth
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary and Biomedical Sciences, Texas A and M University, College Station, Texas;,
| | - Corinna N Ross
- College of Arts and Sciences, Texas A and M University-San Antonio, San Antonio, Texas
| | - Andrew D Miller
- Department of Biomedical Sciences, Section of Anatomic Pathology, College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - Steven N Austad
- Department of Biology and Nathan Shock Center of Excellence in the Basic Biology of Aging, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jonathan A Lidbury
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary and Biomedical Sciences, Texas A and M University, College Station, Texas
| | - Jan S Suchodolski
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary and Biomedical Sciences, Texas A and M University, College Station, Texas
| | - Jörg M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary and Biomedical Sciences, Texas A and M University, College Station, Texas
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McLeish SA, Burt K, Papasouliotis K. Analytical quality assessment and method comparison of immunoassays for the measurement of serum cobalamin and folate in dogs and cats. J Vet Diagn Invest 2019; 31:164-174. [PMID: 30638139 DOI: 10.1177/1040638718824073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Serum cobalamin and folate are often measured in cats and dogs as part of laboratory testing for intestinal disease, small intestinal dysbiosis, or exocrine pancreatic deficiency. We performed an analytical validation of human immunoassays for cobalamin and folate measurement (AIA-900 analyzer, Tosoh Bioscience) and compared results with those obtained using chemiluminescence assays (Immulite 2000 analyzer, Siemens Medical Solutions Diagnostics). Accuracy, precision, total observable error (TEobs%), and σ values were calculated for the immunoassays. Correlation and agreement were evaluated with Deming regression, Passing-Bablok regression, and Bland-Altman analysis. Cobalamin intra-assay and inter-assay CVs were 1.8-9.3% and 2.6-6.8%, respectively. Folate intra-assay and inter-assay CVs were 1.5-9.1% and 3.4-8.1%, respectively. TEobs (%) were ≤19 and ≤31 for cobalamin and folate, respectively. Sigma values were 3.60-11.50 for cobalamin and 2.90-7.50 for folate. Regression analysis demonstrated very high or high correlations for cobalamin [ r = 0.98 (dogs), 0.97 (cats)] and folate [ r = 0.88 (dogs), 0.92 (cats)] but Bland-Altman analysis revealed poor agreement for both. The immunoassays had good analytical performance for measuring cobalamin and folate in both species. Results obtained by the 2 analyzers cannot be used interchangeably and should be interpreted using instrument-specific reference intervals. Further studies are required to establish immunoassay-specific reference intervals and to evaluate the diagnostic performance and clinical utility of the analyzer for these analytes.
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Affiliation(s)
- Susan A McLeish
- Diagnostic Laboratories, Langford Vets, Bristol Veterinary School, University of Bristol, Langford, Bristol, UK (McLeish, Burt).,IDEXX Laboratories Ltd, Grange House, Sandbeck Way, Wetherby, West Yorkshire, UK (Papasouliotis)
| | - Kay Burt
- Diagnostic Laboratories, Langford Vets, Bristol Veterinary School, University of Bristol, Langford, Bristol, UK (McLeish, Burt).,IDEXX Laboratories Ltd, Grange House, Sandbeck Way, Wetherby, West Yorkshire, UK (Papasouliotis)
| | - Kostas Papasouliotis
- Diagnostic Laboratories, Langford Vets, Bristol Veterinary School, University of Bristol, Langford, Bristol, UK (McLeish, Burt).,IDEXX Laboratories Ltd, Grange House, Sandbeck Way, Wetherby, West Yorkshire, UK (Papasouliotis)
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