Assessment of serum pancreatic (DGGR) lipase concentrations in equids
with gastrointestinal disease
Abstract
Background : Pancreatitis is a poorly understood condition in the
horse. The DGGR lipase assay has recently been validated for horses.
Objectives : Evaluate serum DGGR lipase concentrations in equids
presented to an equine hospital in the UK with gastrointestinal disease.
Study design : Prospective descriptive. Methods: Blood samples were
obtained by convenience sampling of horses and donkeys presented for
evaluation of gastrointestinal disease. Results : Serum pancreatic
(DGGR) lipase concentrations were measured in 205 equids with
gastrointestinal disease, of which 147 survived, 47 were euthanised and
11 died. The median serum pancreatic lipase concentration in all animals
was 17 U/l (IQR 14 – 27; range 1 – 3484). The lipase concentration was
categorised as normal in 124 animals (60.5%) and elevated in 81
(39.5%). There was a statistically significant difference in the
disease category and pancreatic lipase concentration (p <
0.001), with colic cases having higher lipase concentrations than
colitis and peritonitis cases. There was strong evidence (p=0.01) of an
association between pain severity and lipase values, with higher lipase
concentrations in horses with more severe pain. Of 12 horses with
severely increased pancreatic lipase concentration (>200 u/L)
3/12 had spontaneous nasogastric reflux and 6/10 had distended and/or
thickened small intestine on abdominal ultrasonography; 7/12 survived to
hospital discharge, and 5/12 died or were euthanised. Main Limitations
: We were unable to confirm the presence of pancreatitis in any of the
horses with elevated serum DGGR lipase concentrations by post-mortem
examination or histopathology. Conclusions : Some equids with
gastrointestinal disease have increased serum pancreatic (DGGR) lipase
concentrations, especially those with colic. This suggests that a degree
of pancreatitis may be present in many colic cases, although this does
not necessarily indicate causation.