Pancreatitis (updated 23 December 2013)
The pancreas is part of the normal digestive system. Anatomically it lies beneath the stomach and lies alongside the adjacent section of the small intestine, the duodenum. It is responsible for secreting enzymes that aid in food digestion, and insulin which helps regulate sugar. Pancreatitis is inflammation of the pancreas. Clinical symptoms of pancreatitis include vomiting, loss of appetite, diarrhea, painful abdomen and fever.
When inflammed, the normal digestive secretions can be released into the surrounding tissues, including the liver, as well as the pancreas itself. This painful condition is potentially life threatening. This inflammatory process can progress to a systemic inflammatory process when toxins from tissues damaged are spread throughout the body. Miniature schnauzers are particularly prone to the development of pancreatitis. If the insulin-secreting glands within the pancreas are affected, the animal may then develop diabetes. This may be permanent or temporary dependent upon the ability of this organ to resolve the inflammation, and the extent of subsequent scarring. Pancreatitis can be acute(sudden) or chronic (long-term illness), mild or severe.
What Causes Pancreatitis
In many cases we never find out what causes it. There are several etiologies:
1. High fat diet ingestion ( bacon and eggs for breakfast!, gravies, garbage, and supplements may all be a source of fat).
2. Reflux of intestinal contents into the pancreatic duct, activating the enzymes within the pancreas. Not recognized as a common cause with pets, moreso with people.
3. Some illnesses may predispose a pet to developing pancreatitis, including diabetes, hypothyroidism or high blood calcium levels. Some medications including sulfa-containing antibiotics, chemotherapeutic agents, or potassium bromide (used to control seizures) have all been implicated.
4. Trauma leading to inflammation of the pancreas.
5. A tumor of the pancreas.
Making the Diagnosis
Elevated amylase and lipase in a chemistry blood panel historically were used to screen for pancreatitis. These enzymes were not specific for pancreatitis. A newer blood test called the PLI or pancreatic lipase can more specifically test for enzymes which have leaked into the blood from the pancreas. Radiographs may be useful in showing some changes that can occur with pancreatitis; however, imaging may find only 24% of cases. Ultrasound can detect 68% of cases and provides information about the other organs or can detect the presence of fluid in the abdomen. Ultrasound provides the opportunity to detect neoplasia (cancers) near or involving the pancreas. In some cases, surgical exploration is the only way to make the correct diagnosis.
In dogs, it has been found to be beneficial not to provide oral nutrition, to allow the pancreatic inflammation time to resolve. The animals are usually placed on intravenous fluids during this time. A critical patient may require intensive care and be referred to a specialty center to allow for constant monitoring and treatment.