Sidler_2025_J.Vet.Intern.Med_39_e70134

BACKGROUND: It is unclear if dogs with acute pancreatitis differ clinically from dogs with non-pancreatic acute gastrointestinal disease (aGId). OBJECTIVES: Compare clinical findings in dogs with acute gastrointestinal signs suspected of having acute pancreatitis (sAP) based on increased DGGR-lipase activity versus those with presumptive aGId. ANIMALS: Twenty-six dogs with sAP, 48 dogs with aGId based on acute signs, lipase activity > 450 U/L (RI, 17-156 U/L) and within/minimally (20 U/L) > RI, respectively. METHODS: Prospective study. Clinical signs were graded using a simplified modified clinical activity index (MCAI). CBC, biochemistry, C-reactive protein (CRP), pancreatic, and gastrointestinal ultrasonographic findings were compared between groups. RESULTS: Median (range) disease duration before presentation (sAP 36 h [3-96 h], aGId 48 h [3-168 h]) did not differ. Diarrhea was significantly more frequent in aGId; MCAI did not differ between groups. Median (range) lipase activities in sAP and aGId dogs were 1280 U/L (451-6712) and 49.5 U/L (14-176), respectively. Alkaline phosphatase activity and bilirubin were significantly higher in sAP. Pancreatic ultrasonographic abnormalities were significantly more common in sAP. In aGId, a mixed-echoic (17/44, 39%), hyperechoic (9/44, 20%), hypoechoic pancreas (3/44, 7%), and hyperechoic mesentery (4/44, 9%) were found. Only a distended stomach was significantly more common in sAP. Multivariable logistic regression analysis only identified pancreatic enlargement and ultrasonographic diagnosis of pancreatitis to increase the odds of sAP. Hospitalization (median, range) did not differ (sAP 3, 1-8 days; aGId 2.5, 1-5 days). CONCLUSION AND CLINICAL IMPORTANCE: Both groups do not differ in clinical severity; diarrhea is less prevalent, and mild cholestasis is more common in sAP. Pancreatic ultrasonographic changes suggestive of AP are rare in aGId.