Why Are My Dog's PLI Levels High ?
Why Are My Cat's PLI Levels High ?
To see what normal blood and urine values are for your pet, go here
For an explanation of causes of most abnormal blood and urine tests go here
To see how tests are often grouped, go here
Ron Hines DVM PhD
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Pancreatic Lipase Immunoreactivity
aka: PLI, fPL, cPL, Pancreas-specific Lipase Test
(This is not your pet’s blood lipase level)
Your veterinarian will probably suggest this test or the TLI test discussed farther along if the symptoms and blood work results found in your pet are suggestive of pancreatitis.
I mentioned in discussing blood total lipase and blood amylase levels that although those were the traditional methods for diagnosing pancreatitis for many years, veterinarians knew that those tests were not very accurate.
It was found that they both tests missed many cases of pancreatitis and falsely suggested pancreatitis when no pancreatic problems existed. In short they were both inaccurate and non-specific. Sometimes they were elevated when the pancreas was inflamed, but sometimes the pancreas was inflamed and they were normal. In still other cases, blood lipase and/or amylase were elevated but the problems were somewhere other than the pancreas (eg intestinal or kidney disease).
Those obstacles led to the development of the pancreatic lipase immunoreactivity test (PLI) and trypsin-like immunoreactivity tests. Both appear to be more accurate in diagnosing pancreatic inflammation (acute pancreatitis) than blood amylase and lipase levels were.
Whether one or the other of these newer tests is better than the other is still a mater of debate. The exact names of the tests are confusing because each commercial laboratory tries to brand them with a distinctive (pantentable) name and suggests that their's is better than the one offered by their competitors.
The patented cPL tests, designed for dogs and the fPL test, designed for cats appear to have much better track record in zeroing in on pancreatic problems when they are the source of excess lipase in your dog or cat’s blood. These tests ares often run to try to explain the cause of a sudden bout of vomiting and depression and abdominal pain.
These tests are thought to be perhaps 75% accurate in predicting ongoing pancreatic problems. A 2012 study emphasizes that false-positive and false-negative PLI test results still do occur (ref)
What if My Pet’s PLI levels Are Only Mildly Elevated ?
Have your pet’s cPL or fPL test repeated in 2-3 weeks if the pet's general condition has not improved. Some pets without pancreatitis seem to naturally have PLI levels moderately above the accepted normal range.
What If My Pet’s PLI Levels Are Markedly Elevated ?
If your pet is a cat, and its test result is high, it may well have pancreatitis. But pancreatitis in cats often exists as part of a wider inflammatory syndrome (triad disease). So be sure that IBD, cholangiohepatitis and diabetes are all ruled out as compounding health problems. These multi-organ problems are less likely to occur in dogs.
Complementary Tests :
CBC/WBC and blood chemistry panel, urinalysis, fecal examination, x-rays and ultrasound (diagnostic imaging), pancreatic biopsy if other tests were inconclusive and risk of the procedure is not too great in the pet’s current condition, vitamin B12 and folate blood levels