scholarly journals Signalment and Clinical Data of Cats with Exocrine Pancreatic Insufficiency Diagnosed Using Feline Trypsin-like Immunoreactivity in Routine Diagnostics

2021 ◽  
Vol 8 (8) ◽  
pp. 155
Author(s):  
Katrin Törner ◽  
Julia Maria Grassinger ◽  
Corinna N. Weber ◽  
Heike Aupperle-Lellbach ◽  
Argine Cerezo-Echevarria ◽  
...  
Keyword(s):  
Treatment Response ◽  
Clinical Data ◽  
Pancreatic Insufficiency ◽  
Clinical Signs ◽  
Clinical Information ◽  
Reference Interval ◽  
Exocrine Pancreatic Insufficiency ◽  
Reference Limit ◽  
Good Treatment Response ◽  
Group 3

Serum feline trypsin-like immunoreactivity (fTLI) is commonly used to diagnose feline exocrine pancreatic insufficiency (EPI). This study aimed to describe signalment and clinical data of cats with EPI. Determination of TLI was performed using an in-house ELISA; the reference interval was defined using a Reference Limit Estimator. Groups were formed from 4813 cats (2019–2020), based on their fTLI concentration: 1 (<8 µg/L; decreased; n = 275), 2 (8–88 µg/L; reference interval; n = 4256), and 3 (>88 µg/L; increased; n = 282). Males and Domestic Shorthairs were most common in all groups. Group 3 had the highest (13 years), and group 1 had the lowest (9 years), median age. Clinical information was available for 200 cats (decreased fTLI: n = 87, lower reference interval (8–12 µg/L): n = 113). Treatment response was observed in 83% (decreased fTLI) and 66% (lower reference interval). EPI cats displayed weight loss (69%), diarrhoea (68%), vomiting (41%), anorexia (39%), poor hair coat (35%), lethargy (33%), and/or polyphagia (21%). The lower the serum fTLI concentration, the more often good treatment response was reported (p = 0.022) but there were no statistically significant clinical signs. In conclusion, fTLI is a helpful parameter to diagnose EPI but predicting treatment response based on signalment or clinical signs is not possible.

scholarly journals Fat-soluble vitamin deficiency and subsequent coagulopathy in a cat with exocrine pancreatic insufficiency

2020 ◽  
Vol 8 (1) ◽  
pp. e001019
Author(s):  
Alexander James Barnes ◽  
Kathryn Gates ◽  
Jodi Kuntz
Keyword(s):  
Vitamin K ◽  
Pancreatic Insufficiency ◽  
Pancreatic Enzyme ◽  
Clinical Signs ◽  
Gastrointestinal Haemorrhage ◽  
Fresh Frozen Plasma ◽  
Exocrine Pancreatic Insufficiency ◽  
Vitamin Deficiency ◽  
Clotting Factor ◽  
Enzyme Supplementation

This report describes the clinical signs, diagnostic findings and treatment of a female spayed Domestic Shorthair with exocrine pancreatic insufficiency (EPI) who presented in shock due to severe gastrointestinal haemorrhage secondary to coagulopathy caused by vitamin K-dependent clotting factor deficiency. Diagnostics revealed a prolonged prothrombin time, activated partial thromboplastin time, low trypsin-like immunoreactvity and gross evidence of pancreatic atrophy. Gastrointestinal haemorrhage resolved quickly with transfusion of fresh frozen plasma and vitamin K supplementation. Following treatment with oral pancreatic enzyme supplementation, the cat was found to have resolution of gastrointestinal signs, improved body condition and normalisation of clotting times. Fat-soluble vitamin levels were below the expected range and improved following treatment. This is the second report of coagulopathy in a cat with EPI and the first to describe fat-soluble vitamin deficiency that improved with pancreatic enzyme supplementation.

Prolonged Survival in an Aged Labrador Retriever with a Metastatic Insulinoma

2013 ◽  
Vol 49 (3) ◽  
pp. 224-229 ◽  
Author(s):  
Jessica Rychel ◽  
Deanna R. Worley ◽  
Christine S. Hardy ◽  
Brett T. Webb
Keyword(s):  
Serum Insulin ◽  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Insufficiency ◽  
Labrador Retriever ◽  
Hypoglycemic Episode ◽  
Partial Pancreatectomy ◽  
Reference Limit ◽  
Glucose Levels ◽  
Initial Surgery ◽  
Upper Reference Limit

This case report highlights an unusually prolonged, asymptomatic, disease-free interval in an aged male Labrador retriever that underwent partial pancreatectomy for a functionally active pancreatic insulinoma with histologically confirmed hepatic metastasis. The patient developed pancreatitis and nonseptic suppurative peritonitis 24 hr after surgical resection of the insulinoma and was managed medically until discharge. Three mo after surgery, the dog was diagnosed with exocrine pancreatic insufficiency (EPI) that was effectively managed with parenteral pancreatic enzymes. Due to normal glucose levels 3 mo postsurgically, liver samples from the initial surgery were resubmitted for immunohistochemistry. Results confirmed insulinoma metastasis with insulin expression. Ten mo postsurgically, the blood glucose was normal and serum insulin levels were slightly above the upper reference limit. The first hypoglycemic episode was documented 23 mo postoperatively, which was effectively managed with prednisone. The cause for the prolonged disease remission and survival was unknown, but was possibly a result of pancreatitis and peritonitis, partial spontaneous regression of metastatic lesions, or idiopathic. Despite life-threatening postoperative complications, this patient enjoyed a profoundly longer than expected survival. This case highlights the importance of removing the primary tumor (insulinoma) despite the presence of metastatic disease.

scholarly journals CONDITION OF THE PANCREAS IN NEWBORN CALVES WITH DYSPEPSIA AFTER ANTIBIOTIC THERAPY

2021 ◽  
pp. 88-96
Author(s):  
A. A. Elenschleger ◽  
A. S. Erokhin
Keyword(s):  
Antibiotic Therapy ◽  
Pancreatic Insufficiency ◽  
Great Influence ◽  
Clinical Signs ◽  
Exocrine Pancreatic Insufficiency ◽  
The Body ◽  
Industrial Enterprises ◽  
Morphological Studies ◽  
Automatic Analyzer ◽  
Newborn Calves

The pancreas performs the functions of both external and internal secretion, has a great influence on the growth and development of young cattle. Thus, the function of the external secretion is the synthesis and excretion of juice into the duodenum, which includes digestive enzymes and electrolytes, and the internal secretion is the synthesis and excretion of hormones into the blood. Timely identification of the causes of developing deviations from the norm in the body and the adoption of appropriate measures is due to the fact that when raising cattle at industrial enterprises, diseases are widespread, and the manifestation of clinical signs of the disease in one animal often signals the presence of problems in the entire sex and age population. The aim of our research was to determine the functional state of the pancreas in newborn calves during rehabilitation after antibiotic therapy for dyspepsia. The research was carried out on a farm located on the territory of the Altai Territory. In the course of the research, three experimental groups of calves were formed, in which the clinical, biochemical and morphological status was studied. To obtain the results of biochemical studies, a biochemical semi-automatic analyzer with an open Clima MC – 15, RAL system was used, and for morphological studies, an automatic analyzer with a closed MicroCC-20Plus system was used. In the course of the research, it was found that the studied indicators blood samples indicate a violation of intestinal absorption and exocrine pancreatic insufficiency caused by dyspepsia and subsequent antibiotic therapy, while calves from the experimental group receiving the probiotic complex Vetom 1.2 showed better dynamics in restoring homeostasis after the disease.

scholarly journals Digestive enzyme replacement relieves growth failure in preterm infants with poor exocrine pancreatic function: a retrospective case series

2021 ◽  
Author(s):  
Annette Münch ◽  
Christoph Bührer ◽  
Ann Carolin Longardt
Keyword(s):  
Weight Gain ◽  
Preterm Infants ◽  
Digestive Enzyme ◽  
Pancreatic Insufficiency ◽  
Growth Failure ◽  
Exocrine Pancreatic Function ◽  
Exocrine Pancreatic Insufficiency ◽  
Very Preterm Infants ◽  
Enzyme Replacement ◽  
Fecal Pancreatic Elastase

AbstractIn orally fed preterm infants, poor weight gain may be linked to low fecal pancreatic elastase-1 (FPE-1) activity, indicative of exocrine pancreatic insufficiency. The objective of this study was the retrospective assessment of the effect of exogenous digestive enzyme replacement by gavage in preterm infants with growth failure and low FPE-1 (<200 μg/g). We analyzed weight gain relative to baseline and caloric intake during 14-day periods before and after institution of digestive enzyme replacement containing 6000 U lipase and 240 U protease kg−1 d−1. Among 46 of 132 preterm infants < 1250g birth weight surviving to at least 14 days in whom FPE-1 was determined, 38 infants had low FPE-1 (< 200 μg/g), and 33 infants received exogenous digestive enzyme replacement. Average daily weight gain significantly increased from 14.4 [range 2.6–22.4] g kg−1 d−1 to 17.4 [8.4–29.0] g kg−1 d−1 (P = 0.001), as did weight gain per kcal, from 0.08 [0.02–0.13] g kcal−1 d−1 to 0.11 [0.05–0.18] g kcal−1 d−1.Conclusion: In preterm infants with signs and symptoms of exocrine pancreatic insufficiency, exogenous digestive enzyme replacement is associated with improved growth. What is Known:• Very preterm infants on full enteral nutrition may display growth failure linked to transient poor exocrine pancreatic function.• Porcine pancreatic enzymes covered with an acid-resistant coating are too large to pass the internal diameter of most gavage tubes used in very preterm infants.What is New:• Administration of a liquid formulation of acid-resistant microbial digestive enzymes in preterm infants with growth failure and low fecal pancreatic elastase-1 values was associated with improved weight gain.• Response to exogenous digestive enzyme replacement was associated with the prior extent of growth failure.

scholarly journals POS1309 PREVALENCE AND CORRELATES OF UNDERWEIGHT, OVERWEIGHT AND OBESITY AMONG PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS (JIA): EVIDENCE FROM THE NATIONAL PAEDIATRIC RHEUMATOLOGIC DATABASE (NPRD)

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 936.2-937
Author(s):  
F. Milatz ◽  
J. Klotsche ◽  
M. Niewerth ◽  
J. Hörstermann ◽  
D. Windschall ◽  
...  
Keyword(s):  
Physical Activity ◽  
Juvenile Idiopathic Arthritis ◽  
General Population ◽  
Children And Adolescents ◽  
Treatment Response ◽  
Weight Status ◽  
Overweight And Obesity ◽  
Age Group ◽  
Group 3 ◽  
Obesity In Children

Background:In patients with JIA, growth impairment and variance in body composition are well-known long-term complications that may be associated with prolonged drug therapy (e.g. glucocorticoids) as well as impaired physical and psychosocial well-being. An increased accumulation of body fat represents a significant risk factor for metabolic abnormalities and a modifiable variable for a number of comorbidities. Recently, evidence has emerged in favour of the potential negative influence of overweight on the course of the disease and treatment response [1].Objectives:The study aimed a) to estimate the prevalence of underweight, overweight and obesity in children and adolescents with JIA compared to the general population, and b) to investigate correlates of patients’ weight status.Methods:A cross-sectional analysis of physicians’ recorded body weights and heights of patients with JIA enrolled in the NPRD in the year 2019 was performed. Underweight (BMI <10th), overweight (BMI >90th) and obesity (BMI >97th) were defined according to age- and sex-specific percentiles used in the German reference system. For comparison with data from the general population [2], sex- and age-matched pairs of 3-17-year-old patients and controls were generated. A multinomial logistic regression analysis was performed to examine the association between weight status and patients’ clinical and self-reported outcomes.Results:In total, data from 6.515 children and adolescents with JIA (age 11.2 ± 4.1 years, disease duration 4.9 ± 3.8 years, 67% girls, 40% persistent oligoarthritis) were included. Of these, 3.334 (age 5.9 ± 2.1 years, 52.5% girls) could be considered for matched-pair analysis. Compared with the general population, patients underweight, overweight and obesity rates were 10.6% (vs. 8.1%), 8.8% (vs. 8.5%) and 6.1% (vs. 5.7%), respectively. No significant sex differences were found in either group. Largest difference in prevalence was registered for underweight, specifically in the age group 3-6 years (12.9% patients vs. 5.9% controls). Similar to the general population, higher rates of overweight were observed in adolescent patients than in affected children (19.1% age group 11-13 vs. 8.4% age group 3-6). While the highest underweight prevalence was registered in patients with RF+ polyarthritis (16%), patients with Enthesitis-related arthritis (22%), psoriatic arthritis (21%) and systemic JIA (20%) showed the highest overweight rates (including obesity). Younger age (OR = 0.51, 95% CI = 0.31-0.83), more frequent physical activity (OR = 0.92, 95% CI = 0.85-0.99) and high parental vocational education (OR = 0.39, 95% CI = 0.18-0.80) were independently associated with a lower likelihood of being overweight/obese.Conclusion:The overall prevalence of underweight, overweight and obesity in children and adolescents with JIA is comparable to that found in the general population. Behavioural health promotion, including regular physical activity, as part of the treatment strategy in JIA should preventively already begin at preschool age and necessarily be made accessible to patients of all educational levels.References:[1]Giani T et al. The influence of overweight and obesity on treatment response in juvenile idiopathic arthritis. Front Pharmacol 2019;10:637.[2]Schienkiewitz A et al. BMI among children and adolescents: prevalences and distribution considering underweight and extreme obesity. Bundesgesundheitsbl 2019;62:1225–1234.Acknowledgements:The National Paediatric Rheumatological Database has been funded by AbbVie, Chugai, Novartis and GSK.Disclosure of Interests:Florian Milatz: None declared, Jens Klotsche: None declared, Martina Niewerth: None declared, Jana Hörstermann: None declared, Daniel Windschall: None declared, Frank Weller-Heinemann Speakers bureau: Pfizer, AbbVie, SOBI, Roche and Novartis., Frank Dressler: None declared, Rainer Berendes: None declared, Johannes-Peter Haas: None declared, Gerd Horneff: None declared, Kirsten Minden Speakers bureau: Pfizer, AbbVie, Consultant of: Novartis

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