Pancreatitis in Dogs
Pancreatitis is a common disease in dogs and is defined as inflammation of the pancreas. While this may sound like a relatively mild problem, pancreatitis can be acute (sudden) or chronic (long-standing) and in severe cases can be life-threatening and fatal. Understanding how the pancreas works, knowing potential triggers and recognising symptoms leads to a better outcome for most dogs. The pancreas is a small organ that sits just under the stomach and along the duodenum (the first portion of the small intestine). It releases digestive enzymes, as well as insulin and other hormones, that are used to further break down food in the small intestine. It is these digestive enzymes that cause pancreatitis. The enzymes are stored in the pancreas in a protected form. When they are released prematurely and/or activated within the gland this causes inflammation within the pancreas. There is no single cause for pancreatitis but there are factors which predispose dogs to developing the disease:
Pancreatitis in Dogs
High-fat diets or an unusual one-off fatty meal
Being overweight or obese
Pancreatic or abdominal trauma
Certain drugs e.g. some antibiotics, immune-suppressants, diuretics
Certain breeds e.g. Yorkshire Terriers, poodles, Miniature Schnauzers (these dogs naturally have high levels of lipid in their blood which leads to altered fat metabolism)
Other medical conditions e.g. diabetes mellitus, hyperadrenocorticism (Cushing’s disease), hypothyroidism, hypercalcemia
Pancreatic cancer
Classical signs of the disease in dogs include:
Inappetance
Vomiting
diarrhoea (+/- blood)
lethargy
abdominal pain/guarding the abdomen
fever
dehydration
Between 70-90% of dogs with pancreatitis will present with vomiting. The inflammation in the pancreas can cause inflammation in other tissues – the liver, the small intestine and the colon. More severe issues such as DIC (a systemic clotting disorder) can occur due to the spread of inflammation and the body’s reaction to this.
Diagnosing pancreatitis is not always straight forward. Routine blood tests are the first step in the diagnostic workup. Amylase and lipase are two enzymes that are typically elevated with pancreatitis, but unfortunately can be released from other areas of the body and be high due to other conditions. On most occasions, a presumptive diagnosis of pancreatitis can be made if these enzymes are very high. However not all affected dogs will have dramatically elevated levels.
A new test called SPEC cPL (specific canine pancreatic lipase) is available which measures the level of lipase in the body that has been released ONLY by the pancreas. It is a more rapid test than serum PLI (pancreatic lipase immune-reactivity) which can also be used to detect pancreatic lipase. Unfortunately serum PLI can also be increased in cases of inflammatory bowel disease and intestinal foreign bodies. The specificity of the SPEC cPLI means that if your dog tests positively then a diagnosis of pancreatitis has been confirmed.
Imaging can also be useful but has its setbacks – abdominal radiographs are not overly sensitive when it comes to detecting changes in the pancreas. Ultrasonography is a more sensitive tool but results can depend on the size of the dog (obese dogs are harder to image) and the severity of abdominal pain. If blood tests and imaging cannot confirm the presence of pancreatitis, then surgery and a pancreatic biopsy is the final step.
Treatment of acute pancreatitis in dogs is based around rehydration, control of vomiting, pain relief/control and nutrition. Anti-emetics are essential to curb vomiting and nausea. It is also important when it comes to getting a patient to eat and keep their food down. Dehydration needs to be resolved rapidly and carefully which usually involves several days of hospitalisation. Most patients are able to be discharged from hospital once their vomiting (and in some cases diarrhoea) has ceased, and they are comfortable and able to keep down food and water.
A strict diet needs to be followed for 3-4 weeks once at home and a weight loss program designed if required. Owners need to be aware, that dogs who have experienced pancreatitis, are at risk of developing the disease again. The prognosis for dogs with pancreatitis is good if treatment is instigated as soon as possible to avoid systemic complications.