Pancreatitis
What is pancreatitis?
The pancreas is an organ that sits just beneath the stomach and the first part of the small intestine. It is responsible for producing enzymes that aid in digestion and is also the source of insulin production. Pancreatitis refers to an inflammation of this organ. It can happen to dogs and cats of any age, breed or sex. If severe, pancreatitis can lead to irreversible changes in the pancreas and impaired function long term.
The cause of pancreatitis in dogs and cats is not very well understood. There are a few things that we know can predispose to the development of pancreatitis such as fatty diets, certain drugs, underlying diseases, parasites and trauma however, there is also some research that indicates there are genetic factors at play as well.
What are the signs of pancreatitis?
Dogs with pancreatitis may be depressed, lose their appetite, have vomiting or diarrhea. They may also exhibit pain in the abdomen – this may be manifested as restlessness, panting or unwillingness to lie down. Cats can be a little more vague with signs ranging from poor appetite and fever to an elevated heart rate. Unlike dogs, they are less likely to have abdominal pain and vomiting.
Pancreatitis is often divided into acute or chronic cases. Acute cases are usually more severe and may be associated with more dramatic signs. Chronic pancreatitis, which is more common in cats, may have more subtle symptoms and may often be associated with or mistaken for other illnesses.
Pancreatitis is often divided into acute or chronic cases. Acute cases are usually more severe and may be associated with more dramatic signs. Chronic pancreatitis, which is more common in cats, may have more subtle symptoms and may often be associated with or mistaken for other illnesses.
How do we diagnose pancreatitis?
The diagnosis of pancreatitis can be a bit difficult as there is no one test that is specific for this problem. Generally your veterinarian will start with a suspicion of pancreatitis based on history, symptoms or physical exam findings. However, since pancreatitis can mimic numerous gastrointestinal or metabolic problems, further testing is generally required. Abdominal radiographs and routine blood tests are usually the first step in obtaining a diagnosis. There are certain signs that may be seen on radiographs that would increase the index of suspicion for pancreatitis however patients with this disorder can have completely normal radiographs. Other supportive clues may be found in routine blood tests. Elevation in pancreatic enzyme levels may be supportive of a diagnosis but these values may be normal in patients with pancreatitis. Pancreatic enzymes may be elevated due to other diseases such as kidney disease. Blood tests will also allow your veterinarian to make sure there are no other metabolic problems.
Another diagnostic test that can prove to be very useful in the diagnosis of pancreatitis is abdominal ultrasound. This allows us to directly visualize the pancreas and other abdominal organs. It may be possible to see changes within the pancreas that indicate inflammation.
Your veterinarian may choose to do a blood test that is a bit more specific to the pancreas called a TLI (trypsin-like immunoreactivity). This may help aid in a diagnosis in those cases in which the answer is unclear. One disadvantage of this test is that it may take 5-10 days to receive the results. In some situations, biopsy of the pancreas may be required as it is difficult to differentiate pancreatitis from pancreatic cancer without a biopsy.
Another diagnostic test that can prove to be very useful in the diagnosis of pancreatitis is abdominal ultrasound. This allows us to directly visualize the pancreas and other abdominal organs. It may be possible to see changes within the pancreas that indicate inflammation.
Your veterinarian may choose to do a blood test that is a bit more specific to the pancreas called a TLI (trypsin-like immunoreactivity). This may help aid in a diagnosis in those cases in which the answer is unclear. One disadvantage of this test is that it may take 5-10 days to receive the results. In some situations, biopsy of the pancreas may be required as it is difficult to differentiate pancreatitis from pancreatic cancer without a biopsy.
How do we treat pancreatitis?
The treatment of pancreatitis can vary greatly depending on the severity and duration of the illness. Patients with mild pancreatitis may be treated conservatively at home while those with severe disease will require hospitalization and intensive care.
One of the mainstays of therapy in dogs with this disease is to rest the GI system and pancreas by withholding food. In patients with severe signs where there may be a need for prolonged fasting, other routes of nutritional support may be required. For example, intravenous feeding (total parenteral nutrition) or feeding through a tube placed in the lower intestine. Cats may develop other problems if fasted for too long so nutritional support is generally needed sooner in these patients.
Intravenous fluid therapy, antibiotics and anti-nausea medication are also used as part of the therapeutic regime. Because pancreatitis can sometimes be very painful, pain medication may be needed as well to help keep your pet comfortable during treatment.
Dogs with severe pancreatitis may also benefit from a plasma transfusion. Plasma contains factors that help ameliorate severe inflammation. These may become depleted in severe cases and can be replaced with plasma transfusions aiding in recovery and potentially reducing the amount of time your pet will need to stay in the hospital.
Unfortunately, these cases can be very unpredictable and despite aggressive therapy severe cases may not respond to any form of therapy. This seems to be particularly true of cats with severe acute pancreatitis. It is difficult to predict at the onset of treatment which patients will respond and which won’t respond.
One of the mainstays of therapy in dogs with this disease is to rest the GI system and pancreas by withholding food. In patients with severe signs where there may be a need for prolonged fasting, other routes of nutritional support may be required. For example, intravenous feeding (total parenteral nutrition) or feeding through a tube placed in the lower intestine. Cats may develop other problems if fasted for too long so nutritional support is generally needed sooner in these patients.
Intravenous fluid therapy, antibiotics and anti-nausea medication are also used as part of the therapeutic regime. Because pancreatitis can sometimes be very painful, pain medication may be needed as well to help keep your pet comfortable during treatment.
Dogs with severe pancreatitis may also benefit from a plasma transfusion. Plasma contains factors that help ameliorate severe inflammation. These may become depleted in severe cases and can be replaced with plasma transfusions aiding in recovery and potentially reducing the amount of time your pet will need to stay in the hospital.
Unfortunately, these cases can be very unpredictable and despite aggressive therapy severe cases may not respond to any form of therapy. This seems to be particularly true of cats with severe acute pancreatitis. It is difficult to predict at the onset of treatment which patients will respond and which won’t respond.
What are the long term affects of pancreatitis?
In some instances, if the pancreatitis is severe or longstanding, there can be long term side effects. The one seen most often is diabetes mellitus. Because insulin is produced in the pancreas, severe disease and subsequent scarring of this organ may result in insufficient insulin production which leads to diabetes.
Animals that have recovered from pancreatitis are also more prone to developing it again in the future. For this reason your veterinarian will help develop a long term diet plan that will help minimize the risk of this occurring.
Animals that have recovered from pancreatitis are also more prone to developing it again in the future. For this reason your veterinarian will help develop a long term diet plan that will help minimize the risk of this occurring.
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