Ask the Vet | Pancreatitis

One of the most common conditions we diagnose and treat in Macau is Pancreatitis. Most people don’t know what the function of the pancreas is but it actually is in charge of the production of digestive enzymes. These are the enzymes that break down ingested foods into molecules the body can digest. These enzymes are carefully handled by the pancreas in order to prevent them from damaging the pancreas itself or surrounding tissue. When these self-protective mechanisms break down for any reason,the result is leakage of enyzmes which damage the pancreas and any surrounding tissue they reach. This breakdown is called pancreatitis.

There are a number of things which can initiate or facilitate enzyme leakage, so pancreatitis can occur for a number or reasons. Often, it takes a combination of precipitating factors to cause pancreatitis to occur ina dog or cat. High fat diets, obesity and lack of exercise are the most common “life-style” contributors. Miniature schnauzers are predisposed to pancreatitis due to a tendency to have high levels of lipoproteins in their blood streams.

Corticosteroids and azathioprine medications may contribute to the tendency to develop pancreatitis. Hyperadrenocorticism, a naturally occurring overproduction of corticosteriods that is fairly common in dogs may also lead to an increased susceptibility to pancreatitis. Anything that interferes with blood supply to the pancreas or release of digestive enzymes by the pancreas may lead to pancreatitis. For some reason, pancreatitis does not occur, or is not recognized, as often in cats as it does in dogs.

The “typical” pancreatitis patient is middle-aged or older and overweight.There may be a slightly higher prevalence of this problem in female dogs but it does occur commonly in both sexes. Often, the family has just had a party or a big holiday meal when this disease strikes. This is not a disease that restricts itself to any particular scenario, though. It often occurs in patients that do not fit the typical profile and it has highly variable clinical signs.

When your vet examines your dog and suspects pancreatitis, she will look for abdominal pain that seems to be centered in the portion of the abdomen that is partially covered by the ribs. Dehydration is common inpatients with pancreatitis. Rapid heart rate and rapid breathing are sometimes seen with pancreatitis.

Confirming a diagnosis of pancreatitis can be frustrating. Currently, there is no single reliable diagnostic test for this disease. Often, amylase and lipase levels are elevated in the bloodstream. Unfortunately, this seems to happen slowly in comparison to the progress of the disease so a pet may be pretty ill before the enzyme levels elevate and in some casesof pancreatitis an elevation in these enzyme levels doesn’t occur. Often, blood tests that help evaluate liver and kidney function are slightly elevated as well. White blood cell counts are usually high. Ultrasound exam of the pancreas, if your vet can do this, is helpful in diagnosis. X-rays are often taken to make sure other conditions are not causing the pain, such as intestinal obstruction, but usually it is not possible to be sure a dog has pancreatitis based on X-ray changes. Pancreatitis can be acute and only occur once in a dog’s lifetime or it can become chronic and keep returning over and over again. It can be a rapidly fatal illness or a mild attack of pain that resolves in a few hours or a day or so. It can cause tremendous side effects, including shock, blood-clotting disorders, heart arrhythmia’s, liver or kidney damage and death.

Fortunately, most of the time dogs with chronic pancreatitis problems do not die from the attacks. It is possible to lessen the severity and frequency of attacks in many of these dogs by managing their diet and exercise. It is important to take pancreatitis attacks seriously, especially the first one. Pain management helps a great deal in preventing escalation of pancreatic attacks. Totally restricting food intake (no food) for 24 to 72 hours seems to help a great deal as well. This may be due to a decrease in stimulation of the pancreas to release digestive enzymes. Fluid therapy to prevent dehydration and help maintain circulatory function is usually necessary. Medications to control vomiting are often used. Many veterinarians use antibiotics in an effort to ward off secondary infections but this may not be necessary in milder cases as bacterial infections do not commonly accompany pancreatitis. Once the patient seems to feel better, oral fluids are given. If no vomiting occurs in 12 to 24 hours, food can be offered in small quantities. Most pets can go home once they are willing to eat and drink again. Bland diets may be beneficial in some patients but we usually recommend returning to a low fat diet. By Dr Ruan Du Toit Bester

Hope this info helps
Till next week
Dr Ruan

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Royal Veterinary Centre

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