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Pancreatitis

Pancreatitis is a failure of the pancreas, an organ in the abdomen, to do its job. The pancreas has two main functions — to produce digestive enzymes and insulin. The digestive enzymes pass down a duct and empty into the intestine. Eating stimulates the pancreas to increase production of digestive enzymes, which digest meat, carbohydrates and fats. In dogs, this duct enters very close to the opening of the bile duct, which brings bile from the liver to the intestine. In cats, it shares the opening of the bile duct.

Occasionally some of these enzymes may leak into the pancreas and surrounding tissues and the pancreas starts to ‘digest’ itself, causing pain and inflammation — pancreatitis — and sometimes peritonitis.

Pancreatitis may occur simply because a patient has eaten a particularly fatty meal, causing large amounts of digestive enzymes to be released, or there may be no obvious explanation. However, once patients have had one episode of pancreatitis they are more prone to experiencing repeat bouts of the condition. Pancreatitis is much more common in middle-aged, overweight, female dogs but it can occur in male or female dogs of any age or weight.

Clinical signs:

Patients with pancreatitis may just be lethargic. Vomiting is common, as is diarrhoea. Your pet’s appetite may or may not be affected but eating will usually cause vomiting. Thirst may also be increased and, again, drinking will often cause vomiting. There may be fever and dehydration and, often, abdominal pain which the dog may attempt to ease by getting into a ‘praying’ position standing on hind legs, but with elbows on the ground.

Jaundice — yellowing of the skin and other surfaces — may be seen as an inflamed pancreas can block off the bile duct and cause yellow pigment to build up in the blood.

How Is pancreatitis diagnosed?

Diagnosis is usually made on a combination of clinical signs and the results of blood and urine tests. The blood tests assess the level of two enzymes (amylase and lipase) that the pancreas releases into the blood. Also examined are the level of inflammatory response, electrolytes, and liver and kidney function, to give a measure of severity of the disease process and help us rule out other diseases with similar signs.

Treatment protocols:

Treatment involves preventing further damage and reversing the signs. This is usually done with a five-pronged approach.

1. We will first place the animal on a ‘no food or water by mouth’ regime to reduce the activity of the pancreas.

2. Provide intravenous fluids, often with a vitamin supplement, to maintain hydration and flush out toxins.

3. Antibiotics will be prescribed to prevent the damaged pancreas becoming infected.

4. Anti-vomiting drugs will be used to settle the stomach and reduce nausea.

5. Pain relief will be given to reduce abdominal discomfort.

As the vomiting and pain subside — usually over 1-5 days — small amounts of water are offered. If no vomiting occurs then bland food is offered. It is very important not to feed too early or too much; if vomiting recurs you can be back to square one. Gradually meals are made larger and mixed with normal (low fat) food.

Occasionally the pancreas can develop one or more abscesses (pockets of pus) after inflammation. This may require ultrasound examination and surgery to diagnose and fix. Rarely, usually after repeated bouts of pancreatitis, the pancreas may have lost so much tissue that it can no longer produce enough enzymes. If insulin production is affected this will make the patient diabetic. If digestive enzyme production is affected, special supplements will need to be added to the food so proper digestion can occur.

Pancreatitis is a quite serious condition. Not all cases require hospitalisation but the majority do. Most patients pull through with proper care and treatment but occasionally a serious case is fatal. The longer a sick animal is left without treatment, the more likely it is to be one that will not survive.

Most dogs will never get pancreatitis, but there are things you can do to improve the odds of your pet suffering the disease. Always avoid very fatty meals and ensure your dog is not overweight.

If a dog has had pancreatitis once this should be taken as a very serious warning to feed only reduced fat food from then on. It takes only one dim sim, or one sausage from the barbecue to potentially put the patient back into hospital in a serious condition. This may mean warning visitors not to feed your dog, or even locking him up until visitors leave. Special prescription diets are often recommended to reduce the risk of another bout of the disease.