(EN10) Risk Factors Associated with Elevated Serum Specific Canine Pancreatic Lipase in Dogs with Hypercortisolism

Abstract: Background Hypercortisolism (HC) is a common endocrine disorder in dogs that is often associated with pancreatitis. However, the relationship between cortisol concentration, pancreatic injury (PI) markers, and serum specific canine pancreatic lipase (Spec cPL) elevation remains unclear. Objectives To investigate the prevalence of PI, identify risk factors for elevated Spec cPL, and evaluate changes in Spec cPL levels following treatment. Animals Seventy-one client-owned dogs diagnosed with naturally-occurring HC between 2015 and 2024. Methods Dogs were classified as PI (Spec cPL ≥400 μg/L) or non-PI (Spec cPL < 400 μg/L). Clinical and laboratory parameters, including abdominal ultrasonography findings, were analyzed. Risk factors were identified using logistic regression analysis. Results The PI comprised 16 dogs (22.5%), with 7 (43.7%) showing ultrasonographic signs of pancreatitis. Univariate analysis showed significant inter-group differences in gamma-glutamyl transferase, blood urea nitrogen (BUN), symmetric dimethylarginine, cholesterol, C-reactive protein, urine protein-to-creatinine ratio (UPC), and post-low-dose dexamethasone suppression test (LDDST) cortisol levels. Multivariate analysis further identified BUN (odds ratio [OR], 1.051; P=.015), UPC (OR, 1.853; P=.021), and post-LDDST cortisol (OR, 1.560; P=.011) as risk factors. Trilostane treatment significantly reduced the post-ACTH cortisol and Spec cPL levels. Conclusions and Clinical Importance PI is common in dogs with HC, and elevated post-LDDST cortisol, BUN, and UPC levels are significant risk factors. Chronic HC may cause PI by reducing pancreatic perfusion and inducing inflammation. Elevated Spec cPL concentrations, even without clinical or ultrasonographic evidence of pancreatitis, require cautious interpretation along with clinical signs and imaging to mitigate misdiagnosis.