How vets score severity of sudden pancreatitis in dogs

Abstract

Objective To derive a severity score for spontaneous canine acute pancreatitis applicable to general practice. Design Cohort study of canine pancreatitis cases. Procedure Cases (n = 68) of spontaneous canine acute pancreatitis presented to general practitioners were identified among accessions to Veterinary Pathology Services Brisbane. The primary veterinarian was surveyed by telephone to ascertain the outcome of each case. Scores were assigned for extent of hyperamylasaemia, hyperlipasaemia and number of organ systems other than the pancreas compromised. The probability of mortality with each score of each analyte was calculated. The strength of interaction between scores for each analyte and mortality rate was assessed by chi‐square analysis where appropriate. Relationships between the organ system score, other physiological variables and likelihood of euthanasia were analysed. Results Scores derived mathematically from analysis of enzyme activities had poor abilities to predict mortality. The score based upon the number of organ systems compromised showed good ability to predict mortality and the interaction between the organ system score and mortality rate was significant by chi‐square analysis (P < 0.01). Distribution of data within the amylase and lipase scores was not compatible with chi‐square analysis. Conclusion Assessment of severity of spontaneous canine acute pancreatitis using pancreatic enzyme activities is potentially inaccurate. The use of a severity score based upon organ system compromise was more accurate in determining the likelihood of mortality in spontaneous canine acute pancreatitis. This is compatible with the hypothesis that severe canine acute pancreatitis is a multiple organ failure syndrome.