Positive fPLI

myrnafaye

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I am confused about this test and its accuracy.  I was hoping some of the veterans here will comment.  So what does a positive fPLI really mean?  and I understand that t here are false negatives frequently as well...@StephenQ?
 

stephenq

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I am confused about this test and its accuracy.  I was hoping some of the veterans here will comment.  So what does a positive fPLI really mean?  and I understand that t here are false negatives frequently as well...@StephenQ?
I think the general answer is fairly accurate for pancreatitis.  This link to the Idexx testing site gives specific statistics on its accuracy when using their test. http://www.idexx.co.uk/smallanimal/reference-laboratories/testmenu/innovative-tests/spec-fpl.html

This article talks intelligently about pancreatitis.  http://www.vcahospitals.com/main/pe...ancreatic-lipase-immunoreactivity-in-cats/362

What my vet told me is that its important to test a cat who is having a flare up, so when he would go into a vomiting attack (like he would start throwing up multiple times in a very short period of time) we would rush him to the vet so they could get an accurate test, which they did.

Is your cat currently symptomatic?
 
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myrnafaye

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Last week Obi was not as interested in finishing his food and was going under the bed.  He did not appear to be sick but my 6th sense said something was "off" in her personality.  I was planning to leave town for  a few days and though my husband would be with the cats, I felt Obi should be looked at.  In addition, he had thrown two hairballs in three days.

The vet ran tests and the fPli was positive.  FYI, just to refresh your memory, he had a "mild" attackof pancreatitis last late spring/early summer, was put on B12, pain meds, etc.  So his blood work last week showed a positive PLI and a slightly elevated ALT, I believe.  The vet put him  on  a course of Cerenia, and he went back to his normal self.  I am still unclear as to what an elevated PLI means in the absence of more definitive symptoms.   And as a sidebar, to day he threw up a HUGE hairball, as well as some food.  He almost never throws up food, but is acting fine.  Another sidebar:  he got into a loaf of bread last night, my husband left it on the counter.  I assume white bread is not terrible for a cat, while certainly not the NV rabbit he is used to.  Comments appreciated.
 

stephenq

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Last week Obi was not as interested in finishing his food and was going under the bed.  He did not appear to be sick but my 6th sense said something was "off" in her personality.  I was planning to leave town for  a few days and though my husband would be with the cats, I felt Obi should be looked at.  In addition, he had thrown two hairballs in three days.

The vet ran tests and the fPli was positive.  FYI, just to refresh your memory, he had a "mild" attackof pancreatitis last late spring/early summer, was put on B12, pain meds, etc.  So his blood work last week showed a positive PLI and a slightly elevated ALT, I believe.  The vet put him  on  a course of Cerenia, and he went back to his normal self.  I am still unclear as to what an elevated PLI means in the absence of more definitive symptoms.   And as a sidebar, to day he threw up a HUGE hairball, as well as some food.  He almost never throws up food, but is acting fine.  Another sidebar:  he got into a loaf of bread last night, my husband left it on the counter.  I assume white bread is not terrible for a cat, while certainly not the NV rabbit he is used to.  Comments appreciated.
One of the problems with pancreatitis is that the symptoms can be both non-specific and connected to other illnesses.  From http://www.vcahospitals.com/main/pe...ancreatic-lipase-immunoreactivity-in-cats/362  "Feline pancreatitis is often part of a larger inflammatory disease process that may also involve the liver, intestine, and kidney. Clinical signs are often vague and non-specific, and include lethargy, dehydration, weight loss, loss of appetite, increased heart rate, increased respiration rate, and jaundice. A small percentage of cats will show vomiting and abdominal pain."

As to to what the fPli test means in the absence of symptoms, when the blood has elevated values of Pancreas-specific Lipase  which is what the test is measuring, it means that the pancreas is inflamed regardless of what the symptoms suggest or don't suggest.

​Because Pancreatitis comes and goes in waves, one of the clinical goals is to watch for it and to try and beat it back down when it rears its head so to speak, often with various combinations of sub q fluids, cerenia, zofran, and sometimes painkillers like Buprenorphine.  If your cat is acting off and  has elevated PL levels that strongly suggests that he is uncomfortable.
 
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