Köpeklerde deneysel akut pankreatitisin teşhisinde serum C-peptid ve idrar amilaz klirensinin önemi

Abstract

7. SUMMARY The importance of serum C-peptide and urine amylase / creatinine ratio in the diagnosis of experimentally induced canine acute pancreatitis. In this study the importance of serum C-peptide and urine amylase / creatinine ratio in the diagnosis of experimentally induced canine acute pancreatitis were investigated. For this purpose, totally 13 healthy and mature dogs were used. 7 of which were used as an experimental group and remaining 6 dogs were used as a control group. After base - line clinical and biochemical examination, the experimental group of dogs were anesthezied with thiopental sodium. The pancreas were exposed through a ventral midline incision and injected oleic acid (0.5 ml/kg body weight) into 8 parts to induce experimental acute pancreatitis. On the control group of dogs laparatomie was only performed. Clinical status was monitored and blood hematocride values (Ht), red and white cells counts (RBC, WBC), serum amylase, lipase, ALP, ALT enzyme activities, C-peptide, urea, creatinine, glucose, cholesterole, trigliseride, Ca*/ Na/ K* ve Cl~ concentrations and urine amylase / creatinine ratios were determined once in a day at the 1st, 2nd, 3rd, 5th and 8th days of the experiment. Two experiment group of dogs died on the 4th day of the experiment and they necropsied on the same day. The remaining dogs were necropsied on the 8th day of the experiment and histopathologic examination of the pancreas and the other visceral organ samples were performed. The most prominent clinical symptoms were fever, anorexia, depresion, vomiting and steatorrhea at the experimental group of dogs. None of the control group of dogs showed considerable clinic symtoms after experimental laparatomie, only one dog had persistent vomiting for 6 hours after laparatomie. The mean blood Ht values and WBC counts did not show significant difference during the experiment, whereas, RBC count significantly increased in the experiment group of the dogs on the 2nd and 3rd days of the experiment. There was no significant difference in the mean serum creatinine concentrations between control and experimental group of dogs. Mean serum urea concentrations in experimental group of dogs significantly increased on the 1st and 2nd days of the experiment. The mean serum glucose concetrations was found to be significantly increased 53only on the 3rd day of the experiment, whereas the mean C-peptide concentrations did not show any significant alteration between control and experimental group of dogs. The median serum cholesterole and trigliseride concentrations were found to be significantly increased in the experimental group of dogs on the 3rd and 8th and 2nd, 3rd and 8th days of the experiment when compared to the values of control group of dogs. The mean serum C/~ concentrations didn't show any significant alteration, whereas the mean serum Na* and K4 concentrations decreased significantly on the 1st, 2nd and 1st, 2nd, 3rd and 5th days of the experiment respectively. The mean serum Caf 4 concentrations in experimental group of dogs decreased significantly on the 2nd, 3rd. 5th and 8th days of the experiment when compared to the values of control group of dogs. The median serum ALP activities were found to be significantly increased on the 2nd, 3rd, 5th and 8th days of the experiment. However, the median serum ALT activities did not show any significant alteration. The both median serum amylase and lipase activities increased significantly in the experimental group of dogs on the 1st, 2nd, 3rd and 5th days of the experiment. The increament in the urine amylase / creatinine ratio was significant on the 2nd day and continued to be different during the experiment when compared to the values of control group of dogs. When the test performance was evaluated, serum lipase activity had higher sensitivity when cut off values for serum lipase of > 350 U/L, for urine amylase / creatinine ratio of > 5, for serum ALP of > 138 U/L, for serum Ca` of < 7.78 mg/dl and for serum amylase of > 1800 U/L were used. Gross and histopathologic evidence for severe necrotizing haemorrhagic pancreatitis was present in all dogs of experimental group. In conclusion, serum lipase enzym activity was found to be more sensitive indicator in the diagnosis of acute pancreatitis induced by oleic acid administration. The combination of serum lipase enzyme activity with urine amylase / creatinine ratio, might be useful diagnostic pattern of acute pancreatitis. 54

7. SUMMARY The importance of serum C-peptide and urine amylase / creatinine ratio in the diagnosis of experimentally induced canine acute pancreatitis. In this study the importance of serum C-peptide and urine amylase / creatinine ratio in the diagnosis of experimentally induced canine acute pancreatitis were investigated. For this purpose, totally 13 healthy and mature dogs were used. 7 of which were used as an experimental group and remaining 6 dogs were used as a control group. After base - line clinical and biochemical examination, the experimental group of dogs were anesthezied with thiopental sodium. The pancreas were exposed through a ventral midline incision and injected oleic acid (0.5 ml/kg body weight) into 8 parts to induce experimental acute pancreatitis. On the control group of dogs laparatomie was only performed. Clinical status was monitored and blood hematocride values (Ht), red and white cells counts (RBC, WBC), serum amylase, lipase, ALP, ALT enzyme activities, C-peptide, urea, creatinine, glucose, cholesterole, trigliseride, Ca*/ Na/ K* ve Cl~ concentrations and urine amylase / creatinine ratios were determined once in a day at the 1st, 2nd, 3rd, 5th and 8th days of the experiment. Two experiment group of dogs died on the 4th day of the experiment and they necropsied on the same day. The remaining dogs were necropsied on the 8th day of the experiment and histopathologic examination of the pancreas and the other visceral organ samples were performed. The most prominent clinical symptoms were fever, anorexia, depresion, vomiting and steatorrhea at the experimental group of dogs. None of the control group of dogs showed considerable clinic symtoms after experimental laparatomie, only one dog had persistent vomiting for 6 hours after laparatomie. The mean blood Ht values and WBC counts did not show significant difference during the experiment, whereas, RBC count significantly increased in the experiment group of the dogs on the 2nd and 3rd days of the experiment. There was no significant difference in the mean serum creatinine concentrations between control and experimental group of dogs. Mean serum urea concentrations in experimental group of dogs significantly increased on the 1st and 2nd days of the experiment. The mean serum glucose concetrations was found to be significantly increased 53only on the 3rd day of the experiment, whereas the mean C-peptide concentrations did not show any significant alteration between control and experimental group of dogs. The median serum cholesterole and trigliseride concentrations were found to be significantly increased in the experimental group of dogs on the 3rd and 8th and 2nd, 3rd and 8th days of the experiment when compared to the values of control group of dogs. The mean serum C/~ concentrations didn't show any significant alteration, whereas the mean serum Na* and K4 concentrations decreased significantly on the 1st, 2nd and 1st, 2nd, 3rd and 5th days of the experiment respectively. The mean serum Caf 4 concentrations in experimental group of dogs decreased significantly on the 2nd, 3rd. 5th and 8th days of the experiment when compared to the values of control group of dogs. The median serum ALP activities were found to be significantly increased on the 2nd, 3rd, 5th and 8th days of the experiment. However, the median serum ALT activities did not show any significant alteration. The both median serum amylase and lipase activities increased significantly in the experimental group of dogs on the 1st, 2nd, 3rd and 5th days of the experiment. The increament in the urine amylase / creatinine ratio was significant on the 2nd day and continued to be different during the experiment when compared to the values of control group of dogs. When the test performance was evaluated, serum lipase activity had higher sensitivity when cut off values for serum lipase of > 350 U/L, for urine amylase / creatinine ratio of > 5, for serum ALP of > 138 U/L, for serum Ca` of < 7.78 mg/dl and for serum amylase of > 1800 U/L were used. Gross and histopathologic evidence for severe necrotizing haemorrhagic pancreatitis was present in all dogs of experimental group. In conclusion, serum lipase enzym activity was found to be more sensitive indicator in the diagnosis of acute pancreatitis induced by oleic acid administration. The combination of serum lipase enzyme activity with urine amylase / creatinine ratio, might be useful diagnostic pattern of acute pancreatitis. 54