Pancreatitis

What is Pancreatitis?

The pancreas is a V-shaped organ located behind the stomach and the first section of the small intestine, the duodenum. It has two main functions: it aids in metabolism of sugar in the body through the production of insulin, and is necessary for the digestion of nutrients by producing pancreatic enzymes. These enzymes help the body promote the digestion and absorption of nutrients from food. Acute pancreatitis is a sudden onset of pancreatic inflammation. Chronic pancreatitis can also occur.

What are the Causes of Pancreatitis?

Multiple factors can contribute to the development of pancreatitis in dogs:

• Nutrition - Dogs with diets high in fat seem to have a higher incidence of the disease. This includes dogs who have recently gotten into the trash or have been fed table scraps, or those who 'steal' or are fed greasy 'people food'. 
• Obese and overweight dogs appear to be more at risk
• Genetics may play a role, with Schnauzers and Yorkshire terriers appearing to be more prone to pancreatitis
• Previous pancreatitis diagnosis. If a dog has had it before, he/she is more likely to get it again
• Certain medications, especially potassium bromide, as well as some anti-cancer drugs and some antibiotics
• Metabolic disorders including hyperlipidemia (high amounts of lipid in the blood) and hypercalcemia (high amounts of calcium in the blood)
• Hormonal diseases such as Cushing's Disease (hyperadrenocorticism), hypothyroidism and diabetes mellitus
• Abdominal surgery, trauma to the abdomen (e.g., hit by a car), shock, or other conditions that could affect blood flow to the pancreas

What are the Symptoms of Pancreatitis?

Symptoms of acute pancreatitis may range from mild to very severe. The symptoms are similar to those of other diseases and may include a very painful abdomen, abdominal distention, lack of appetite, depression, dehydration, a 'hunched up' posture, vomiting, and perhaps diarrhoea. And fever can often accompanies these symptoms.

Animals with more severe disease can develop heart arrhythmias, sepsis (body-wide infection), difficulty breathing, and a life-threatening condition called disseminated intravascular coagulation (DIC), which results in multiple hemorrhages. If the inflammation is severe, organs surrounding the pancreas could be 'autodigested' by pancreatic enzymes released from the damaged pancreas and become permanently damaged.

Dogs with chronic pancreatitis may show signs similar to those in acute pancreatitis, but they are often milder, and severe complications are less likely.

How is Pancreatitis Diagnosed?

To diagnose pancreatitis, other causes of the symptoms must be ruled out first. Then the following is conducted

• A complete history is obtained
• A thorough physical exam is conducted
• Complete blood count, chemistry panel and urinalysis are performed. Blood levels of two pancreatic enzymes, amylase and lipase, may be obtained.
• cPLI (canine pancreatic lipase immunoreactivity)SNAP test is another diagnostic tool that can be done in-house and if positive a sample can be sent to the lab for quantification
• Radiography (x-rays) and ultrasound can also help in making the diagnosis.
• Biopsy can result in a conclusive diagnosis, but is not commonly performed.

How is Pancreatitis Treated?

The goals of treatment are to:

• Correct dehydration
• Provide pain relief
• Control vomiting
• Provide nutritional support
• Prevent complications

Dehydration and electrolyte imbalances are common in dogs with acute pancreatitis, so supplemental fluids are given either by the subcutaneous or intravenous route; depending upon the severity of the condition.

Dogs who are experiencing pain can be treated with pain relievers.

Medications are often given to decrease the amount of vomiting such as cerenia or maxalon. If vomiting is severe, food, water, and oral medications are withheld for at least 24 hours. Depending upon the dog's response, food intake can be started again after a day or more. The dog is generally fed small meals of a bland, easily digestible, high-carbohydrate, low-fat food. In some cases, it may be necessary to use tube feeding to provide proper nutrition.

If the pancreatitis was caused by a medication, the medication should be stopped. If it was caused by a toxin, infection, or other condition, the appropriate therapy for the underlying condition should be started.

In rare instances where there are intestinal complications or the development of a pancreatic abscess, surgery may be necessary.

What is the Prognosis for Dogs with Pancreatitis?

Pancreatitis can be a very unpredictable disease. In most cases, if the pancreatitis was mild and the pet only had one episode, chances of recovery are good and keeping the dog on a low-fat diet may be all that is necessary to prevent recurrence or complications. In other cases, what appears to be a mild case may progress, or may be treated successfully only to have recurrences, sometimes severe.

Some animals develop chronic pancreatitis, which can lead to diabetes mellitus and/or pancreatic insufficiency, also called 'maldigestion syndrome.'

Home Care and Prevention

It may take your dog several days up to a couple of weeks to recover completely. Some dogs will have a reduced appetite but should improve each day. Some dogs will also experience diarrhoea or soft faeces but this should also be improving each day. Follow medication directions carefully and contact your vet if you have any concerns regarding the medication or your dogs progress or health.

Diet is essential in recovery and preventing further bouts of pancreatitis. Avoiding fatty foods especially ‘human food’ such as meat scraps, sausages etc is essential as once dogs have had pancreatitis they are much more vulnerable to getting it again.

An easy solution is to use specialised food designed specifically for pancreatitis. These are available to purchase at the Maraboon Veterinary Surgery:

• Hills Prescription Diet W/D (wet and dry) - which is low fat and also excellent for weight loss.
• Hills Prescription Diet I/D Low fat (wet and dry) – easily digestible for dogs with sensitive digestive tracts and low in fat.
• Hills Science Diet light – regular food low in fat.

Other Complications to be Careful of

Diabetes Mellitus
When the inflammation subsides in the pancreas, some scarring is inevitable. When 80% of the pancreas is damaged to an extent that insulin cannot be produced, diabetes mellitus results. This may or may not be permanent depending on the capacity for the pancreas’ tissue to recover. Check out our page on Diabetes Mellitus to be aware of the symptoms. If you have any concerns, please contact your vet immediately.