Letter regarding “ACVIM consensus statement on pancreatitis in cats”

[...]it is not mentioned that even the highest agreements among ultrasonography and a high Spec fPL (cutoff >16 μg/L; κ = 0.33), and a high DGGR-lipase (cutoff >57 U/L; κ = 0.37) still appear too low to be clinically useful. 2 The currently used Spec fPL cutoffs are based on results of 141 cats with “clinical signs consistent with pancreatitis” and 41 healthy cats. 1 In a presumably retrospective study, 2 internists blinded to Spec fPL divided cats into 6 groups with different probabilities of having pancreatitis based on history, clinical examination, CBC, biochemistry panel, urinalysis, ultrasonography, and clinical outcome (no specifics given on ultrasound, outcome, follow-up). Most probably, it is more realistic to look at lipase results as continuous variables that are surrogates for the degree of pancreatic injury, than to dichotomize a test to absence or presence of disease. [...]inclusion of published Spearman correlation coefficients between Spec fPL and DGGR-lipase (rs = 0.83, n = 251, 6 rs = 0.83, n = 161) 2 would have been helpful. 5 We added a logistic regression analysis (and Akaike information criterion [AIC] as a model selection criterion) to assess if the histological disease activity index was better explained by variations in Spec fPL or DGGR-lipase.