Pancreatitis

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Ingleburn Veterinary Hospital
Unit 4, 2 Noonan Road
Ingleburn
NSW 2565

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Phone:
02 9829 1947

Ingleburn Veterinary Emergency Centre
Unit 4, 2 Noonan Road
Ingleburn
NSW 2565

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Phone:
02 9829 1628

What is Pancreatitis?

Pancreatitis is a disease process that is seen commonly in the dog (and occasionally in cats).

The pancreas is a small organ located near the stomach. It connects via a duct to the small intestine and has 2 major functions:

1. To produce hormones, such as insulin.

2. To produce enzymes which help in the digestion of food.

Enzymes produced by the pancreas are normally not activated until they reach the small intestine.

Inflammation of the pancreas is called pancreatitis. When this occurs, the enzymes are prematurely activated inside the pancreas, and cause digestion of the pancreas itself! Pancreatitis can range in severity from a mild oedematous form to a severe haemorrhagic form. In the latter case, digestive enzymes can spill into the abdominal cavity, causing peritonitis and damage to other surrounding organs. There is also a chronic relapsing form of pancreatitis.

What are the causes and risk factors?

The causes of pancreatitis are not well understood.

In dogs it may be associated with a recent rich, fatty meal, or in some cases might be caused by drugs or toxins. In cats, viral infections are a possible cause.

Any dog of any age can be affected, but some dogs seem to be at greater risk:

• Overweight dogs are at most risk.

• Dogs fed fatty foods.

• Dogs greater than 5 years old.

• Dogs with diabetes or other endocrine diseases.

• Females are at slightly more risk than males.

• Schnauzers and terriers are at slightly more risk.

 What are the symptoms?

The symptoms of pancreatitis vary depending on the degree of damage to the pancreas.

There will typically be depression, loss of appetite, vomiting, fever, abdominal pain and possibly dehydration and diarrhoea. In severe cases, there may be damage to other organs - acute shock, depression, and death may occur.

In cats, the symptoms are vague and the diagnosis much more difficult. This article focuses on pancreatitis in dogs.

How is it diagnosed?

There is currently no single accurate test for pancreatitis. The diagnosis of pancreatitis is never straight-forward and must be based a number of criteria:

1. Clinical signs (symptoms) and risk factors,

2. Laboratory tests - may reveal an increased white blood cell count and lipid (fat) levels, elevated enzymes (amylase, lipase and TLI) and possibly dehydration. There may also be evidence of associated liver or kidney disease. Recently, pancreatic-specific lipase has been shown to be highly sensitive for the diagnosis of pancreatitis but the test is not yet commercially available.

3. Radiographs (x-rays) may show an area of inflammation in the area of the pancreas but this is usually unclear. Ultrasound (or even CT scan) is more sensitive but not always readily available and is dependent on a skilled ultra-sonographer.

Unfortunately, many dogs with pancreatitis will elude detection with any of these tests. Consequently, the diagnosis of pancreatitis may be tentative in some cases, and depends on the clinical judgement of your veterinarian. The tests do however often help by ruling out other possible causes for the illness.

Will my dog recover?

The prognosis depends on the extent of the disease when presented and a favourable response to initial therapy. Dogs that present with shock and depression have a very guarded prognosis. Milder cases of pancreatitis have a good prognosis. In our experience, most dogs seem to recover completely following appropriate treatment.

How is pancreatitis treated?

The successful management of pancreatitis depends on early diagnosis and prompt medical therapy. The pancreas must be rested from its role in digestion, and adequate perfusion (blood supply) must be maintained. The only way to "turn off" the pancreas is to withhold all oral fluids and food. The dog must be hospitalised and placed on intravenous fluids (an IV ‘drip’) to maintain normal fluid and electrolyte balance. Regular blood tests are needed to monitor the fluid therapy and progression of the disease. Analgesics may be given to relieve abdominal pain and drugs to control severe vomiting may also be required. Antibiotics are usually unnecessary but may be given if infection is suspected. Plasma transfusions may be beneficial and even exploratory surgery may be needed in severe cases.

Food and water cannot be reintroduced until 2-3 days after the abdominal pain and vomiting have subsided. This is done very cautiously, starting with small amounts of water, and then small amounts of highly digestible, low-fat, low-protein food. Treatment will usually require at least 4-5 days in hospital.

Home-Care:

For the first week after discharge from hospital, it is important to feed 4-6 very small meals each day of a highly digestible, low-fat food such as Hill’s Prescription Diet Canine w/d or Canine i/d. Pasta, rice or potatoes are also suitable foods and lean chicken is a good source of digestible protein. After this first week, normal meal sizes can be resumed if everything is going well.

Excessively fatty foods should be avoided for the rest of the dog’s life to reduce the risk of recurrence. Overweight dogs need a strict weight loss program.

Will there be any long-term problems?

Most dogs recover from pancreatitis with no long-term effects. However, there is the possibility of relapses. There are also several possible (but uncommon) long-term complications that may follow severe or repeated pancreatitis. These result from excessive damage to the cells in the pancreas and may include pancreatic insufficiency (where insufficient digestive enzymes are produced), and diabetes (where insulin-producing cells are destroyed).

Prevention

Prevention is always better than cure! The risks of pancreatitis can be reduced by:

1. Keeping your pet’s weight under control.

We can assess your dog’s body condition and give advice on weight loss if needed.

2. Avoid large meals of highly fatty foods such as sausages.

3. If your dog is vomiting repeatedly, remove any access to food and seek veterinary advice promptly.