Does hypercortisolism increase pancreatic injury?
Journal Article
Risk factors associated with elevated serum canine pancreatic lipase immunoreactivity concentration in dogs with hypercortisolism Open Access
Journal of Veterinary Internal Medicine, Volume 40, Issue 1, January-February 2026, aalaf004, https://doi.org/10.1093/jvimsj/aalaf004
Published:
21 January 2026
Abstract
Background
Hypercortisolism (HC) is a common endocrine disorder in dogs that is often associated with pancreatitis. However, the relationship between cortisol concentration, pancreatic injury (PI) markers, and serum specific canine pancreatic lipase immunoreactivity (Spec cPL) concentration elevation remains unclear.
Hypothesis/Objectives
To investigate the prevalence of PI, identify risk factors for elevated Spec cPL, and evaluate changes in Spec cPL concentrations after treatment.
Animals
Seventy-one client-owned dogs diagnosed with naturally occurring HC between 2015 and 2024.
Methods
Retrospective cross-sectional study with a nested cohort analysis. Dogs were classified as PI (Spec cPL ≥400 μg/L) or non-PI (Spec cPL <400 μg/L). Clinical and laboratory variables, including abdominal ultrasonography findings, were analyzed. Risk factors were identified using logistic regression analysis. A subset of dogs with follow-up data was analyzed to assess changes in Spec cPL concentration after treatment for HC.
Results
The PI comprised 16 dogs, with 7 (44%) showing ultrasonographic signs of pancreatitis. Univariate analysis showed significant intergroup differences in gamma-glutamyl transferase, blood urea nitrogen (BUN), symmetric dimethylarginine, cholesterol, C-reactive protein, urine protein-to-creatinine ratio (UPC), and post–low-dose dexamethasone suppression test (LDDST) cortisol concentrations. Multivariate analysis further identified BUN (odds ratio [OR], 1.05; 95% CI, 1.01–1.09; P =.02), UPC (OR, 1.84; 95% CI, 1.09–3.11; P =.02), and post-LDDST cortisol (OR, 1.55; 95% CI, 1.11–2.17; P =.01) as risk factors. Trilostane treatment significantly reduced the post-ACTH cortisol and Spec cPL concentrations.
Conclusions and clinical importance
PI could occur in dogs with HC, especially those having elevated post-LDDST cortisol, BUN, and UPC.
