Pancreatitis

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What is the pancreas and what does it do?

The pancreas is an organ that sits just beneath the stomach and the first part of the small intestine. It is responsible for producing enzymes that aid in digestion and is also the source of insulin production. Pancreatitis refers to an inflammation of this organ. It can happen to dogs and cats of any age, breed, or sex. If severe, pancreatitis can lead to irreversible changes in the pancreas and impaired function long term.

 

What causes pancreatitis?

The cause of pancreatitis in dogs and cats is not very well understood. There are a few things that we know can predispose to the development of pancreatitis such as fatty diets, certain drugs, underlying diseases, parasites, and trauma, however there is also some research that indicates there are genetic factors at play as well.

 

What are the clinical signs?

Dogs with pancreatitis may be depressed, lose their appetite, have vomiting or diarrhea. They may also exhibit pain in the abdomen, this may be manifested as restlessness, panting or unwillingness to lie down. Cats can be a little more vague with signs ranging from poor appetite and fever to an elevated heart rate. Unlike dogs, they are less likely to have abdominal pain and vomiting. Pancreatitis is often divided into acute or chronic cases. Acute cases are usually more severe and may be associated with more dramatic signs. Chronic pancreatitis, which is more common in cats, may have more subtle symptoms and may be associated with or mistaken for other illnesses.

 

How is it diagnosed?

The diagnosis of pancreatitis can be a bit difficult since there is no one test that is specific for this problem. Generally your veterinarian will start with a suspicion of pancreatitis based on history, symptoms or physical exam findings. However since pancreatitis can mimic numerous gastrointestinal or metabolic problems, further testing is generally required. Abdominal radiographs and routine blood tests are often the first step in obtaining diagnosis. There are certain signs that may be seen on radiographs that would increase the index of suspicion for pancreatitis however patients with this disorder can have completely normal radiographs. Other supportive clues may be found in routine blood tests. Elevation in pancreatic levels may be supportive of a diagnosis but these values may be normal in patients with pancreatitis. Pancreatic enzymes may be elevated due to other diseases such as kidney disease. Blood tests will also allow your veterinarian to make sure there are no other metabolic problems. Another diagnostic test that can prove to be very useful in the diagnosis of pancreatitis is abdominal ultrasound. This allows us to directly visualize the pancreas and other abdominal organs. It may be possible to see changes within the pancreas that indicate inflammation. Your veterinarian may choose to do a blood test that is a bit more specific to the pancreas called TLI (trypsin-like immunoreactivity) or cPLi tests. These may help in diagnosis in those cases in which the answer is unclear. In some situations, biopsy of the pancreas may be required as it is difficult to differentiate pancreatitis from pancreatic cancer without a biopsy.

 

How is pancreatitis treated?

The treatment of pancreatitis can vary greatly depending on the severity and duration of the illness. Patients with mild pancreatitis may be treated conservatively at home while those with severe disease will require hospitalization and intensive care. Intravenous fluid therapy, antibiotics and anti-nausea medication are mainstays of treatment. Because pancreatitis can sometimes be very painful, pain medication may be needed as well to help keep your pet comfortable during treatment. In severe cases, a plasma transfusion is given to help address severe inflammation. Unfortunately, these cases can be very unpredictable and despite aggressive therapy severe cases may not respond to any form of therapy. It is difficult to predict at the onset of treatment which patients will respond and which won’t respond. In some instances, if the pancreatitis is severe or longstanding, there can be long term side effects. The one seen most often is diabetes mellitus. Because insulin is produced in the pancreas, severe disease and subsequent scarring of this organ may result in insufficient insulin production which leads to diabetes. Animals that have recovered from pancreatitis are also more prone to developing it again in the future. For this reason, your veterinarian may help develop a long term diet plan that will help minimize the risk of this occurring.