Study links diabetes in dogs and cats with repeat pancreatitis markers: full analysis

A new study in the Journal of Small Animal Practice suggests concurrent pancreatic disease may be more common in diabetic dogs and cats than a single workup would show. In surplus serum samples from 52 dogs and 19 cats with diabetes mellitus, researchers found pancreatic lipase concentrations consistent with pancreatitis in roughly one-third of patients at diagnosis and in an even larger share at follow-up testing. The study was published online ahead of print on February 11, 2026. (pubmed.ncbi.nlm.nih.gov)

The work builds on a long-running question in small animal internal medicine: how often diabetes and exocrine pancreatic disease overlap, and whether that overlap is clinically silent. In dogs, a 2021 cross-sectional study found no clear evidence of exocrine pancreatic insufficiency by canine trypsin-like immunoreactivity in diabetic dogs overall, but it did identify concurrent increases in canine pancreatic lipase immunoreactivity in some cases, raising the possibility that pancreatic inflammation and endocrine disease often coexist. In cats, more recent work has likewise reported that diabetes is associated with higher feline pancreatic lipase immunoreactivity concentrations, sometimes without obvious clinical signs of pancreatitis. (pubmed.ncbi.nlm.nih.gov)

In the new study, pancreatic lipase concentrations above the study’s pancreatitis cutoffs were present in 16 of 52 dogs and 5 of 19 cats at initial presentation. When animals were followed over time, that increased to 22 of 52 dogs and 7 of 19 cats having at least one re-examination result in the pancreatitis-indicative range. Trypsin-like immunoreactivity told a different story: results consistent with exocrine pancreatic insufficiency were found in 2 of 52 dogs at presentation and 3 of 52 dogs at any recheck, while no cats met the feline cutoff for exocrine pancreatic insufficiency. The authors concluded that repeated testing for concurrent exocrine pancreatic disorders may be indicated in diabetic dogs and cats even when patients appear subclinical. (pubmed.ncbi.nlm.nih.gov)

That message lands in a field where interpretation has always required nuance. ACVIM consensus guidance and review articles describe pancreatic lipase immunoreactivity as the preferred clinicopathologic marker for suspected pancreatitis in dogs and cats, but they also emphasize that no single antemortem test is a perfect standalone answer. Instead, clinicians are advised to combine biomarker data with signalment, clinical signs, imaging, and the broader medical picture. In cats especially, consensus guidance highlights diabetes mellitus as an important comorbidity in pancreatitis cases. (pmc.ncbi.nlm.nih.gov)

Industry and academic commentary around related studies points in the same direction. A 2023 retrospective cohort abstract in diabetic dogs found higher canine pancreatic lipase immunoreactivity concentrations in poorly controlled or untreated diabetes than in well-controlled disease, with fructosamine and triglycerides associated with cPLI concentration. Two of five dogs with cPLI values consistent with pancreatitis had ultrasonographic evidence of pancreatitis despite lacking clinical signs, underscoring how easily pancreatic involvement may be missed in day-to-day practice. (aaha.org)

Why it matters: For veterinary professionals, the practical takeaway isn’t that every diabetic dog or cat needs an automatic pancreatitis label. It’s that pancreatic biomarker abnormalities may emerge over time, and that a normal or borderline result early in the course of diabetes may not settle the question. In patients with diabetic instability, gastrointestinal signs, diabetic ketoacidosis, unexplained weight loss, poor response to insulin adjustments, or concern for maldigestion, repeat pancreatic testing may help identify a clinically relevant comorbidity that changes case management, monitoring, nutrition planning, or client communication. The study also reinforces that exocrine pancreatic insufficiency appears to be much less common than pancreatitis-associated lipase elevations in this population, and may be more relevant in dogs than cats. (pubmed.ncbi.nlm.nih.gov)

There are still limits. The PubMed abstract does not provide the full clinical phenotype of affected animals, so it’s not yet clear how many of these biomarker elevations reflected clinically important pancreatitis versus subclinical or chronic pancreatic change. That distinction matters because elevated pancreatic lipase immunoreactivity can support suspicion, but it does not replace full clinical assessment. Even so, the serial design is useful: it suggests that one-time screening may underestimate pancreatic involvement in diabetic patients. (pubmed.ncbi.nlm.nih.gov)

What to watch: The next question is whether serial pancreatic biomarker testing will improve outcomes, not just detection, and whether future studies can identify which diabetic dogs and cats benefit most from repeat screening and at what intervals. (pubmed.ncbi.nlm.nih.gov)