Webb, C. B. and C. Trott (2008). “Laparoscopic diagnosis of pancreatic disease in dogs and cats.” J Vet Intern Med 22(6): 1263-6.
Despite advances in diagnostic testing, the diagnosis of many pancreatic diseases is not straightforward. The pancreatic-lipase immunoreactivity (PLI) assay is sensitive and specific for pancreatic disease, but cannot identify the source of the inflammation. Pancreatic disease may be due to many different causes, such as acute nonsuppurative or chronic lympoplasmacytic pancreatitis, or pancreatitis secondary to another disease process such as inflammatory bowel disease or bile duct obstruction. Noninvasive imaging methods such as ultrasound or radiology have variable degrees of sensitivity and specificity. The gold standard for the diagnosis of exocrine pancreatic disease in animals remains biopsy and histopathology. Laparoscopy offers a minimally invasive route by which to obtain pancreatic biopsies. In this retrospective case series, the medical records of 18 dogs and 13 cats examined between 1999 and 2007 at Colorado State University that underwent laparoscopy during which observation or biopsy of the pancreas was recorded were examined. The presenting complaints, imaging studies, and histopathologic findings were recorded. For comparison, all hospital admissions were searched for animals with the same presenting complaints and of those it was determined which animals had exploratory surgery and their pancreas biopsied. In 14 animals a laparoscopic biopsy of the pancreas resulted in a histopathologic diagnosis when the sonographic findings or the gross assessment failed to do so. Results of this study suggests that laparoscopy is a safe and potentially underutilized diagnostic tool in animals where exocrine pancreatic disease is a prominent differential diagnosis, as in dogs and cats examined for vomiting, anorexia, or both.
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Richter, K. P. (2001). “Laparoscopy in dogs and cats.” Vet Clin North Am Small Anim Pract 31(4): 707-27, ix.
Zoran, D. L. (2006). “Pancreatitis in cats: diagnosis and management of a challenging disease.” J Am Anim Hosp Assoc 42(1): 1-9.