Happy Holidays from VetTechPrep! What better topic to review than pancreatitis this time of year?
What is pancreatitis? Pancreatitis is the presence of neutrophilic inflammation in the body of the pancreas. It can be acute or chronic, and symptoms can be mild to life threatening.
What causes pancreatitis? The cause is often unknown. Some breeds (such as dachshunds, yorkies, or miniature schnauzers) seem to be over-represented. The enciting cause is often dietary, and the patient may have a history of getting into the garbage or eating some people food (especially foods higher in fat).
What are the symptoms? The symptoms are most often lethargy, vomiting, diarrhea, decreased appetite, and a tender abdomen (usually pain in the cranial abdomen).
How is it treated? In mild cases, sometimes witholding food temporarily, or a bland diet, anti-nausea medication, and analgesia is enough. It is generally recommended to try and feed these patients earlier and not withold food if possible. More severe cases require hospitalization with IV fluid therapy, and also antibiotics if there is a concern of bacterial translocation. Some severe cases may require feeding tubes or plasma administration.
Are there any complications? If the pancreatitis is severe, it can lead to complications such as cardiac arrhythmias, disseminated intravascular coagulation (DIC), or respiratory problems. The pancreas is near the bile duct, where it empties into the duodenum, and can cause a bile duct obstruction. Also, the insulin producing beta cells of the pancreas could be damaged and lead to diabetes.
How do you test for pancreatitis? Signalment and clinical symptoms often raise suspicion of the condition. Abdominal radiographs may show a decreased amount of detail in the cranial abdomen around the area of the pancreas. Bloodwork may show an increase in pancreatic enzymes (amylase and lipase), but this is only about 50% of the time and is not definitive. There is a SNAP- cPL (canine pancreatic lipse) test available which has a sensitivity around 75%. It should be interpreted in light of clinical signs and ideally used with concurrent diagnostic imaging. Patients with other acute abdominal conditions can show a false positive on this SNAP test. Abdominal ultrasound can be very useful in diagnosing cases of pancreatitis if the pancreas region appears hyperechoic or if the pancreas appears enlarged.
How is this prevented or managed long-term? The general recommendation is that patients with a history of pancreatitis be started on a low-fat diet. Hyperlipidemia can predispose dogs to pancreatitis; therefore, fasting triglycerides and cholesterol levels should be monitored.