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Dog: Pancreatitis

General information

Other common/scientific names: acute pancreatitis, chronic pancreatitis, gastrointestinal upset, garbage can gut

The pancreas is a pale pink glandular organ which is found under the stomach and along the initial part of the small intestine or duodenum. The pancreas has two main functions. First, it produces and secretes insulin and glucagon for sugar metabolism. A dysfunction in this area can result in the lack of insulin which causes diabetes mellitus. A second function is secretion of enzymes which aid in the digestion of food. A dysfunction in this area can result in pancreatitis or pancreatic insufficiency.

Pancreatitis is defined as inflammation of the pancreas and it can be either acute or chronic with acute form being more common in the dog. This inflammation is a result of the digestive enzymes being released inappropriately, causing autodigestion of the pancreatic tissue with resulting damage and necrosis which causes more inflammation. Toxins released from this tissue damage enter the dog’s circulation and can cause widespread inflammation in the body which can result in life threatening conditions of shock and multi organ failure.

Abb. GSIJTPBL
Abb. GSIJTPBL: Schematic illustration of the canine gastrointestinal system showing the location of the pancreas.

Causes

The exact cause of pancreatitis is unknown but there are several risk factors for the development of pancreatitis. These include:

  • High fat diets, table-scrap feasting or greasy people food
  • Obesity
  • Hormone disorders which affect fat metabolism such as hypothyroidism, hyperadrenocorticism and diabetes mellitus
  • The use of some medications such as corticosteroids, anti-seizure medications and medications for immune system diseases
  • Abdominal trauma to the pancreas such as from being hit by a car
  • Infections
  • While any breed of dog can develop pancreatitis, Miniature Schnauzers and Yorkshire Terriers are more prone to this condition
  • Recurring cases of acute pancreatitis can result in chronic pancreatitis

Cardinal symptom

  • Vomiting
  • Diarrhea

Symptoms

The clinical signs of pancreatitis are nonspecific meaning they could be related to many other diseases of the abdomen such as gastrointestinal disease (e.g. gastritis, vomiting, diarrhea, endoparasites), liver disease (e.g. hepatitis, infectious hepatitis, liver cancer), gastrointestinal obstruction or neoplasia.

Acute Pancreatitis

Mild cases of acute pancreatitis may be subclinical (having no clinical signs) and self limiting. Dogs with more severe cases of pancreatitis will have vomiting, diarrhea, abdominal pain, appetite loss and fever. Life threatening conditions of dehydration, acute renal failure, cardiovascular shock, disseminated intravascular coagulation (DIC) and multi organ failure can be a result in severe cases of pancreatitis.

Chronic Pancreatitis

Most cases of chronic pancreatitis are mild and subclinical. Signs of chronic pancreatitis can mimic acute pancreatitis but less severe such as decreased appetite, vomiting, diarrhea and abdominal pain. Dogs with chronic pancreatitis can develop diabetes mellitus or pancreatic insufficiency. The severe, life threatening symptoms of acute pancreatitis are rare with chronic pancreatitis.

Diagnosis

Canine pancreatitis can be challenging to diagnose. There is no one single diagnostic test for diagnosing pancreatitis. Rather, the diagnosis must be based on evidence from the dog’s history, clinical signs, laboratory tests and imaging diagnostics.

Laboratory tests comprising of a complete blood test, serum biochemistry and electrolyte panel and urinalysis should be performed on all dogs suspected of having pancreatitis. Dog’s with pancreatitis may have abnormalities on these tests. These tests not only help to diagnose pancreatitis, but they are necessary to diagnose conditions associated with pancreatitis such as hyperthyroidism, hyperadrenocorticism and diabetes mellitus. Additionally, these tests are needed to determine the proper course of treatment.

Abdominal radiographs and ultrasonography can show an enlarged pancreas, changes in the texture of the pancreas, abdominal fluid, pancreatic abscesses and pancreatic calcification. While ultrasonographic evaluation of the pancreas is more sensitive than radiographic evaluation, it is also more difficult to perform and should be conducted by a veterinarian with advanced ultrasound experience.

A definitive diagnosis of pancreatitis can only be made by a biopsy. This can be done via a laparoscope, a laparotomy or ultrasound guided fine needle aspirate. These procedures are not commonly performed due to the expense, anesthetic risks and advanced expertise needed to perform the biopsy.

Treatment

Treatment of pancreatitis will depend on the severity of signs, laboratory test results and imaging results. Resting the pancreas by withholding food and water is common in dogs with pancreatitis. This prevents any further stimulation of the pancreas and allows it to heal. In some instances, a feeding tube is placed into the dog’s stomach to administer enteral nutrition.

Because most dogs with pancreatitis are dehydrated, hospitalization with intravenous fluids is most important. Since vomiting is a main clinical symptom of pancreatitis, injectable antiemetics and antacids are administered to reduce the nausea and vomiting. Injectable antibiotics are used in patients with shock and fever. Many dogs with pancreatitis experience abdominal pain. Because of this, analgesic (pain) therapy is needed. Dogs which develop devitalized tissue or pancreatic abscesses may need surgery to remove the unhealthy tissue

Feeding can be resumed when the dog’s appetite returns and there is no vomiting or abdominal pain. Because fat is regarded as a major stimulus of the pancreas, a low fat diet is necessary to prevent recurrence. These diets are often specially formulated, prescription only diets meaning they can only be purchased with a prescription from a veterinarian. Overweight dogs will also benefit from the low fat diet which will encourage weight loss.

Prognosis

If pancreatitis is diagnosed early and proper treatment is implemented, the prognosis can be good and a complete recovery can occur. However, dogs with pancreatitis can develop fatal complications. Dogs that do recover can also develop chronic pancreatitis which can lead to diabetes mellitus or pancreatic insufficiency. In these cases, a guarded prognosis is given.

Prevention

Dogs should never be fed table scraps or high fat “people” food. It is important to prevent your dog from foraging in the trash.

Tips

The clinical course of pancreatitis is highly variable, ranging from subclinical to life-threatening disease. Because of the potential for life-threatening complications, timely and accurate diagnosis of pancreatitis is essential. If your dog eats a high fat, table scrap meal or raids the garbage can and develops vomiting and diarrhea, call your veterinarian immediately. Watch your dog carefully for any signs of vomiting, diarrhea or abdominal pain.

Update version: 4/24/2014, © Copyright by www.enpevet.de
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