Clinical Utility of Adapted Modified Canine Activity Index (aMCAI) in Canine Acute Pancreatitis: A Prospective Observational Study

Assessing disease severity and prognosis in canine acute pancreatitis (AP) remains a major clinical challenge. This study evaluated the clinical utility of the Adapted Modified Canine Activity Index (aMCAI), a clinical scoring system refined from the original MCAI. A prospective observational study was conducted on 42 dogs diagnosed with AP, with aMCAI scores assessed on Days 1, 3, and 5. A linear mixed model (LMM) was used to analyze score progression over time and differences between survivors and non-survivors. Receiver operating characteristic (ROC) curves evaluated the prognostic accuracy for 30 day survival. The LMM analysis revealed that non-survivors had significantly higher aMCAI scores than survivors (p = 0.035), and overall scores decreased significantly over time (p < 0.001). ROC analysis showed poor discrimination on Days 1 and 3. However, on Day 5 the aMCAI demonstrated good prognostic performance (AUC = 0.813, p < 0.001). A cutoff value of ≥2.5 on Day 5 yielded 100% sensitivity, a negative likelihood ratio of 0.00 and a 100% negative predictive value, providing clinically relevant prognostic information. These findings suggest that the aMCAI is a practical tool for monitoring disease progression and may support the identification of dogs with a high likelihood of survival.