Diagnostic performance of 1,2-O-dilauryl-rac-glycero glutaric acid-(6'-methylresorufin) ester lipase activity in cats presenting to a veterinary referral hospital.

Normal DGGR lipase effectively rules out feline pancreatitis, but elevated results require cautious interpretation due to low positive predictive value.

This prospective observational study evaluated the diagnostic performance of serum DGGR lipase activity (measured via the Randox lipase assay, with a threshold of >25 U/L) in 231 cats presenting to a veterinary referral hospital. The prevalence of increased DGGR lipase was 25.5%. Pancreatitis likelihood was assessed using a blinded clinician-assigned score (0–4) and an ultrasonographic score (0–4) based on the number of supportive pancreatic changes. No cats received a clinical score of 4 (definite pancreatitis), and the majority scored 1 (55.4%), reflecting a low-prevalence population. Using a clinical score of 3 as the reference standard for pancreatitis, DGGR lipase demonstrated a sensitivity of 70% and specificity of 79%. Critically, the positive predictive value was only 24%, while the negative predictive value was 97%. DGGR lipase activity was significantly lower in cats with ultrasonographic scores of 0 compared to scores of 1, 2, and 3, and similarly lower in cats with clinical scores of 0 and 1 compared to 2 and 3. These findings indicate that DGGR lipase performs best as a rule-out test in referral settings where pancreatitis prevalence is low. A normal result substantially reduces the likelihood of clinician-suspected pancreatitis, but an elevated result should be interpreted cautiously given the poor positive predictive value in this population.

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