Pancreatic disorders in dogs and cats
The role of TLI and DGGR lipase in diagnostics
Pancreatic disease represents a significant diagnostic challenge in small animal veterinary medicine. The pancreas has a dual function — exocrine (secretion of digestive enzymes) and endocrine (secretion of insulin and glucagon). Dysfunction of either part of this organ can lead to serious disorders, and the most frequently diagnosed conditions are exocrine pancreatic insufficiency (EPI) and pancreatitis.
Clinical signs of these conditions are often non-specific: diarrhoea, weight loss, vomiting, anorexia or abdominal pain. Laboratory tests therefore play a central role in diagnosis. The most important parameters are TLI (trypsin-like immunoreactivity) and DGGR lipase, which enable reliable differentiation between EPI and pancreatitis.
Exocrine pancreatic insufficiency (EPI) and TLI
- EPI arises as a consequence of loss of acinar cells and the inability to secrete a sufficient quantity of digestive enzymes. The most common cause in dogs is pancreatic acinar atrophy (PAA), while in older animals it may be a consequence of chronic pancreatitis.
- The TLI test is the gold standard for diagnosing EPI. It measures the concentration of trypsin and trypsinogen in serum.
- In healthy dogs, TLI values fall within a narrow reference range, while in EPI there is a significant reduction (<2.5 µg/L).
- TLI has high specificity but may be mildly elevated in acute pancreatitis due to release of enzymes into the circulation.
Clinical significance: every dog with chronic diarrhoea, loss of body condition and polyphagia should have a TLI performed to exclude EPI.
Pancreatitis and DGGR lipase
Pancreatitis is one of the most common pancreatic conditions in dogs and cats, but also the more diagnostically challenging one. Ultrasound can be helpful but is not sufficiently sensitive in the early stages. For this reason, clinical practice most commonly relies on biochemical markers, particularly pancreatic lipases.
DGGR methodology
- Uses the synthetic substrate DGGR (1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6′-methylresorufin) ester).
- Specifically measures pancreatic lipase activity, unlike classical lipases which may be elevated in other conditions (e.g. liver disease or gastrointestinal disorders).
- Correlates excellently with cPLI (canine pancreatic lipase immunoreactivity), which is considered the reference test for diagnosing pancreatitis.
Advantages of DGGR over cPLI
- Availability: can be performed in routine biochemistry laboratories.
- Speed: result available on the same day, unlike cPLI which is performed at reference laboratories.
- Cost: DGGR is significantly more economical.
- Monitoring: enables dynamic monitoring of the patient during therapy.
Practical application in clinical practice
- Suspicion of EPI → perform TLI (most reliable test).
- Suspicion of pancreatitis → start with DGGR lipase; if results are unclear, cPLI may serve as a confirmatory test.
- Monitoring → DGGR lipase is better suited for repeated measurements during therapy and monitoring of recovery.
Diagnosis of pancreatic disease in dogs requires a combination of clinical data, imaging methods and specific laboratory tests. TLI is irreplaceable in detecting EPI, while DGGR lipase is a practical, rapid and reliable marker of pancreatitis, which in everyday practice often surpasses cPLI in terms of availability and application.
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Strahinja Medić DVM, PhD, MS, FRCPath Specialist in Veterinary Clinical Pathology
References
1. Steiner JM, Williams DA. Exocrine pancreatic insufficiency in the dog and cat: diagnostic approach and management. Vet Clin North Am Small Anim Pract. 1997;27(1):67-91. 2. Xenoulis PG. Diagnosis of pancreatitis in dogs and cats. J Small Anim Pract. 2015;56(1):13-26. 3. Kook PH, Oppliger S, Riond B, Reusch CE. Evaluation of the diagnostic specificity of serum lipase and DGGR lipase assays for pancreatitis in dogs. J Vet Intern Med. 2014;28(2):479–487. 4. Cridge H, MacLeod AG, Pachtinger GE, Mackin AJ, Sullivant AM. Pancreatitis in dogs: a review. J Small Anim Pract. 2021;62(6):409–423. 5. Trivedi S, Marks SL, Kass PH, Luff JA, Keller SM, Johnson EG. Sensitivity and specificity of canine pancreas-specific lipase (cPLI) and DGGR lipase for the diagnosis of pancreatitis in dogs. J Vet Intern Med. 2011;25(6):1241–1247.