The pancreas is a glandular organ located behind the stomach, tucked under the duodenum (the first portion of the small intestine). The pancreas has two main functions: 1.) Endocrine function. The pancreas produces hormones, mainly insulin, which facilitates the uptake and storage of glucose (sugar) into the body's cells. 2.) Exocrine function. The pancreas produces enzymes necessary for the digestion of nutrients. These enzymes aid the body in the digestion and absorption of fats and proteins.
Pancreatitis is an inflammation of the pancreas, which causes the digestive enzymes to leak from the storage cells into the surrounding pancreatic tissue. The pancreas literally starts to "digest itself". Pancreatitis can be acute (sudden onset) or chronic (happening gradually over a period of time). Both the acute and chronic forms are serious and can be life-threatening.
Multiple factors can contribute to the development of pancreatitis, however for the majority of cases, the cause is unknown. Pancreatitis can occur in both dogs and cats, but is generally more common in dogs. Cats commonly have the chronic form, and it can be difficult to diagnose. In dogs, obese middle age to older animals have a higher incidence, as do females. As a breed, Schnauzers and Yorkshire Terriers appear to be more prone to pancreatitis. Nutrition also plays a role. Dogs with diets high in fat, or dogs who are fed table scraps seem to have a higher incidence of the disease. Even though exact causes are not known, there are identifiable risk factors.
Age, breed, sex of the dog
Hyperlipidemia (high fat content in blood)
High fat meal
Concurrent disease - (Cushing's disease or Diabetes)
Bacterial or viral infection
Hypercalcemia (high amounts of calcium in the blood)
Trauma and shock
Most animals present with signs of gastrointestinal upset such as:
Lack of appetite
Very painful abdomen
Hunched body posture
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 affected by the leaking pancreatic enzymes and become permanently damaged.
The diagnosis of pancreatitis is made through information obtained from the owner regarding recent history, the physical examination, and bloodwork. Dogs with pancreatitis generally have an increased blood levels of the pancreatic enzymes called amylase and lipase. If the liver becomes inflamed, liver enzymes may also be increased. The white blood cell count is generally elevated in acute pancreatitis. Newer tests including pancreatic specific lipase (PLI) and serum trypsin-like immunoreactivity (TLI) are valuable diagnostic aids, but may take several days to obtain results. We now have a bedside PLI SNAP test for dogs that can yield diagnostic results in as little as 10 minutes.
Radiographs (x-rays) may also be done to rule out a gastric or intestinal foreign body or other GI diseases. Ultrasound can also help in making the diagnosis. Biopsy of the pancreas will result in a conclusive diagnosis, but is not commonly performed due to the risks involved.
The goal of treatment is to rest the pancreas, provide supportive care and control complications. Treatment always begins with a withholding of food, water, and oral medications for at least 24 to 48 hours, but may be for as long as 5-7 days. The lack of oral intake stops the stimulation of the pancreas to produce digestive enzymes, and allows the pancreas to begin healing. The second major component of treatment is fluid therapy. Dehydration and electrolyte imbalances are common in dogs with pancreatitis so intravenous fluid therapy is necessary. Dogs who are experiencing severe pain are treated with narcotic pain relievers to keep them comfortable, and antibiotics are often administered to protect against infection.
Depending upon the animal's response to supportive treatment, oral intake of food can begin again after a few days. Dogs are generally fed smaller more frequent meals consisting of a bland, easily digestible, low-fat food. Over the course of a week or more, the size of meals and quantity of food fed are increased. Your pet will likely be prescribed a low-fat, high-fiber diet to aid in recovery and to prevent future instances of pancreatitis. Depending on your pet's case, the diet recommendations may be for life for optimal health and preventative care.
In most cases, if the pancreatitis was mild and the pet only had one episode, chances of recovery are good, and avoiding high fat foods may be all that is necessary to prevent recurrence or complications. Some animals develop chronic pancreatitis, which can lead to diabetes mellitus and/or pancreatic insufficiency, also called maldigestion syndrome. Follow up examinations and bloodwork should be done for all animals diagnosed with pancreatitis to avoid long term complications from this disease.
If your pet is exhibiting signs of pancreatitis please call us at 516-379-6200 to schedule an appointment for an examination today.