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Canine Pancreatitis
The pancreas is a vital organ which lies
on the right side of the abdomen. It has two functions: 1) to produce enzymes which help
in digestion of food and, 2) to produce hormones, such as insulin. When the pancreas
becomes inflamed, the disorder is called pancreatitis. It is a disease process that is
seen commonly in the dog. There is no age, sex, or breed predisposition.
There are two main forms of acute (sudden
onset) pancreatitis: 1) the mild, edematous form and, 2) the more severe, hemorrhagic
form. A few dogs that recover from an acute episode of pancreatitis may continue to have
recurrent bouts of the acute disease, known as chronic, relapsing pancreatitis. The
associated inflammation allows digestive enzymes to spill into the abdominal cavity; this
may result in secondary damage to surrounding organs, such as the liver, bile ducts, gall
bladder, and intestines.
The cause of pancreatitis is not known;
however, there may be several contributory factors. It is often associated with a rich,
fatty meal. In some cases, it may be associated with the administration of cortisone;
however, some dogs with pancreatitis do not have exposure to either.
Under normal conditions, digestive enzymes
produced by the pancreas are activated when they reach the small intestines. In
pancreatitis, these enzymes are activated prematurely in the pancreas instead of in the
small intestines. This results in digestion of the pancreas itself. The clinical signs of
pancreatitis are often variable, and the intensity of the disease will depend on the
quantity of enzymes that are prematurely activated.
The diagnosis of pancreatitis is based on
three criteria: clinical signs, laboratory tests, and radiographs (x-rays) and/or
ultrasound examination. The disease is typically manifested by nausea, vomiting, fever,
abdominal pain, and diarrhea. If the attack is severe, acute shock, depression, and death
may occur. Laboratory tests usually reveal an elevated white blood cell count; however, an
elevated white blood cell count may also be caused by many other things besides
pancreatitis. The elevation of pancreatic enzymes in the blood is probably the most
helpful criteria in detecting pancreatic disease, but some dogs with pancreatitis will
have normal levels. Radiographs and ultrasound studies may show an area of inflammation in
the location of the pancreas. Unfortunately, many dogs with pancreatitis will elude
detection with any of these tests. Consequently, the diagnosis of pancreatitis may be
tentative in some cases.
The successful management of pancreatitis
will depend on early diagnosis and prompt medical therapy. The mild form of the disease is
best treated by resting the pancreas from its role in digestion. The only way to
"turn off" the pancreas is to withhold all oral fluids and food. This approach
is accompanied by intravenous fluids to maintain normal fluid and electrolyte balance. In
addition, anti-inflammatory drugs are sometimes administered. The presence of shock
necessitates the immediate and intense use of intravenous fluids. Antibiotics are also
indicated in many cases.
The prognosis depends on the extent of the
disease when presented and a favorable response to initial therapy. Dogs that present with
shock and depression have a very guarded prognosis. Most of the mild forms of pancreatitis
have a good prognosis.
There are three possible long-term
complications that may follow severe or repeated pancreatitis. If a significant number of
cells that produce digestive enzymes are destroyed, a lack of proper food digestion may
follow. This is known as pancreatic insufficiency and can be treated with daily
administration of enzyme tablets or powder in the food. If a significant number of cells
that produce insulin are destroyed, diabetes mellitus can result and insulin therapy may
be needed. In rare cases, adhesions between the abdominal organs may occur as a
consequence of pancreatitis. However, most dogs recover with no long-term effects.