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Tierarztl Prax Ausg K Kleintiere Heimtiere 2018; 46(06): 386-392
DOI: 10.1055/s-0038-1677391
Originalartikel – Original Articles
Georg Thieme Verlag KG Stuttgart · New York

Prognostische Bedeutung sonographischer Parameter der Pankreatitis der Katze

Eine retrospektive Untersuchung bei 42 KatzenEvaluation of sonographic parameters as prognostic risk factors in cats with pancreatitisA retrospective study in 42 cats
Katharina Moser
1   Tierklinik Haar, Haar
,
Stefanie Mitze
1   Tierklinik Haar, Haar
,
Erik Teske
2   Department of Clinical Science of Companion Animals, University of Utrecht, The Netherlands
,
Christian Stockhaus
1   Tierklinik Haar, Haar
› Author Affiliations
Further Information

Publication History

Eingegangen: 31 August 2018

Akzeptiert nach Revision: 05 September 2018

Publication Date:
18 January 2019 (online)

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Zusammenfassung

Gegenstand: Die feline Pankreatitis ist eine Erkrankung mit sehr unterschiedlichen klinischen Verlaufsformen. Häufig stellt sich die Frage, inwieweit Parameter der klinischen, labordiagnostischen oder bildgebenden Untersuchungsverfahren zur Früherkennung eines progressiven, mit schlechterer Prognose verbundenen Verlaufs verwendet werden können. Nur wenige Studien untersuchten bei dieser Erkrankung prognostische Faktoren. Bei Vorliegen passender klinischer Symptomen dienen vor allem die feline pankreatische Lipase-Immunreaktivität (fPLI) und die abdominale Ultraschalluntersuchung zur Diagnose-stellung. Verschiedene sonographische Parameter wurden im Zusammenhang mit einer Pankreatitis beschrieben. Ziel der Studie war zu überprüfen, ob einzelne sonographische Kriterien bei Katzen mit Pankreatitis signifikant mit der Prognose korrelieren. Material und Methoden: In dieser retrospektiven Untersuchung (2009–2017) wurden bei 42 Katzen mit mindestens zwei klinischen Symptomen und erhöhtem Serum-fPLI-Wert (> 5,3 µg/l) die folgenden sonographischen Parameter des Pankreas untersucht: Pankreasbreite, -oberfläche, -echogenität, Echogenität des peripankreatischen Fettgewebes und Vorhandensein von Aszites. Tiere, die die ersten 30 Tage überlebten, galten als „Survivor“ (S), Tiere, die innerhalb der ersten 30 Tage starben, als „Nonsurvivor“ (NS). Ergebnisse: Sonographische Veränderungen lagen bei 33/42 (79 %) Katzen vor. Am häufigsten fanden sich hyper-echogenes peripankreatisches Fettgewebe (55 %), hypoechogenes Pankreasgewebe (45 %) und Pankreasverbreiterung (36 %). Bei keinem sonographischen Untersuchungskriterium konnte eine statistisch signifikante Korrelation mit der Zuordnung in die Gruppen S versus NS gefunden werden. Der fPLI-Wert hingegen korrelierte statistisch signifikant mit der Prognose. Schlussfolgerung: Weder vom Vorliegen sonographischer Veränderungen noch von deren Charakter oder Intensität ist ein Rückschluss auf die Prognose möglich. Im Gegensatz dazu stellt, wie in vorherigen Untersuchungen belegt, eine höhere fPLI-Konzentration einen negativen prognostischen Faktor dar.

Summary

Objective: Pancreatitis in cats can have different clinical courses. A range from asymptomatic or mild, unspecific clinical signs to severe disease with multi-organ dysfunction or even death has been described. It is sometimes difficult to evaluate the prognosis of the cat based on clinical findings, laboratory diagnostics and diagnostic imaging. There are only a few studies that have examined the outcome and prognostic factors for cats with pancreatitis. In cats presenting with signs of pancreatitis, the feline pancreatic lipase immunoreactivity (fPLI) and sonography are frequently used for establishing a diagnosis. Different sonographic parameters have been described to be asso ciated with pancreatitis. The aim of this retrospective study was to determine whether certain sonographic parameters correlate with the severity and the outcome of pancreatitis in the cat. Material and methods: In 42 cats, presented with at least two clinical signs consistent with pancreatitis and increased fPLI-values (> 5.3 µg/l), the following sonographic parameters were examined: thickness, surface and echogenicity of the pancreas, echogenicity of the peripancreatic fat tissue and the presence of ascites. Cats surviving the first 30 days were classified as survivors and those dying within 30 days as nonsurvivors. Results: Sonographic changes were found in 33/42 cats (79 %). The most frequent sonographic abnormalities were hyper-echoic peripancreatic fat (55 %), hypoechoic pancreatic tissue (45 %) and a thickened pancreas (36 %). There was no significant correlation between sonographic changes and the outcome of the cats. No significant differences in the fPLI concentration were found between the two groups. The fPLI concentration correlated significantly with the prognosis. Conclusion: Neither the presence nor the intensity of the sonographic changes correlate with the outcome of cats with pancreatitis. Contrary to this, the fPLI value is a negative prognostic factor, as has been described previously.

Schlüsselwörter:

Feline Pankreatitis - abdominale Sonographie - Prognose - fPLI

Keywords

Feline pancreatitis - abdominal sonography - prognostic factor - fPLI
 

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