M&P Winter 2024

WHAT IS PANCREATITIS? Deborah Dennis, DVM

T he pancreas is an or gan in the upper ab domen. A healthy pancreas is a pale pinkish organ that is attached to the side of the lower stomach where it joins the upper most part of the small in testine. There are two kinds of pancreas cells. One kind makes insulin and gluca

is very important to rule out other causes of the symptoms, like foreign body ingestion, cancer or even pyometra. Damage to other organs like the nearby liver or downstream kidneys are common com plications that cause test abnormalities and need to be addressed as well. A newer blood test, the

gon, which manage the balance between incoming food and blood sugar. The other kind makes enzymes that break down food products into small enough compounds that the intestines can absorb them. These enzymes are very power ful. They are maintained in inactive forms inside the pan creas and, when food arrives in the small intestines the en zymes are released through a duct and become active as they arrive in the intestines. Normally, these inactive en zymes are only able to digest food when they are activated in this way. In pancreatitis, something goes wrong and the enzymes activate before they get to the intestines. These digestive enzymes start digesting the pancreas itself. This causes severe pain and the inflammation spreads to the sur rounding organs like the liver and intestines. The triggering cause of pancreatitis is often unknown, although ingestion of unusual and fatty foods is often associated with it. Other factors include breed, age, body fat, spay/neuter status, other diseases, and medications. The most common type of patient with pancreatitis is a middle- aged, overweight, spayed or neutered dog that got into the garbage or was fed fatty people food. The breeds most commonly affected are: the Miniature Schnauzer, Poodle, Cavalier King Charles, Cocker Spaniel, and terriers. The most common symptoms are severe vomiting, depression, and abdominal pain. Additional symptoms are fever, diarrhea, collapse, and severe dehydration. Pancreatitis can be mild or deadly. The veterinary work-up usually includes CBC, chemistry, urinalysis, and abdominal radiographs. Abdominal ultrasound is an excellent tool to rule out other complications such as tumors and inflammation of organs, but is not diagnostic on its own. It

canine pancreatic lipase immunoreactivity (cPLI) is a very helpful test to confirm pancreatitis when other diseases have been ruled out. Unfortunately, there is no single test that gives a 100 percent result. While lab work and x-rays are being run, serious cases may be in shock and need immediate IV fluid therapy. There is no cure for pancreatitis. Treatment is primarily supportive care with fluids for shock and dehydration, drugs that stop vomiting, pain medicine, electrolytes and antibiotics. The severe cases benefit from transfer to a 24 hour specialty care hospital for intensive care. The toxins released from pancreatitis can result in DIC, disseminated intravascular coagulation, where control on clotting functions is lost. These cases rarely survive. Fortunately, most patients gradually improve and can start back on food in three to five days. Management and prevention of future recurrence is often focused on a very low fat, highly digestible diet. Some cases of pancreatitis are more chronic, with low- grade symptoms while inflammation and fibrosis or may result from a previous acute bout. Long-term inflammation can lead to damage to the cells of the pancreas that make insulin, resulting in Diabetes Mellitus, or cause the loss of function of the cells making digestive enzymes, resulting in Exocrine Pancreatic Insufficiency. Pancreatitis is a serious and painful condition. To reduce the risk of pancreatitis, all dogs should be kept in fit condition and prevented from access to garbage or countertop goodies. Good luck, corgis. Reprinted with permission from the Spring 2021 PWC NL. llustration: Tigatelu / iStock / Getty Images Plus

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Winter 2023