Study examines DGGR lipase performance for pancreatitis in cats

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A newly reported JAVMA study takes on a familiar clinical problem: how much confidence veterinarians should place in DGGR lipase activity when evaluating cats for pancreatitis. The paper, by J. Godoy, A. Willems, and Patricia Ibarrola, focuses on cats presenting to a veterinary referral hospital and evaluates DGGR lipase against a blinded clinical diagnosis built from signs, clinicopathologic data, and ultrasonographic findings. That matters because feline pancreatitis remains one of the more frustrating diagnoses in small animal internal medicine, with no simple ante-mortem gold standard in everyday practice. (bsavaclinicalabstracts.com)

The background here is important. In cats, pancreatitis is typically diagnosed through a combination of clinical presentation, laboratory testing, and imaging, because histopathology is invasive, imperfect for focal disease, and rarely pursued purely for confirmation. Over the past decade, DGGR-based lipase assays have gained attention because they are faster, more available, and often less expensive than pancreas-specific immunoassays such as Spec fPL. But the clinical literature has been mixed, which is why each new diagnostic performance study draws attention. (pmc.ncbi.nlm.nih.gov)

In the referral-hospital study, investigators measured DGGR lipase in 231 cats and assessed how often results were increased in cats with and without pancreatitis. The abstracted conference version describes a blinded internal medicine-led classification process using clinical signs, clinicopathologic abnormalities, and ultrasound changes as the comparator, rather than relying on a single test or imaging result alone. That design reflects real referral practice, where clinicians are usually integrating multiple imperfect signals rather than choosing between one definitive positive or negative result. (bsavaclinicalabstracts.com)

What makes the paper especially relevant is the larger evidence base around DGGR. Earlier studies found substantial agreement between DGGR lipase and Spec fPL in cats with suspected pancreatitis, including one report with a kappa of 0.68 at commonly used cutoffs and another showing substantial agreement between the two lipase assays overall. At the same time, agreement between either lipase assay and pancreatic ultrasonography has been only fair, underscoring that test concordance drops when clinicians move from bloodwork-to-bloodwork comparisons to bloodwork-versus-imaging comparisons. (pubmed.ncbi.nlm.nih.gov)

There are also analytical caveats that continue to shape expert interpretation. The 2021 ACVIM consensus statement noted that DGGR-based assays are not specific for pancreatic lipase and cited poor agreement between ultrasonographic diagnosis and DGGR lipase in cats. Separate experimental work showed DGGR assay activity can rise after heparin administration, supporting concern that hepatic and lipoprotein lipases can interfere with results. Another study has suggested renal function may also complicate interpretation, a practical issue in older cats with multimorbidity. (academic.oup.com)

Why it matters: For veterinarians, this study is most useful if it helps sharpen expectations around test performance rather than promising a diagnostic shortcut. In many practices, DGGR lipase is attractive because it is accessible and economical, and it may be particularly helpful as part of an initial workup or serial monitoring strategy. But if the full paper confirms only moderate discrimination, or shows meaningful false positives in cats without pancreatitis, that would reinforce the current standard of care: interpret DGGR lipase as one piece of a multimodal assessment, not as a standalone answer. That is especially relevant for referral clinicians managing cats with concurrent gastrointestinal disease, diabetes, kidney disease, or nonspecific illness, where pancreatic biomarkers can be harder to contextualize. (pubmed.ncbi.nlm.nih.gov)

Industry and expert reaction around DGGR has generally followed that same middle ground. Commercial and laboratory-facing materials have emphasized its speed, cost, and operational convenience, while consensus statements and analytical studies have continued to urge caution about specificity and cutoff interpretation. In other words, the field has not rejected DGGR, but it has not fully settled on how far clinicians should trust it when results conflict with ultrasound or the broader clinical picture. This new referral-hospital dataset adds weight because it reflects a population closer to the cats internists actually see, rather than idealized or narrowly selected cases. (zoetisdiagnostics.com)

What to watch: The next thing to watch is the full JAVMA publication record and any follow-up discussion that clarifies the assay’s optimal cutoff, sensitivity and specificity by case definition, and performance in cats with common comorbidities. If those details show stronger rule-out than rule-in value, DGGR lipase may become even more useful as a triage tool; if not, the study may mainly confirm that feline pancreatitis diagnosis still depends on combining biomarkers with imaging and clinical judgment. (bsavaclinicalabstracts.com)