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Fuzapladib Sodium In the early stages of AP, neutrophils migrate into the pancreas causing further inflammation. Neutrophil migration into the pancreas (or any tissue) is dependent on the rolling, activation, adhesion, and migration of neutrophils within capillaries into tissues (Figure 1). The migration of neutrophils is dependent on the binding of a molecule called leukocyte function-associated antigen type-1 (LFA-1) on the neutrophil with another molecule on the surface of endothelial cells (called ICAM-1). Fuzapladib sodium (Panoquell®-CA1) is an LFA-1 inhibitor, which prevents migration of neutrophils into the pancreas. It has received FDA conditional approval for the treatment of clinical signs of AP in dogs in the US. It is given at a dose of 0.4 mg/kg IV q24h for three consecutive days. CONCLUSIONS Acute-onset pancreatitis is common in dogs and is associated with high morbidity and even mortality. The diagnosis of AP should not depend on a single test in isolation. Rather, a comprehensive clinical picture is important when diagnosing dogs with AP. While the management of AP in the past has been supportive and symptomatic, a new specific therapeutic agent, fuzapladib sodium, is now available in Japan and the USA.

Other supportive management includes identifying the cause of pancreatitis, fluid therapy, early identification and management of complications, antiemetics, and antinausea, analgesia, and nutrition.

FIGURE 1: NEUTROPHIL EXTRAVASATION CASCADE

With permission from Cridge H, Lim SY, Algül H, et al. New insights into the etiology, risk factors, and pathogenesis of pancreatitis in dogs: Potential impacts on clinical practice. J Vet Intern Med. 2022;36:847-864. The author has used Panoquell®-CA1 in outpatient and inpatient settings and have found that it was helpful in avoiding mortality (from euthanasia or from disease progression).

REFERENCES

1. Cridge H, Twedt DC, Marolf AJ, et al. Advances in the diagnosis of acute pancreatitis in dogs. J Vet Intern Med 2021;35:2572-2587. 2. Lim SY, Steiner JM, Cridge H. Understanding lipase assays in the diagnosis of pancreatitis in veterinary medicine. J Am Anim Hosp Assoc 2022;260:1249-1258. 3. Lim SY, Xenoulis PG, Stavroulaki EM, et al. The 1,2-o-dilauryl-rac- glycero-3-glutaric acid-(6'-methylresorufin) ester (DGGR) lipase assay in cats and dogs is not specific for pancreatic lipase. Vet Clin Pathol 2020;49:607-613. 4. Prummer JK, Howard J, Grandt LM, et al. Hyperlipasemia in critically ill dogs with and without acute pancreatitis: Prevalence, underlying diseases, predictors, and outcome. J Vet Intern Med 2020;34:2319- 2329. 5. Stieger-Vanegas, S.M. and P.M. Frank, Peritoneal Space, in Textbook of Veterinary Diagnostic Radiology. 2018. p. 764-791. 6. Cridge H, Sullivant AM, Wills RW, et al. Association between abdominal ultrasound findings, the specific canine pancreatic lipase assay, clinical severity indices, and clinical diagnosis in dogs with pancreatitis. J Vet Intern Med 2020;34:636-643. 7. Lamb CR. Pancreatic edema in dogs with hypoalbuminemia or portal hypertension. J Vet Intern Med 1999;13:498-500. 8. Cridge H, Lim SY, Algül H, et al. New insights into the etiology, risk factors, and pathogenesis of pancreatitis in dogs: Potential impacts on clinical practice. J Vet Intern Med 2022;36:847-864.

9. de-Madaria E, Buxbaum JL, Maisonneuve P, et al. Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. N Engl J Med 2022;387:989-1000. 10. Zhou S, Buitrago C, Foong A, et al. Comprehensive meta-analysis of randomized controlled trials of Lactated Ringer's versus Normal Saline for acute pancreatitis. Pancreatology 2021;21:1405-1410. 11. Leese T, Holliday M, Watkins M, et al. A multicentre controlled clinical trial of high-volume fresh frozen plasma therapy in prognostically severe acute pancreatitis. Ann R Coll Surg Engl 1991;73:207-214. 12. Kenward H, Elliott J, Lee T, Pelligand L. Anti-nausea effects and pharmacokinetics of ondansetron, maropitant, and metoclopramide in a low-dose cisplatin model of nausea and vomiting in the dog: a blinded crossover study. BMC Vet Res 2017;13:244. 13. Henze L, Foth S, Meller S, et al. Ondansetron in dogs with nausea associated with vestibular disease: A double-blinded, randomized placebo-controlled crossover study. J Vet Intern Med 2022;36:1726- 1732. 14. Monteiro BP, Lascelles BDX, Murrell J, et al. 2022 WSAVA guidelines for the recognition, assessment and treatment of pain. J Small Anim Pract 2023;64:177-254. 15. Qin HL, Su ZD, Gao Q, Lin QT. Early intrajejunal nutrition: bacterial translocation and gut barrier function of severe acute pancreatitis in dogs. Hepatobiliary Pancreat Dis Int 2002;1(1):150-154.

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