Information

Acute Pancreatitis in Dogs


Overview
The pancreas has many functions, including the production and secretion of digestive enzymes and the production of insulin. Digestive enzymes are critical for food digestion, while insulin aids in the control of the metabolism and blood-sugar levels. Pancreatitis means “inflammation” of the pancreas and acute means “sudden.” When the pancreas becomes inflamed, digestive enzymes that are normally inactive until they reach the small intestine become active in the pancreas instead—resulting in pain and swelling as the pancreas actually begins to digest itself.

Risks
There are many suggested causes of acute pancreatitis including: obesity, high-fat diets, endocrine diseases such as hypothyroidism, and various medications or toxins. Even if your dog doesn’t normally eat a high-fat diet, the introduction of a large amount of fatty food all at once can cause acute pancreatitis. Veterinarians see an increase in pancreatitis around the holidays, since many people think a nice way to celebrate is to share their holiday meals with their dog. In addition, dogs that get into garbage are much more likely to develop pancreatitis, so be sure to keep your trash out of your dog’s reach! Pancreatitis can occur in any dog, but some breeds are more susceptible to this disease. They include the miniature schnauzer, miniature poodle, and cocker spaniel. Additionally, pancreatitis is more common in middle-age to older dogs, overweight dogs, and females.

Symptoms
The most common symptoms of acute pancreatitis in dogs are loss of appetite, vomiting, and abdominal pain. Other symptoms you may notice include:

  • Swollen abdomen
  • Abnormal posture; arching of the back
  • Diarrhea
  • Lethargy
  • Restlessness
  • Gagging

Diagnosis/Treatment
Your veterinarian will take a complete history and perform a thorough physical exam. Additionally, diagnostic tests will be required to identify if your dog has acute pancreatitis. These may include:

  • Chemistry tests to evaluate kidney, liver, and pancreatic disease or dysfunction, as well as blood sugar levels
  • A complete blood count to screen your pet for infection, inflammation, or anemia and other blood-related conditions
  • Electrolyte tests to ensure your dog is neither dehydrated nor suffering from an electrolyte imbalance
  • Pancreas-specific tests to help diagnose or rule out the disease
  • Imagaing studies to evalutate the pancreas and other abdominal organs

The treatment of pancreatitis depends on the severity of the disease and may include:

  • Hospitalization at the veterinary clinic and in more severe cases 24 hour intensive care and monitoring
  • Intravenous fluids
  • Pain medicine
  • Antivomiting medication (antiemetics)
  • Antibiotics, if a secondary bacterial infection is suspected
  • Nutritional support
  • Other medications, depending on your dog’s symptoms

Keep in mind that your veterinarian may recommend that some diagnostic tests, such as the CBC, chemistry tests, and pancreatic-specific tests be repeated to monitor your dog’s progress during treatment.

Your veterinarian will recommend a treatment plan that is specific for your pet. Make sure you give all medications as directed and carefully follow any dietary recommendations. Following recovery a low fat diet may be recommended to decrease the chance of recurrence. Keep a close eye on your best friend; if he or she becomes lethargic or stops eating, call your veterinarian right away.

Prevention
While you can’t completely prevent acute pancreatitis, the following will help reduce the risk of your dog developing the disease and ensure his health and well-being:

  • Don’t let your dog become overweight—weight management is just as important for our four-legged friends as it is for us!
  • Avoid high-fat diets.
  • Avoid giving your dog table scraps, especially if he isn’t accustomed to eating people food.
  • Make sure you discuss all medications your dog is receiving with your veterinarian.
  • Don’t let your dog have access to garbage!

Learn about chronic pancreatitis in dogs.

If you have any questions or concerns, you should always visit or call your veterinarian – they are your best resource to ensure the health and well-being of your pets.


Classic signs of pancreatitis in dogs

  • Hunched back
  • Repeated vomiting (either several times within a few hours or periodically over several days)
  • Pain or distention of the abdomen (dog appears uncomfortable or bloated)
  • Diarrhea
  • Loss of appetite
  • Dehydration
  • Weakness/lethargy
  • Fever

If your dog exhibits one of these signs, and only infrequently, monitor her. But if she exhibits multiple signs at once, and repeatedly, a call to the veterinarian quickly is vital.


Pancreatitis In Dogs Can Be Fatal. Is Your Dog At Risk?

Like the owners who love them, dogs are susceptible to any number of disorders that can not only stem from but become exacerbated by diets that are high in fat. While any dog can suffer from such issues, this article will focus mainly on adult dogs, excluding expecting dams and puppies.

Modern-day dog owners are all too aware of the constant bombardment of toxins and the constant state of excess that we experience on a daily basis it can be frustrating to discover that your dog is suffering from health problems due to these oversights by the larger canine market that makes itself available to us.

To combat these issues, the best offense is a successful defense making sure you keep your dog’s diet varied, supplemented and healthy can do a world of good for his or her future. If it’s simply too late and your dog has already received that diagnosis, however, there are many ways to rectify the issue without breaking the bank or making you or your dog miserable.


Pancreatitis in Dogs

The pancreas is a gland within the abdomen located along the stomach and the first part of the small intestine. It performs both endocrine and exocrine functions.

How the Pancreas Functions

The endocrine function of the pancreas includes the production of insulin, which is secreted into the blood in response to carbohydrate and protein ingestion.

The exocrine function involves the secretion of inactive digestive enzymes and bicarbonate into the intestine where they become activated to help break down ingested foodstuffs.

Pancreatitis

Pancreatitis refers to the inflammation of the pancreas and is caused by activation of the digestive enzymes within the pancreas due to pancreatic damage or blockage of its outflow duct. This results in pancreatic auto-digestion, whereby the enzymes destroy the pancreatic tissue.

Acute pancreatitis is defined as reversible pancreatic inflammation, while chronic pancreatitis refers to permanent changes in the pancreatic tissue. These two forms of pancreatitis cannot be differentiated clinically, although, clinical signs in acute pancreatitis are usually more severe than those seen with chronic pancreatitis.

Acute pancreatitis can quickly lead to systemic inflammation, shock and death and must be treated aggressively. Chronic manifestations of pancreatitis include diabetes mellitus (30-40% of dogs with diabetes have pancreatitis) or loss of digestive enzyme production (exocrine pancreatic insufficiency).

Other potential complications include pancreatic pseudocysts and abscesses.

Cause

The cause of pancreatitis is usually unknown, although these factors have all been associated with its development:

  • Diet, particularly high fat diets
  • Hereditary disorders associated with fat metabolism
  • Medications
  • Prior surgery
  • Obesity
  • Trauma
  • Cancer
  • Obstruction of the pancreatic outflow tract because of biliary stones
  • Inflammation
  • Masses

Diagnosis

Clinical signs of pancreatitis in dogs usually include some or all of the following:

  • Vomiting
  • Anorexia
  • Depression
  • Abdominal pain
  • Diarrhea

In severe cases, dogs may be recumbent and in shock.

Diagnostics that may be recommended include:

  • Abdominal radiographs (X-rays): While these images are not usually very helpful in establishing a diagnosis of pancreatitis, they are important in ruling out other causes of disease.
  • Abdominal ultrasound: This test can be very specific in identifying pancreatitis, but the pancreas may appear normal in up to 32% of dogs with pancreatic inflammation.
  • Blood work including a complete blood count (CBC) and biochemical profile: Blood work can be normal or demonstrate diseases of other organ systems either unrelated to or caused by the pancreatitis
  • Urinalysis
  • Urine culture
  • A canine pancreatic lipase immunoreactivity (cPLI) test: The cPLI test is a highly accurate test in diagnosing pancreatitis, but the presence of an abnormal cPLI test does not definitely rule in pancreatitis as the sole cause of the clinical signs. This is an important concept, as resolution of the pancreatitis may not lead to resolution of the clinical signs.

Currently, the combination of the tests above is usually recommended to obtain a presumptive diagnosis of pancreatitis. The only definitive way to diagnose pancreatitis is to obtain a biopsy via surgery or laparoscopy, although, many times the patient is too unstable to undergo anesthesia.

Treatment

Treatment is truly supportive in nature, and its aggressiveness depends on the severity of the pancreatitis. In severe cases, hospitalization is required for restoration and maintenance of hydration, control of pain and vomiting, nutritional support and possibly antibiotic administration.

If the patient is vomiting, food and water are withheld. Otherwise, an ultra low-fat diet can be offered. The use of very low-fat diets in dogs is to decrease the workload on the pancreas.

In less severe chronic cases, hospitalization may not be required if the patient is hydrated and not vomiting. An extremely low-fat diet will be recommended for home use, as well as regular monitoring of blood work such as the cPLI and/or abdominal ultrasound.

Prognosis

Prognosis is dependent on:

  • The severity of clinical signs
  • The degree of pancreatic tissue damage
  • The duration of illness
  • The presence of concurrent disease

In uncomplicated cases, continuous use of a low-fat diet may prevent any future recurrences of pancreatitis. Conversely, some dogs will experience repeated bouts of pancreatitis, which will progress to chronic pancreatic changes and persistent disease accompanied by unrelenting clinical signs.

An acute severe episode of pancreatitis can quickly lead to shock and death if aggressive treatment is not started promptly. Unfortunately, even with aggressive treatment, some patients may still die.

Because of the complexity in diagnosis and unpredictability of response to treatment, suggesting a prognosis is difficult. In severe cases, hospitalization may be required for several weeks before the patient is stable enough to be discharged.

For more information on this subject, speak with the veterinarian who’s treating your pet.


The pancreas is composed of two sections: the smaller endocrine portion, which is responsible for producing hormones such as insulin, somatostatin, and glucagon, and the larger, exocrine portion, [4] which produces enzymes needed for the digestion of food. Acinar cells make up 82% of the total pancreas these cells are responsible for the production of the digestive enzymes. [1] [5]

Pancreatitis is caused by autodigestion of the pancreas thought to begin with an increase in secretion of pancreatic enzymes in response to a stimulus, [6] [7] which can be any source from table scraps to getting into the garbage to drugs, toxins, and trauma. [3] [8] The digestive enzymes are released too quickly and begin acting on the pancreas instead of the food they normally digest. [2] [8] [9] [10] Once the process cascades, inflammatory mediators and free radicals are released and pancreatitis develops, causing amplification of the process. [9]

The clinical signs can vary from mild gastrointestinal upset to death, with most dogs presenting with common gastrointestinal signs of upset, such as vomiting, anorexia, painful abdomen, hunched posture, diarrhea, fever, dehydration, and lack of energy, with vomiting being the most common symptom. [8] [11] [12] These signs are not specific just for pancreatitis and may be associated with other gastrointestinal diseases and conditions. [3] [8] [13]

Acute pancreatitis can trigger a build-up of fluid, particularly in abdominal and thoracic (chest) areas, acute kidney injury, and cause inflammation in arteries and veins. The inflammation triggers the body's clotting factors, possibly depleting them to the point of spontaneous bleeding. [8] [14] This form can be fatal in animals and in humans. [12]

Chronic pancreatitis can be present though no clinical signs of the disease are seen. [13]

Pancreatitis can result in exocrine pancreatic insufficiency, if the organ's acinar cells are permanently damaged the pancreatic enzymes then need replacement with pancrelipase or similar products. The damage can also extend into the endocrine portion of the pancreas, resulting in diabetes mellitus. [15] Whether the diabetes is transient (temporary) or permanent depends on the severity of the damage to the endocrine pancreas beta cells. [14]

Although various causes of dog pancreatitis are known, such as drugs, fatty diet, trauma, etc., the pathophysiology is very complex. [2] [13] Pancreatitis can be idiopathic no real causation factor can be found. [9] [12] Obese animals as well as animals fed a diet high in fat may be more prone to developing acute and chronic pancreatitis. [2] [11] [16] Certain breeds of dogs are considered predisposed to developing pancreatitis including Miniature Schnauzers, Cocker Spaniels, and some terrier breeds. [8] [9] [11] [17] Miniature Schnauzers as a breed tend toward developing hyperlipidemia, an excess of circulating fats in the blood. [18] The breed that appears to be at risk for the acute form of pancreatitis is the Yorkshire Terrier, while Labrador Retrievers and Miniature Poodles seem to have a decreased risk for the acute form of the disease. Genetics may play a part in the risk factor. [2] Dogs suffering from diabetes mellitus, Cushing's disease (hyperadrenocorticism), hypothyroidism, and epilepsy are at increased risk for pancreatitis. [2] [14] Diabetes and hypothyroidism are also associated with hyperlipidemia. [19] [20] Those with other types of gastrointestinal conditions and dogs that have had previous pancreatitis attacks are also at increased risk for the disorder. [2]

No treatments for canine pancreatitis have been approved. Treatment for this disease is supportive, and may require hospitalization to attend to the dog's nutritional and fluid needs, pain management, and addressing any other disease processes (infection, diabetes, etc.) [15] while letting the pancreas heal on its own. [3] [11] Treatment often involves "resting" the pancreas for a short period of time by which the patient receives no food or fluids by mouth, but is fed and hydrated by intravenous fluids and a feeding tube. [8] [12] Dehydration is also managed by the use of fluid therapy. [21] [14] [15] However, a specialist from Texas A&M University has stated, "There is no evidence whatsoever that withholding food has any beneficial effect." Other specialists have agreed with his opinion. [13]

Canine pancreatitis is complex, often limiting the ability to approach the disease.

A low-fat diet is indicated. [3] The use of drugs that are known to have an association with pancreatitis should be avoided. [13] [14] Some patients benefit from the use of pancreatic enzymes on a supplemental basis. One study indicated that 57% dogs followed for six months after an acute pancreatitis attack, either continued to exhibit inflammation of the organ or had decreased acinar cell function, though they had no pancreatitis symptoms. [13] [22]


Watch the video: My Dog has Pancreatitis (September 2021).