Labordiagnostik von Pankreaserkrankungen des Hundes – Möglichkeiten und Grenzen

T. Spillmann

doi:10.1055/s-0037-1622110

Tierärztliche Praxis Ausgabe K: Kleintiere / Heimtiere, Table of Contents

Tierarztl Prax Ausg K Kleintiere Heimtiere 2003; 31(01): 49-59
DOI: 10.1055/s-0037-1622110

Labor

Schattauer GmbH

Labordiagnostik von Pankreaserkrankungen des Hundes – Möglichkeiten und Grenzen^[*]

Laboratory diagnosis of pancreatic diseases in dogs – possibilities and limitations

T. Spillmann

¹Aus der Medizinischen und Gerichtlichen Veterinärklinik I, Innere Krankheiten der Kleintiere (Prof. Dr. E.-G. Grünbaum) der Justus-Liebig-Universität Gießen

› Author Affiliations

Abstract

Zusammenfassung

Da die Diagnostik von Pankreaserkrankungen des Hundes eine besondere Herausforderung darstellt, wird der aktuelle Stand labordiagnostischer Möglichkeiten in der Pankreasdiagnostik aufgeführt und diskutiert. Studien zur Diagnostik der akuten Pankreatitis wiesen nach, dass die Sensitivität und Spezifität der Blutserumparameter Amylase-und Lipaseaktivität relativ gering sind. Von noch geringerem diagnostischen und prognostischen Wert zeigten sich canine trypsin-like immunoreactivity (cTLI), kanines α₂-Makroglobulin, kaniner α₁-Proteaseinhibitor-Trypsin-Komplex im Blutserum sowie trypsinogen activation peptid (TAP) im Blutplasma oder Urin. Vielversprechend erscheint die Ermittlung von kaniner pankreatischer Lipase-Immunoreaktivität (cPLI), kaniner pankreatischer Elastase (cE1) und kaninem C-reaktivem Protein (cCRP) im Blutserum sowie der UCTR (urine creatinine-TAP-ratio) im Urin. Allerdings ist von Nachteil, dass für diese Parameter nur zeit-und kostenintensive Labormethoden verfügbar sind. Somit stehen sie im Gegensatz zu den Blutserumaktivitäten von Amylase und Lipase noch nicht für die Notfalldiagnostik zur Verfügung.

Der Nachweis einer klinisch manifesten exokrinen Pankreasinsuffizienz (EPI) beruht auf den für eine EPI typischen Symptomen in Verbindung mit pathologisch verminderten Konzentrationen an cTLI im Blutserum oder cE1 im Kot.

Hinweise auf eine subklinische EPI infolge einer partiellen Pankreasatrophie geben wiederholt auftretende subnormale oder pathologische cTLI-Werte im Blutserum von klinisch unauffälligen Hunden oder Patienten mit unspezifischen gastrointestinalen Störungen. Von geringem oder eingeschränktem diagnostischem Wert in der EPI-Diagnostik sind folgende Methoden: unverdaute Nahrungsbestandteile, proteolytische Aktivität und Chymotrypsinaktivität im Kot, Fettbelastungstest, Pancrolauryltest und Ceruletidoder

TLI-Stimulationstest. Labordiagnostische Verfahren zum Nachweis einer chronischen Pankreatitis oder eines Pankreaskarzinoms existieren zurzeit nicht. Die Diagnostik dieser Erkrankungen beruht daher auf der Nutzung bildgebender Verfahren (Sonographie, Computertomographie) oder der Laparoskopie bzw. Laparotomie mit Pankreasbiopsie.

Summary

Since the diagnosis of pancreatic diseases is still challenging in dogs the article revues and discusses the current status of laboratory possibilities to reveal these diseases. Studies about the diagnosis of acute pancreatitis showed that the sensitivity and specificity of serum amylase and lipase activity are relatively low. Even lower diagnostic and prognostic values were revealed for the diagnostic and prognostic value of serum canine trypsin-like immunoreactivity (cTLI), canine α₂-macroglobulin, canine α₁-protease inhibitor-trypsin-complex as well as plasma or urine trypsinogen activation peptid (TAP). Promising parameters are serum canine pancreatic lipase immunoreactivity (cPLI), canine pancreatic elastase (cE1), canine C-reactive protein (cCRP) and the UCTR (urine creatinine-TAP-ratio). However, the disadvantage of these parameters is the need of laboratory methods that are time and cost intensive. Therefore they are not available as a diagnostic tool for emergency cases in contrast to serum amylase and lipase activity.

The diagnosis of clinical exocrine pancreatic insufficiency (EPI) bases on clinical signs typical for EPI in connection with pathologically low serum cTLI or faecal cE1 values. An indication for a subclinical EPI caused by partial pancreatic acinar atrophy are repeated subnormal or pathologic cTLI values in clinically normal dogs or patients with unspecific gastrointestinal problems. Of low or limited diagnostic value for the diagnosis of EPI are the following methods: undigested food components, proteolytic activity and chymotrypsin activity in faeces, lipid assimilation test, pancreolauryl test as well as the ceruletide or TLI stimulation test.

Currently there are no laboratory tests available for the diagnosis of chronic pancreatitis or pancreatic carcinoma. The diagnosis of these diseases bases on the use of imaging techniques (ultrasound, computed tomography) or laparoscopy/laparotomy with pancreatic biopsy.

Schlüsselwörter

Pankreaserkrankungen - Hund - Labordiagnostik

Key words

Pancreatic diseases - Dog - Laboratory diagnosis

Full Text

References

Literatur
1 Archer FJ, Kerr ME, Houston DM. Evaluation of three pancreas specific protein assays, TLI (trypsin-like immunoreactivity), PASP (pancreas specific protein) and CA 19-9 (glycoprotein) for use in the diagnosis of canine pancreatitis. J Vet Med 1997; 44: 109-13.
2 Barry RE, Behrend WA. Studies on the pharmacokinetics of fluorescein and its dilaurate ester under the conditions of the fluorescein dilaurate test. Arzneimittel-Forschung 1985; 35: 644-8.
3 Beechey-Newman N, Simpson KW, Rae D, Sumar N, Hermon-Taylor J. Specific diagnosis of canine acute pancreatitis by an ELISA for trypsinogen activation peptide. J Vet Intern Med 1994; 08: 151.
4 Benini L, Rizotti P, Vaona B, Sembenini C, Brocco G, Micciolo R, Chiarioni G, Pederzoli P, Vantini I, Cavallini G, Marini M, Scuro LA. Elastase-1 vs. trypsin, lipase and amylase serum levels in pancreatic diseases. Int J Pancreatol 1987; 02: 361-70.
5 Börngen S. Nachweis von C-reaktivem Protein beim Hund. Diss med vet, Leipzig. 1999
6 Büchler MW, Uhl W, Malfertheiner P. Pankreaserkrankungen, 1. Aufl. Basel: Karger; 1996
7 Carrière F, Raphel V, Moreau H, Bernadac A, Devaux M-A, Grimaud R, Barrowman JA, Bènicourt C, Junien JL, Laugier R, Verger R. Dog gastric lipase: Stimulation of its secretion in vivo and cytolocalization in mucous pit cells. Gastroenterology 1992; 102: 1535-45.
8 Caspi D, Snell JJ, Batt RM, Bennett D, Ruttemann GR, Hartmann G, Baltz ML, Gruys E, Pebys MB. C-reactive protein in dogs. Am J Vet Res 1987; 06: 919-21.
9 Chaudhry YS. Der Pancreolauryl-Test in der Diagnostik der exokrinen Pankreasinsuffizienz beim Hund. Diss med vet, Gießen. 2002
10 Chen CC, Wang SS, Chao Y, Lu CW, Lee SD, Tsai YT, Lo KJ. C-reactive protein and lactatdehydrogenase isoenzymes in the assessment of the prognosis of acute pancreatitis. J Gastroent Hepatol 1992; 07: 363-6.
11 Clavien PA, Burgan S, Moosa AR. Serum enzymes and other laboratory tests in acute pancreatitis. Brit J Surg 1989; 76: 1234-43.
12 Dick M, Spillmann T, Burkhardt E, Grünbaum E-G. Comparison of faecal pancreatic elastase (cE1) and serum trypsin-like immunoreactivity (cTLI) with morphological-histological findings in the exocrine pancreas of dogs. 7. FECAVA und 47. DVG-Jahreskongress, Berlin. 2001
13 Driver J. Statistische Untersuchungen zu Abgangsursachen bei Hunden anhand des Sektionsgutes des Institutes für Veterinär-Pathologie der Justus-Liebig-Universität Gießen aus den Jahren 1978-1992. Diss med vet, Gießen. 1997
14 Eckersall PD, Connor JG, Harvie J. An immunoturbidimetric assay for canine C-reactive protein. Vet Res Commun 1991; 15: 17-24.
15 Eckersall PD, Connor JG, Parton H. An enzyme linked immunosorbent assay for canine C-reactive protein. Vet Rec 1989; 124: 490-1.
16 Eim C. Herstellung und Charakterisierung monoklonaler Antikörper gegen die Pankreaselastase-1 des Hundes zur Entwicklung eines ELISA für die Pankreasdiagnostik. Diss med vet, Gießen. 1998
17 Fischer S, Müller E. Exokrine Pankreasinsuffizienz beim Hund. Prakt Tierarzt, Colleg Vet XXIV. 1993: 116-7.
18 Flasshoff HJ, Heusinger A. Krankheiten des exokrinen Pankreas und das differentialdiagnostische Umfeld. Prakt Tierarzt 1990; 06: 5-11.
19 Freudiger U. Epidemilogie, Ätiologie, Klinik und Diagnose der chronisch exokrinen Pankreasinsuffizienz. Prakt Tierarzt 1976; 57: 300-14.
20 Freudiger U. Physiologie, Pathologie, Labor und Therapie der exokrinen Erkrankungen der Bauchspeicheldrüse beim Hund. Kleintierprax 1991; 36: 5-16.
21 Grünbaum EG. Das Malassimilationssyndrom. Prakt Tierarzt 1990; 02: 35-43.
22 Hamano H, Hayakawa T, Kondo T. Serum immunoreactive elastase in diagnosis for pancreatic disease. Dig Dis Sci 1987; 32: 50-6.
23 Harmoinen J, Saari S, Rinkinen M, Westermarck E. Evaluation of pancreatic forceps biopsy by laparoscopy in healthy beagles. Vet Therapeut 2002; 03: 31-6.
24 Hänichen T, Minkus G. Retrospektive Studie zur Pathologie der Erkrankungen des exokrinen Pankreas bei Hund und Katze. Tierärztl Umsch 1990; 45: 363-8.
25 Hill FWG, Kidder DE. The estimation of daily faecal trypsin levels in dogs as an indicator of gross pancreatic exocrine insufficiency. J Small Anim Pract 1970; 11: 191-5.
26 Hudson EB, Strombeck DR. Effects of functional nephrectomy on the disappearance rates of canine serum amylase and lipase. Am J Vet Res 1977; 08: 1316-21.
27 Hurley PR, Cook A, Jehanli A, Austen BM, Hermon-Tayler J. Development of radioimmunoassays for free tetra-1-aspartyl-1-lysine trypsinogen activation peptides (TAP). J Immunol Methods 1988; 111: 195-203.
28 Jacobs R, Murtaugh RJ, DeHoff WD. Review of the clinicopathological findings of acute pancreatitis in the dog: use of an experimental model. J Am Anim Hosp Assoc 1985; 21: 795-800.
29 Jergens AE. Diseases of the exocrine pancreas Part 1 – EPI. Proceedings of the 19th ACVIM-Forum. Denver, CO; 2001: 56-7.
30 Kaffarnik H, Meyer-Bertenrath J-G. Zur klinischen Wertigkeit des oralen Pankreasfunktionstests mit Fluoreszein-Dilaurat. Münch Med Wschr 1970; 45: 1467-70.
31 Keller P. Enzyme activities in the dog: tissue analyses, plasma values, and intracellular distribution. Am J Vet Res 1981; 42: 575-82.
32 Kerber-Pinho M, Wirth W. Zur Diagnostik der exokrinen Pankreasinsuffizienz des Hundes. Kleintierprax 1986; 31: 137-8.
33 Korrell J, Spillmann T, Börngen S, Krüger M, Grünbaum E-G, Leidinger K. Pankreatitis-assoziiertes Protein (PAP) und canines C-reaktives Protein (cCRP) bei der akuten Pankreatitis des Hundes. 8. Jahrestagung der Fachgruppe Innere Medizin und Klinische Labordiagnostik der DVG, München. 1999
34 Kraft W, Bauer G. Akute Pankreatopathien als Nebenwirkungen der Leishmaniose-Therapie?. Kleintierprax 1994; 39: 309-10.
35 Lamb CR. Abdominal ultrasonography in small animals: Examination of the liver, spleen and pancreas. J Small Anim Pract 1990; 31: 5-14.
36 Lamb CR, Simpson KW, Boswood A, Matthewman LA. Ultrasonography of pancreatic neoplasia in the dog: a retrospective review of 16 cases. Vet Rec 1995; 137: 65-8.
37 Lankisch PG. Exocrine pancreatic function tests. Gut 1982; 23: 777-98.
38 Malfertheiner P, Büchler B, Müller A, Ditschuneit H. Fluorescein dilaurate serum test: a rapid tubless pancreatic function test. Pancreas 1987; 02: 53-60.
39 Malfertheiner P, Büchler M, Stanescu A, Uhl W, Ditschuneit H. Serum elastase 1 in inflammatory pancreatic and gastrointestinal disease and in renal insufficiency. A comparison with other serum pancreatic enzymes. Int J Pancreat 1987; 02: 159-70.
40 Malfertheiner P, Dominguez-Munoz JE. Prognostic factors in acute pancreatitis. Int J Pancreat 1993; 01: 1-8.
41 Malfertheiner P, Dominguez-Munoz JE. Clinical and laboratory diagnosis of acute pancreatitis. Ann Ital Chir 1995; 02: 165-70.
42 Mansfield CS, Jones BR. Plasma and urinary trypsinogen activation peptide in healthy dogs, dogs with pancreatitis and dogs with other systemic diseases. Aust Vet J 2000; 78: 416-22.
43 Mansfield CS, Jones BR. Trypsinogen activation peptide in the diagnosis of canine pancreatitis. Proceedings of the 18th ACVIM Forum. Seattle, WA: 2000: 723.
44 Mansfield CS, Jones BR, Spillmann T. Predicting the severity of canine pancreatitis. Res Vet Sci (in press).
45 Meyer-Bertenrath JG. Pancreolauryl test measures the lipolytic activity of pancreatic cholesterol ester hydrolase. Digestion 1982; 25: 54.
46 Millson CE, Charles K, Macfie J, Mitchel CJ. A prospective study of serum pancreatic elastase-1 in the diagnosis and assessment of acute pancreatitis. Scand J Gastroent 1998; 33: 664-8.
47 Moeller EM, Steiner JM, Clark LA, Murphy KE, Famula TR, Williams DA, Stankovics M, Vose A. Inheritance of pancreatic acinar atrophy in German Shepherd Dogs in the USA. Am J Vet Res 2002; 63: 1429-34.
48 Murdoch BA. Diarrhoea. In: Canine Medicine and Therapeutics. 3rd. ed. Chandler EA, Thompson DJ, Sutton JB, Price CJ. eds. Oxford: Blackwell; 1991: 545-59.
49 Murtaugh RJ. Acute pancreatitis: diagnostic dilemmas. Sem Vet Met Surg 1987; 04: 282-95.
50 Murtaugh RJ, Herring DS, Jacobs RM, De Hoefs WD. Pancreatic ultrasonography in dogs with experimentally induced acute pancreatitis. Vet Radiol 1985; 26: 27-32.
51 Murtaugh RJ, Jacobs RM. Serum amylase and isoamylase and their origins in healthy dogs and dogs with experimentally induced pancreatitis. Am J Vet Res 1984; 03: 742-7.
52 Polzin DJ, Osborn CA, Stevens JB, Hayden DW. Serum amylase and lipase activities in dogs with chronic primary renal failure. Am J Vet Res 1981; 44: 404-10.
53 Probst A, Kneissl S. Computed tomographic anatomy of the canine pancreas. Vet Radiol Ultrasound 2001; 42: 226-30.
54 Puolakkainen P, Valtonen V, Paananen A, Schröder T. C-reactive protein (CRP) and serum phospholipase A2 in the assessment of the severity of acute pancreatitis. Gut 1987; 28: 764-71.
55 Reusch C. Photometrische Chymotrypsinbestimmung im Kot des Hundes. Eine neue Methode in der Diagnostik der chronisch exokrinen Pankreasinsuffizienz. Tierärztl Prax 1986; 14: 147-52.
56 Rinderknecht H. Activation of pancreatic zymogens: normal activation, premature intrapancreatic activation, protective mechanisms against inappropriate activation. Dig Dis Sci 1986; 31: 314-21.
57 Ruaux CG, Atwell RB. Levels of total alpha-macroglobulin and trypsinlike immunoreactivity are poor indicators of clinical severity in spontaneous canine acute pancreatitis. Res Vet Sci 1999; 67: 83-7.
58 Ruaux CG, Lee RP, Atwell RB. Detection and measurement of canine alpha-macroglobulins by enzyme immuno-assay. Res Vet Sci 1999; 66: 185-90.
59 Rutz GM, Steiner JM, Hirschberger J. Exokrine Pankreasinsuffizienz des Hundes. Tierärztl Prax 2000; 28 (K): 138-44.
60 Rüst SK. Computertomographische Darstellung des Pankreas beim Hund. Diss med vet, Gießen. 2001
61 Säteri H. Investigations on the exocrine pancreatic function in the dogs suffering from chronic exocrine pancreatic insufficiency. Acta Vet Scand 1975; Suppl 53: 1-86.
62 Scheefers-Borchel U, Scheefers H, Arnold R, Fischer P, Sziegoleit A. Pankreatische Elastase-1: Parameter für die chronische und akute Pankreatitis. Lab Med 1992; 16: 427-32.
63 Simpson JW, Doxey DL. Quantitative asessment of fat absorption and its diagnostic value in exocrine pancreatic insufficiency. Res Vet Sci 1983; 35: 249-51.
64 Simpson KW. Current concepts of the pathogenesis and pathophysiology of acute pancreatitis in the dog and cat. Small Anim Comp 1993; 15: 247-53.
65 Simpson KW. Diseases of the exocrine pancreas. In: Canine Medicine and Therapeutics. 4th. ed. Gorman N. ed. Oxford: Blackwell; 1998: 556-73.
66 Simpson KW, Batt RM, McLean L, Morton DB. Circulating concentration of trypsin-like immunoreactivity and activities of lipase and amylase after pancreatic duct ligation in dogs. Am J Vet Res 1989; 05: 629-32.
67 Simpson KW, Beechey-Newman N, Lamb CR, Smith JBA, Hughes G, Coombe K, Sumar N, Hermon-Taylor J. Cholecystokinin-8 induces edematous pancreatitis in dogs associated with short burst of trypsinogen activation. Dig Dis Sci 1995; 40: 2152-61.
68 Simpson KW, Simpson JW, Morton DB, Batt RM. Effect of pancreatectomy on plasma activities of amylase, isoamylase, lipase and trypsin-like immunoreactivity in dogs. Res Vet Sci 1991; 51: 78-82.
69 Simpson KW, Starkey R, Dibartola S, Chew D, McLaughlin M, Williams DA. The effect of subtotal nephrectomy on circulating trypsin-like immunoreactivity, amylase, lipase and gastrin in the dog. 10th ACVIM Forum. 1992
70 Spillmann T. Zur Diagnostik der exokrinen Pankreasinsuffizienz beim Hund. Diss med vet, Gießen. 1995
71 Spillmann T. Endoscopic retrograde Cholangio-Pancreaticography. Proceedings of the 20th ACVIM Forum. Dallas, TX: 2002
72 Spillmann T, Eigenbrodt E, Sziegoleit A. Die Bestimmung und klinische Relevanz der fäkalen pankreatischen Elastase beim Hund. Tierärztl Prax 1998; 26 (K): 364-8.
73 Spillmann T, Korrell A, Wittker A, Börngen S, Krüger M. Serum canine pancreatic elastase and canine C-reactive protein for the diagnosis and prognosis of acute pancreatitis in dogs. J Vet Intern Med 2002; 16: 635.
74 Spillmann T, Leidinger K, Müller E, Failing K. Zur Bestimmung der Blutserumkonzentration caniner Trypsin-like immunoreactivity (cTLI) – Testvergleich zwischen Radioimmunoassay und Enzyme-linked immunosorbent assay. Tierärztl Prax 1999; 27 (K): 74-80.
75 Spillmann T, Litzlbauer H-D, Moritz A, Rüst SK, Burkhardt E, Grünbaum E-G. Computed tomography and laparoscopy for the diagnosis of pancreatic diseases in dogs. Proceedings of the 18th ACVIM Forum. Seattle, WA: 2000
76 Spillmann T, Moritz A, Burkhardt E. Die Stellung der Laparoskopie in der Diagnostik von Pankreaserkrankungen des Hundes. Tierärztl Prax 2000; 28 (K): 349-55.
77 Spillmann T, Müller E, Grünbaum E-G. Pancreatic Stimulation Test – A new technique for the diagnosis of exocrine pancreatic insufficiency. Focus on Gastroenterology, Proceedings of the WALTHAM/ESCG Symposia 1994; 55-7.
78 Spillmann T, Schnell-Kretschmer H. Endoscopic retrograde cholangiopancreaticography (ERCP) for the investigation of canine bile and pancreatic duct system. Proceedings of the 11th ESVIM Congress. Dublin; 2001
79 Spillmann T, Wiberg ME, Teigelkamp S, Failing K, Chaudhry YS, Kirsch A, Eifler R, Westermarck E, Eigenbrodt E, Sziegoleit A. Canine faecal pancreatic elastase (cE1) in dogs with clinical exocrine pancreatic insufficiency, normal dogs and dogs with chronic enteropathies. Eur J Comp Gast 2000; 05: 5-10.
80 Spillmann T, Wittker A, Teigelkamp S, Eim C, Burkhardt E, Eigenbrodt E, Sziegoleit A. An immunoassay for canine pancreatic elastase 1 as a potential indicator for exocrine pancreatic insufficiency in dogs. J Vet Diagnost Invest 2001; 13: 468-74.
81 Steiner JM. Trypsin bei der Katze. Diss vet med, München. 1995
82 Steiner JM, Berridge BR, Wojcieszyn J, Williams DA. Immunolocalization of canine pancreatic and gastric lipase in normal canine tissue. Am J Vet Res 2002; 63: 722-7.
83 Steiner JM, Broussard J, Mansfield CS, Gumminger SR, Williams DA. Serum canine pancreatic lipase immunoreactivity (cPLI) concentrations in dogs with spontaneous pancreatitis. Proceedings of the 19th ACVIM Forum. Denver, CO; 2001: 839.
84 Steiner JM, Finco DR, Gumminger SR, Wiliams DA. Serum canine pancreatic lipase immunoreactivity (cPLI) in dogs with experimentally induced chronic renal failure. Proceedings of the 19th ACVIM Forum. Denver, CO; 2001: 876.
85 Steiner JM, Gumminger SR, Rutz GM, Williams DA. Serum canine pancreatic lipase immunoreactivity (cPLI) concentrations in dogs with exocrine pancreatic insufficiency (EPI). Proceedings of the 19th ACVIM Forum. Denver, CO; 2001: 839.
86 Steiner JM, Gumminger SR, Williams DA. Development and validation of an enzyme-linked immunosorbent assay (ELISA) for the measurement of canine pancreatic lipase immunoreactivity (cPLI) in serum. Proceedings of the 19th ACVIM Forum. Denver, CO; 2001: 876.
87 Strombeck DR, Guilford GW. The pancreas. In: Small Animal Gastroenterology. 2nd. ed. Strombeck DR, Guilford GW. eds. London: Wolfe; 1991: 429-59.
88 Strombeck DR, Wheeldon E, Harrold D. Model of chronic pancreatitis in the dog. Am J Vet Res 1984; 45: 131-6.
89 Suchodolski JS, Collard JC, Steiner JM, Ruaux CG, Williams DA. Development and validation of an enzyme-linked immunosorbent assay for measurement of α₁-proteinase inhibitor/trypsin complexes in canine sera. Proceedings of the 19th ACVIM Forum. Denver, CO; 2001: 876.
90 Suchodolski JS, Ruaux CG, Steiner JM, Collard JC, Simpson KW, Williams DA. Serum α₁-proteinase inhibitor/trypsin complex as a marker for canine pancreatitis. Proceedings of the 19th ACVIM Forum. Denver, CO; 2001: 838.
91 Sziegoleit A, Linder D. Die menschliche Pankreaselastase 1. Med Welt 1991; 42: 682-4.
92 Tagata K, Yokoyama S, Ginbo T, Honda M, Okimura T, Odakura M, Nomura T, Yamamoto S. Quantitative capillary reversed passive latex agglutination test for C-reactive protein in the dog. Vet Res Comm 1996; 20: 21-30.
93 Uhl W, Büchler M. Akute Pankreatitis: Labordiagnostik und Prognosefaktoren. In: Erkrankungen des exkretorischen Pankreas, 1. Aufl. Gülzow M. Hrsg. Jena: Fischer; 1995: 211-7.
94 Umeki S, Satoh T, Ueda S. Alterations in serum pancreatic elastase 1 content in acute and chronic pancreatitis: Comparison with amylase activity. J Lab Clin Med 1985; 106: 578-82.
95 Van Enkefort BA, O’Brien RT, Young KM. Pancreatic pseudocysts in 4 dogs and 2 cats: Ultrasonographic and clinicopathologic findings. J Vet Int Med 1999; 13: 309-13.
96 Ventrucci M, Pezilli R, Gullo L, Plate L, Sprovieri G, Barbara L. Role of serum pancreatic enzyme assays in diagnosis of pancreatic disease. Dig Dis Sci 1989; 34: 39-45.
97 Von Weber W, Freudiger U. Erbanalytische Untersuchungen über die chronische exokrine Pankreasinsuffizienz beim Deutschen Schäferhund. Schweiz Arch Tierheilk 1977; 119: 257-63.
98 Westermarck E. The hereditary nature of canine pancreatic degenerative atrophy in the German Shepherd Dog. Acta Vet Scand 1980; 21: 389-94.
99 Westermarck E, Batt RM, Vaillant C, Wiberg M. Sequential studies of pancreatic structure and function during development of pancreatic acinar atrophy in a German shepherd dog. Am J Vet Res 1993; 54: 1088-94.
100 Westermarck E, Pamilo P, Wiberg M. Pancreatic degenerative atrophy in the Collie breed: A hereditary disease. J Vet Med 1989; A 36: 549-54.
101 Westermarck E, Rimaila-Pärnänen E. Two unusual cases of canine exocrine pancreatic insufficiency. J Small Anim Pract 1989; 30: 32-4.
102 Westermarck E, Sandholm M. Faecal hydrolase activity as determined by radial enzyme diffusion – a new method for detecting pancreatic dysfunction in the dog. Res Vet Sci 1980; 28: 341-6.
103 Wiberg ME, Nurmi A-K, Westermarck E. Serum trypsin-like immunoreactivity measurement for the diagnosis of subclinical exocrine pancreatic insufficiency. J Vet Intern Med 1999; 13: 426-32.
104 Wiberg ME, Saari SAM, Westermarck E. Exocrine pancreatic atrophy in German Shepherd dogs and Rough-coated Collies: An end result of lymphocytic pancreatitis. Vet Pathol 1999; 36: 530-41.
105 Wiberg ME, Saari SAM, Westermarck E, Meri S. Cellular and humoral immune response in atrophic lymphocytic pancreatitis in German shepherd dogs and rough-coated collies. Vet Immunol Immunopathol 2000; 76: 103-15.
106 Wiberg ME, Westermarck E, Spillmann T, Teigelkamp S, Eifler R. Canine faecal pancreatic elastase (cE1) for the diagnosis of subclinical exocrine pancreatic insufficiency in dogs. Europ J Comp Gast 2000; 05: 21-5.
107 Willard MD. The exocrine pancreas. In: Small Animal Internal Medicine. 2nd. ed. Nelson RW, Couto CG. eds. St. Louis: Mosby; 1998: 555-70.
108 Williams DA. New tests of pancreatic and small intestinal function. Comp Small Anim 1987; 09: 1167-74.
109 Williams DA. Exocrine pancreatic disease. In: Canine Medicine and Therapeutics. Chandler EA, Thompson DJ, Sutton JB, Price CJ. eds. Oxford: Blackwell; 1991561-77.
110 Williams DA. The pancreas. In: Small Animal Gastroenterology. 3rd. ed. Strombeck DA, Guilford WG, Center SA, Williams DA, Meyer DA. eds. Philadelphia: Saunders; 1996: 381-92.
111 Williams DA. Exocrine pancreatic disease. In: Textbook of Veterinary Internal Medicine, Vol. 2. 5th. ed. Ettinger SJ, Feldman EC. eds. Philadelphia: Saunders; 2000: 1345-67.
112 Williams DA, Batt RM. Diagnosis of canine exocrine pancreatic insufficiency by the assay of serum trypsin-like immunoreactivity. J Small Anim Pract 1983; 24: 583-8.
113 Williams DA, Batt RM. Sensitivity and specificity of radioimmunoassay of serum trypsin-like immunoreactivity for the diagnosis of canine exocrine pancreatic insufficiency. J Am Vet Med Assoc 1988; 192: 195-201.
114 Williams DA, Steiner JM. Canine pancreatitis. In: Kirk´s Current Veterinary Therapy XIII. 13th ed. Bonagura JD. ed. Philadelphia: Saunders; 2000: 697-700.
115 Yamamoto S, Miyaji S, Abe N, Otabe K, Furakawa E, Naiki M. Canine C-reactive protein does not share common antigenicity with human CRP. Vet Res Commun 1993; 17: 259-66.
116 Yamamoto S, Shida T, Okimura T, Otabe K, Honda M, Ashida Y, Furakawa E, Sarikaputi M, Naiki M. Determination of C-reactive protein in serum and plasma from healthy dogs and dogs with pneumonia by ELISA and slide reverse passiv latex agglutination test. Vet Quart 1994; 16: 74-7.

Labordiagnostik von Pankreaserkrankungen des Hundes – Möglichkeiten und Grenzen[*]

Labordiagnostik von Pankreaserkrankungen des Hundes – Möglichkeiten und Grenzen^[*]