Pancreatitis
What does the pancreas do?
The pancreas is a vital organ which lies on the right side of the abdomen.
It has two functions - to produce enzymes which help in digestion of food and to produce hormones, such as insulin. When the pancreas becomes inflamed, the disorder is called pancreatitis.
It is a disease process that is seen commonly in the dog. There is no age, sex, or breed predisposition.
There are two main forms of acute (sudden onset) pancreatitis:
1. The mild, oedematous form and
2. The more severe, haemorrhagic form.
A few dogs that recover from an acute episode of pancreatitis may continue to have recurrent bouts of the disease, known as chronic, relapsing pancreatitis. The associated inflammation allows digestive enzymes to spill into the abdominal cavity; this may result in secondary damage to surrounding organs, such as the liver, bile ducts, gall bladder, and intestines.
What causes it?
The cause of pancreatitis is not known; however, there may be several contributory factors. It is often associated with a rich, fatty meal. In some cases, it may be associated with the administration of corticosteroid drugs however, some dogs with pancreatitis do not have exposure to either.
Under normal conditions, digestive enzymes produced by the pancreas are activated when they reach the small intestines. In pancreatitis, these enzymes are activated prematurely in the pancreas instead of in the small intestines. This results in digestion of the pancreas itself. The clinical signs of pancreatitis are often variable, and the intensity of the disease will depend on the quantity of enzymes that are prematurely activated.
What are the clinical signs?
The diagnosis of pancreatitis is based on several criteria: clinical signs, laboratory tests, and radiographs (x-rays) and/or ultrasound examination. The disease is typically manifested by nausea, vomiting, fever, abdominal pain, and diarrhoea. If the attack is severe, acute shock, depression, and death may occur. Laboratory tests usually reveal an elevated white blood cell
count (WBC); however, as an elevated WBC may be caused by other conditions, it
is the elevation of pancreatic enzymes in the blood that is the most helpful criteria in detecting pancreatic
disease. It must be noted that some dogs with pancreatitis will have normal
levels, consequently, the diagnosis of pancreatitis may be tentative in some cases.
How is pancreatitis treated?
The successful management of pancreatitis will depend on early diagnosis and prompt medical therapy. The mild form of the disease is best treated by resting the pancreas from its role in digestion.
This is achieved by withholding all oral fluids and food for several days.
Affected animals usually receive intravenous fluids over this period to maintain normal fluid and electrolyte balance. In addition, anti-inflammatory drugs
and antibiotics are often administered. Severely affected animals that are in
shock need immediate, aggressive fluid therapy to recover.
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. Most of the mild forms of pancreatitis have a good prognosis.
Will there be any long-term problems?
There are three possible long-term complications that may follow severe or repeated pancreatitis. If a significant number of cells that produce digestive enzymes are destroyed, a lack of proper food digestion may follow. This is known as pancreatic insufficiency and can be treated with daily administration of enzyme tablets or powder in the food. If a significant number of cells that produce insulin are destroyed, diabetes mellitus can result and insulin therapy may be needed. In rare cases, adhesions between the abdominal organs may occur as a consequence of pancreatitis. However, most dogs recover with no long-term effects.
As pancreatitis can be triggered
by fatty food, it is often necessary for animals to be fed special low fat prescription
foods for the rest of their lives to prevent recurrent bouts of pancreatitis.
