Dr Felicity Educational Series – Pancreatitis
Pancreatitis, or inflammation of the pancreas is commonly seen in dogs. The pancreas lies within the abdomen, near the start of the small intestine. It produces hormones (like insulin) and also produces enzymes which are released into the stomach to aid in digestion of food. When the pancreas becomes inflamed, the disease process is called pancreatitis.
There are two main forms of sudden onset or acute pancreatitis. There is a mild, oedematous form, and a more severe, haemorrhagic form. The inflammation in the pancreas is caused when the enzymes that are supposed to be activated in the small intestine to aid digestion are activated prematurely within the pancreas. This causes autodigestion of the pancreas and results in pancreatitis. The severity of the disease depends on the quantity of enzymes that are prematurely activated within the pancreas.
What causes pancreatitis?
The cause of a bout of pancreatitis is usually not known but there are a number of contributing factors that can increase a dog’s risk of pancreatitis.
A fatty meal can trigger pancreatitis especially in dogs that are not used to eating fat. Innocently fed meat offcuts can be a trigger and pancreatitis cases often increase around Christmas time when pets have access to leftovers of rich, fatty meats like ham, pork and lamb.
Obesity is thought to be a risk factor for pancreatitis due to elevated levels of triglyceride fats in the blood (hyperlipidemia) and overweight dogs also seem to suffer from more severe pancreatitis if they get it. Miniature Schnuazers have a breed predisposition to hyperlipidemia even when they are not overweight and are also thought to have faulty pancreatic enzyme function which predisposes them to spontaneous pancreatitis.
Several medications have been suggested as risk factors for pancreatitis. These include steroids, chemotherapy drugs, diuretics, some anticonvulsants, some antibiotics and some non-steroidal anti-inflammatories.
Other disease states can increase susceptibility to pancreatitis when they cause biochemical changes in the body, for example, hypercalcaemia which can occur during kidney failure.
Trauma to the pancreas, either during surgery or due to an accident can also trigger pancreatitis.
What are the clinical signs of pancreatitis in dogs?
Dogs with pancreatitis usually have nausea, vomiting, fever or abnormally low temperature, abdominal pain and sometimes diarrhoea. In severe cases, acute shock and death can occur.
How is pancreatitis diagnosed?
Clinical signs will give a high index of suspicion for a diagnosis of pancreatitis.
The elevation of pancreatic enzymes (amylase and lipase) in the blood is helpful for detecting pancreatitis but some dogs with pancreatitis will have normal levels. Blood work can show an elevated white blood cell count however, an elevated white blood cell count can be caused by several other conditions so this change is not specific for pancreatitis.
Radiographs and ultrasound studies may show an area of inflammation in the location of the pancreas.
How is pancreatitis treated?
The successful management of pancreatitis depends on early diagnosis and prompt veterinary treatment. This involves administration of intravenous fluids to maintain normal fluid and electrolyte balance, pain relief, anti-vomiting medications and sometime antibiotics. It is also important to start oral fluids and food as soon as possible to maintain healthy intestinal cells which need direct nutrition from food consumption.
Will your dog recover?
The prognosis depends on the extent of the disease when veterinary therapy is sought and a favourable response to initial therapy. Dogs that present with shock 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 several possible long-term complications that may follow severe or repeated pancreatitis. If a large number of cells that produce digestive enzymes are destroyed, the pancreas may not be able to produce enough enzymes for normal digestion in the small intestine. In these cases, pancreatic enzymes are supplemented in the diet.
If many cells that produce insulin are destroyed, diabetes can result and insulin therapy may be needed.
Most dogs recover with no long-term effects.
Will your dog need a special diet?
Dogs that have had pancreatitis need to be maintained on a low fat diet during recovery where fat makes up 5-10% of the food by dry weight. This is to prevent re-triggering of the pancreatitis by fat present in the diet. Not all animals become permanently sensitive to fat following acute pancreatitis and the requirement for long-term nutritional management will depend on the initial cause of the inflammation and whether recurrence of the disease is anticipated.