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Pancreatic Disease, Pancreatitis
The two main functions of the pancreas are the production of insulin which is passed into the blood to aid in the utilization of sugars, and the production of enzymes that are passed into the the first part of the small intestine for the digestion of fats, carbohydrates and proteins.
Inflammation of the pancreas is called pancreatitis. It is associated with obesity, poor nutrition, trauma, and tumors. Obstruction of the bile or pancreatic ducts can also lead to pancreatitis. Bacterial infections are not a primary cause, but can complicate pancreatitis once it has occurred. Pancreatitis can be acute or chronic. The cause of pancreatitis in a given dog often remains unknown.
This disease is believed to be caused by multiple factors, involving a complex interplay between breed, age, weight, trauma, drug use, and concurrent endocrine disease. Episodes of pancreatitis can range from mild to severe, where patients may exhibit a plethora of signs from mild lethargy to multiple organ failure or death. 1
Signs
Acute Pancreatitis
- Severe abdominal pain. The dog will be reluctant to move and will stand with an arched back and tensed abdomen.
- Vomiting may occur some hours after eating, rather than immediately, which is more diagnostic of acute pancreatitis.
- Diarrhea
- Dehydration
- Depression, collapse and shock
Chronic Pancreatitis
- Increased thirst and excessive urination
- Bulky, fatty, foul-smelling gray stool, particularly after a high-fat meal.
- Weight loss
- Occasional vomiting, flatulence, and other signs of digestive upsets.
- Poor general condition, particularly of the skin and coat.
- Signs of diabetes mellitus in progressive cases.
Diagnosis & Treatment
Diagnosis is made from the history, clinical signs, physical examination, and confirmed by laboratory tests on the blood, urine, and feces. Acute pancreatitis needs emergency treatment for shock. Antibiotics and pain-relief drugs will also be necessary. No food can be given by mouth, so intravenous fluids and feeding will be part of treatment. However, although fasting is recommended to give the organ a respite, it has more recently been shown that appropriate nutritional therapy is critical to support healing. It is, therefore, generally not advisable to withhold nutrition beyond 2 to 3 days, including the length of time the dog may have been anorexic. 1 Some cases will require surgical intervention if this will reverse the cause.
The prognosis is generally not good for acute pancreatitis, although up to 5% of affected dogs can be saved with early treatment. Some cases tend to recur and become chronic, and require careful watching for signs and feeding of special diet available from veterinarians. Pancreatic extracts and vitamins will also be part of the chronic case's treatment and are often needed for the rest of the dog's life. Animals that recover from acute pancreatitis may continue to have flare-ups throughout their lives. In either the acute or chronic disease, dogs are at risk of developing diabetes mellitus, chronic pancreatitis, and exocrine pancreatic insufficiency 2
References
- Acute pancreatitis attributed to dietary indiscretion in a female mixed breed canine
- Christopher Norkus (editor). Veterinary Technician's Manual for Small Animal Emergency and Critical Care
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