A presumptive diagnosis of pancreatitis can be made based on a history and physical examination. In particular, significant risk factors such as obesity, or the recent ingestion of a high fat meal, may warrant a suspicion of pancreatitis. The examining veterinarian will perform other tests to confirm this diagnosis and to help determine the cause of the illness.
Diagnostic procedures commonly include a CBC, or complete blood count, a serum chemistry that evaluates the pancreatic enzymes amylase and lipase, and a urinalysis. Amylase and lipase values typically will be elevated in the early or acute stage of pancreatitis. These values may increase threefold in some dogs, but such an elevation should not be relied upon in interpreting the severity of the disease. Other blood tests the examining veterinarian may perform include a serum trypsin-like immunoreactivity assay, or TLI assay, and an ELISA test for trypsinogen activation peptide, or TAP. Trypsin substances are elevated in cases of pancreatitis, and are more specific to the pancreas than are amylase and lipase.
X-rays usually are taken of the abdomen, and may show changes associated with pancreatitis; they may also help rule out other problems that can mimic the symptoms of pancreatitis, such as a gastric foreign body. A typical x-ray finding will show a ground-glass appearance corresponding to the location of the pancreas. Also, expansion of the angle between the duodenum, the section of the small intestine adjacent to the stomach, and the pylorus, or outlet of the stomach, may indicate the presence of the disease. Distention of the stomach and intestines with gas is non-specific, but is commonly seen with pancreatitis. If the dog is having respiratory problems, x-rays will be taken of the chest as well.
An abdominal ultrasound may be used to check for the presence of pancreatitis, a pancreatic abscess, a pancreatic tumor, or free fluid within the abdominal cavity. Ultrasound- guided biopsies may be used to confirm a diagnosis. Certain dogs will require a surgical exploration of the abdomen for biopsy samples, or for treatment of abscesses or tumors.
