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Name
Pancreatitis, Canine
Short Description
Pancreatitis
Affected Animals: 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.
Overview: 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.
Clinical Signs: 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.
Symptoms:
See clinical signs.
Description: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.
Diagnosis: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.
Prognosis: 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.
Transmission or Cause: 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.
Treatment
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.
Prevention: 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.
