Diagnostic performance of 1,2-O-dilauryl-rac-glycero glutaric acid-(6’-methylresorufin) ester lipase activity in cats presenting to a veterinary referral hospital

Objective: To determine the prevalence of increased 1,2-O-dilauryl-rac-glycero glutaric acid-(6'-methylresorufin) ester (DGGR) lipase activity in cats with and without pancreatitis, and to evaluate its diagnostic performance relative to a clinical diagnosis of pancreatitis and ultrasonographic assessments. Methods: Serum DGGR lipase activity was measured with the Randox lipase assay and considered increased if > 25 U/L. A board-certified internal medicine clinician, blinded to DGGR results, gave each cat a clinician-assigned score from 0 (no pancreatitis) to 4 (definite pancreatitis). Ultrasonographic scores (0 to 4) were assigned on the basis of the number of changes supportive of pancreatitis. DGGR lipase performance was compared with clinical and ultrasonographic scores. Results: A total of 231 cats were included; 59 of 231 (25.5%) had increased DGGR lipase activity. Clinical scores were 0 in 47 of 231 cats (20.3%), 1 in 128 of 231 (55.4%), 2 in 36 of 231 (15.6%), and 3 in 20 of 231 (8.7%); no cats had a score of 4. With the use of a clinical score of 3 as the reference, DGGR lipase activity had a sensitivity of 70% and specificity of 79% (positive predictive value, 24%; negative predictive value, 97%). DGGR lipase activity was significantly lower in cats with an ultrasound score of 0 compared to scores of 1, 2, and 3. DGGR lipase activity was lower in cats with clinician-assigned scores of 0 and 1 compared to scores of 2 and 3. Conclusions: DGGR lipase activity was lower in cats with lower clinical and ultrasonographic scores and demonstrated a high negative predictive value. Clinical Relevance: In this low-prevalence referral population, a normal DGGR lipase result reduced the likelihood of clinician-suspected pancreatitis.