Dogs and cats. Middle-aged to older
female dogs are more likely to be affected by pancreatitis
than other dogs. Dog breeds with a higher incidence of
the disease include the miniature poodle, cocker spaniel,
and miniature schnauzer. Pancreatitis is more difficult
to diagnose in cats than in dogs.
Canine pancreatitis is a potentially
life-threatening disease that more commonly affects middle-aged
to older female dogs. The pancreas is a gland that functions
as part of the digestive process by producing enzymes
that help break down food. Unfortunately, if these enzymes
become activated within the gland, the pancreas begins
digesting its own glandular tissue, creating inflammation,
or pancreatitis.
- Duodenum
- Pancreas
- Stomach
- Esophagus
Typical symptoms include vomiting, loss
of appetite, and abdominal pain, but sometimes signs can
be more mild or vague. The severity of the disease and
response to treatment will vary from case to case. Animals
with severe disease may die either from complications or
lack of response to treatment.
Diagnosis and treatment are aimed at identifying and eliminating
any underlying causes of pancreatitis. The disease is best
prevented by correcting obesity, ensuring that the animal
does not eat high-fat foods, and preventing other conditions
associated with pancreatitis.
The clinical signs of pancreatitis
in dogs vary, but include vomiting, anorexia, depression,
upper abdominal pain, diarrhea, severe weakness or collapse,
dehydration, shock, and fever. Dogs may exhibit signs
of abdominal pain by acting restless, panting, crying
or wincing when picked up, shaking, standing with an
arched back, or lying with the front end down and the
rear end elevated.
The pancreas is a V-shaped gland found
within the tissue located at the angle formed by the pylorus
and the duodenum. Ducts leading from the pancreas deliver
the digestive enzymes formed within the gland to the duodenum.
The pancreas has a number of functions, including the release
of digestive enzymes that aid in the breakdown and absorption
of ingested nutrients, and the secretion of protective agents
that counteract stomach acid when digesta enter the duodenum.
The protection of the gland itself from autodigestion by
the enzymes it produces is another important function of
the pancreas.
Inflammation of the pancreas, or pancreatitis,
is caused by the failure of the gland to prohibit activation
of the digestive enzymes while they are still within
the gland. Pancreatitis may be acute, with no long-term
effects, or chronic, involving a permanent abnormality
of the gland. Chronic pancreatitis cases usually involve
recurrent bouts of acute illness.
Some common causes of pancreatitis include
obesity, elevated levels of lipids in the blood, ingestion
of a very fatty meal, other diseases, and steroids.
Numerous cases of pancreatitis are diagnosed following
holidays, during which dogs often are given meat or
fat scraps. However, in some cases of pancreatitis,
no cause can be determined.
Symptoms associated with pancreatitis
may be obscure and mild or very clear and severe. Some
dogs recover completely with appropriate medical therapy
and dietary modifications, whereas others die from
severe illness and secondary complications. The course
of pancreatitis is usually unpredictable, and may be
slow.
Complications of pancreatitis include shock, inflammation
and fluid accumulation within the abdomen, sepsis,
respiratory compromise, heart arrhythmias, liver and
kidney failure, and abnormal bleeding and clotting.
Chronic recurrent pancreatitis, pancreatic abscesses,
diabetes mellitus, and insufficiency of pancreatic
enzyme secretion also may be caused by chronic pancreatitis.
The presence of one or more of these problems worsens
the dog's chance of recovery.
A presumptive diagnosis of pancreatitis
can be made based on a history and physical examination.
In particular, significant risk factors such as obesity,
or the recent ingestion of a high fat meal, may warrant a
suspicion of pancreatitis. The examining veterinarian will
perform other tests to confirm this diagnosis and to help
determine the cause of the illness.
Diagnostic procedures commonly include
a CBC, or complete blood count, a serum chemistry that
evaluates the pancreatic enzymes amylase and lipase,
and a urinalysis. Amylase and lipase values typically
will be elevated in the early or acute stage of pancreatitis.
These values may increase threefold in some dogs, but
such an elevation should not be relied upon in interpreting
the severity of the disease. Other blood tests the
examining veterinarian may perform include a serum
trypsin-like immunoreactivity assay, or TLI assay,
and an ELISA test for trypsinogen activation peptide,
or TAP. Trypsin substances are elevated in cases of
pancreatitis, and are more specific to the pancreas
than are amylase and lipase.
X-rays usually are taken of the abdomen,
and may show changes associated with pancreatitis;
they may also help rule out other problems that can
mimic the symptoms of pancreatitis, such as a gastric
foreign body. A typical x-ray finding will show a ground-glass
appearance corresponding to the location of the pancreas.
Also, expansion of the angle between the duodenum,
the section of the small intestine adjacent to the
stomach, and the pylorus, or outlet of the stomach,
may indicate the presence of the disease. Distention
of the stomach and intestines with gas is non-specific,
but is commonly seen with pancreatitis. If the dog
is having respiratory problems, x-rays will be taken
of the chest as well.
An abdominal ultrasound may be used to check for the
presence of pancreatitis, a pancreatic abscess, a pancreatic
tumor, or free fluid within the abdominal cavity. Ultrasound-
guided biopsies may be used to confirm a diagnosis.
Certain dogs will require a surgical exploration of
the abdomen for biopsy samples, or for treatment of
abscesses or tumors.
Pancreatitis can be a life-threatening
condition. Dogs with a mild case of the disease usually
have a fair prognosis and recover with appropriate treatment.
For those cases involving severe disease, concurrent
illness, or secondary complications, the prognosis is
poor to guarded.
Known causes include obesity or hyperlipidemia,
trauma, decreased blood flow to the pancreas, toxins,
medications, chronic kidney disease, infectious agents,
pancreatic duct obstruction, and neoplasia. Pancreatitis
can occur without a known cause, but a veterinarian typically
will find and treat inciting factors.
Most cases of canine pancreatitis require
hospitalized treatment for a minimum of three to four days,
and sometimes much longer. There are several goals to the
treatment of pancreatitis in dogs. First, the overall blood
volume and circulation of blood within the pancreatic gland
must be maintained. The prevention of stimulation of the
pancreas that causes it to secrete enzymes is also essential.
Additional goals include the removal of circulating activated
enzymes from the blood, the management of abdominal pain,
and treatment of acute or chronic complications of the disease.
Intravenous fluid administration is
used in treatment as needed. The veterinarian may try
to allow the pancreas to "rest" by keeping the dog
off food, water, or oral medications for three days
or more. The use of medications to decrease vomiting
and control pain, and occasionally antibiotics, also
may be indicated. A veterinarian also will treat diseases
caused by the pancreatitis.
Dogs that fail to respond to medical therapy may require
surgical exploration of the abdomen. Dogs with pancreatitis
are considered to be at a higher risk for anesthetic
and surgical complications, but they may have little
chance of recovery without the operation. Typical conditions
that require surgical intervention include pancreatic
or bile duct obstruction, severe inflammation of the
pancreas and abdominal cavity, and a pancreatic abscess
or mass of some other type.
Obese dogs should be placed on a weight
reduction diet that excludes high fat foods and treats.
Regular veterinary examinations are useful for the early
detection and treatment of other predisposing illnesses
and could help prevent secondary pancreatitis.
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