Overview

• fPLI  is an acronym for feline Pancreatic Lipase Immunoreactivity, a specific lipase found only in feline pancreatic tissue.
• The commercially available assay measures concentrations of pancreatic lipase in the serum.
• Inflammation of the pancreas leads to an increased release of pancreatic lipase into the circulation, thus elevated concentrations of pancreatic lipase are consistent with a diagnosis of pancreatitis Pancreatitis.

Sampling

Tests

Methodologies

• Serum feline pancreatic lipase immunoreactivity is measured with an ELISA Enzyme linked immunosorbent assay (ELISA).
• This test is (Spec fPL™) is exclusively manufactured by IDEXX Laboratories:
  • A microplate is coated with monoclonal antibodies against feline pancreatic lipase.
  • Sera are diluted and incubated on the plate, allowing the monoclonal antibodies to capture the pancreatic lipase, while other proteins are washed away.
  • A secondary antibody carrying a label is then incubated in the wells.
  • The amount of bound label is proportionate to the quantity of pancreatic lipase in the original serum sample.
  • A standard curve is constructed using a recombinant peptide that is part of the native canine pancreatic lipase protein.
• A point of care test (IDEXX SNAP fPL) is also available using a SNAP ELISA technology and this patient-side test has good agreement with Spec fPL. It is recommended that abnormal SNAP fPL results are followed up with Spec fPL to establish a baseline concentration and to avoid potential false positive results (SNAP fPL may be abnormal when Spec fPL is between 3.5-5.4 ug/L, however, the recognized cut-off for a diagnosis of pancreatitis is 5.4 ug/L. See reference ranges below). 

Validity

Sensitivity

• A wide range of sensitivities has been cited in the literature dependent on the stage of disease. Pancreatic biopsy Biopsy: pancreas is still considered to be the gold standard for the diagnosis of pancreatitis. Many studies have not used pancreatic histology due to inherent difficulties in achieving pancreatic biopsies in sick cats. Sensitivities of  between 42-100% have been reported in cats with histological evidence of pancreatitis. Most data suggests that Spec fPl is sensitive for the diagnosis of pancreatitis in cats with higher sensitivity for severe cases than for mild cases.

Specificity

• When a healthy control group were tested, specificity of spec fPL was cited as being up to 100%, while in cats with signs suggestive of pancreatitis, but normal pancreatic pathology, specificities of 67-69% were reported. In other studies where pancreatic histology was not used as the gold standard, specificity varied depending on the cut-off used for the diagnosis of pancreatitis.

Technique (intrinsic) limitations

• Avoid submission of severely lipemic or hemolyzed samples.

Result Data

Further Reading

Publications

Refereed papers

• Recent references from VetMedResource and PubMed.
• Forman M A, Steiner J M, Armstrong, P J et al (2021) ACVIM consensus statement on pancreatitis in cats. J Vet Intern Med 35, 703-723 PubMed onlinelibrary.wiley.com/doi/10.1111/jvim.16053.
• Lee C, Kathrani A, Maddison J (2020) Retrospective study of the diagnostic utility of Spec fPLin the assessment of 274 sick cats. J Vet Intern Med 34, 1406-1412 PubMed. 
• Törner K, Staudacher M, Tress U, Weber C N, Stadler C, Grassinger J M, Müller E, Aupperle-Lellbach H (2019) Histopathology and Feline Pancreatic Lipase Immunoreactivity in Inflammatory, Hyperplastic and Neoplastic Pancreatic Diseases in Cats. J Comp Pathol 174, 63-72 PubMed.
• Schnauß F, Hanisch F, Burgener I A (2019) Diagnosis of feline pancreatitis with SNAP fPL and Spec fPL. J Feline Med Surg 21(8),700-707 PubMed.
• Xenoulis P G & Steiner J M (2012) Canine and feline pancreatic lipase immunoreactivity. Vet Clin Pathol 41(3), 312-324 PubMed.
• Forman M A, Marks S L, De Cock H E V, Hergesell E J, Wisner E R, Baker T W, Kass P H, Steiner J M & Williams D A (2004) Evaluation of serum feline pancreatic lipase immunoreactivity and helical computed tomography versus conventional testing for the diagnosis of feline pancreatitis. J Vet Intern Med 18 (6), 807-815 PubMed.
• Steiner J M, Wilson B G & Williams D A (2004) Development and analytical validation of a radioimmunoassay for the measurement of feline pancreatic lipase immunoreactivity in serum. Can J Vet Res 68 (4), 309-314 PubMed.
• Steiner J M, Wilson B G & Williams D A (2003) Purification and partial characterization of feline classical pancreatic lipase. Comp Biochem Physiol B Biochem Mol Biol 134 (1), 151-159.
• Gerhardt A, Steiner J M, Williams D A et al (2001) Comparison of the sensitivity of different diagnostic tests for pancreatitis in cats. J Vet Intern Med 15, 329-333 PubMed.

Organization(s)

• The Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station TX 77845-4474, USA;  vetmed.tamu.edu/gilab/.