Pancreatitis refers to inflammation and swelling of the pancreas, which is a large, elongated gland located between the stomach, spleen, liver, kidneys and upper small intestine.
Causes of Canine Pancreatitis
Pancreatitis can be mild or severe. The causes of spontaneous pancreatitis in dogs are not well understood. However, pancreatitis is more common in domestic dogs that are fed high-fat diets. It also can be caused by ingestion of a single large fatty meal. Other suggested contributing factors include hypercalcemia, obesity, blunt trauma to the abdomen, dietary indiscretion and the intake of certain medications. Corticosteroids have been implicated as causing pancreatitis in some dogs, as well as in some people. However, this association has not been scientifically verified. In most cases, the actual cause of canine pancreatitis is never identified.
Regardless of the inciting insult, the physiological course of pancreatitis is fairly well understood. Something causes premature activation and release of pancreatic digestive enzymes, which in turn causes local and system-wide tissue damage and an accelerated inflammatory response. The damage to the pancreas is caused by a process called auto-digestion. Essentially, the cascade of pancreatic enzymes digests the pancreas and surrounding tissues.
Prevention of Pancreatitis
The risk of pancreatitis may be reduced by sound lifestyle and dietary management. Avoidance of especially fatty foods and treats may help prevent acute cases of pancreatitis in dogs that suffer recurrent bouts of the disorder. A diet low in fat and high in fiber is probably best. Obese dogs should be put on a weight-loss program.
If acute pancreatitis is diagnosed, the affected dog normally will be hospitalized immediately. Fortunately, pancreatitis in dogs usually can be successfully treated with appropriate medical attention. Owners play a vital role in their dog's recovery, because special diets and feeding protocols must be followed.
The pancreas is responsible for producing and secreting a number of enzymes that are essential to the digestion of proteins, carbohydrates and fats. Other substances produced by the pancreas help to neutralize the acidic environment of the upper gastrointestinal tract. The pancreas is also responsible for making and releasing insulin into the blood stream, which facilitates the normal cellular uptake of glucose. When the pancreas becomes inflamed, it releases digestive enzymes prematurely, triggering a cascade of internal events. The signs of acute pancreatitis occur suddenly and are severe. Chronic pancreatitis normally causes more mild symptoms that wax and wane with time.
Symptoms of Pancreatitis
Owners of affected dogs may notice one or more of the following clinical signs:
Vomiting (emesis; usually profuse)
Lack of appetite (inappetence; anorexia; refusal to eat)
Lack of thirst (refusal to drink)
Abdominal pain (usually severe and sudden in onset)
Tucked-up belly ("prayer position")
These symptoms can fluctuate, be continuous, resolve on their own or flare up occasionally. As the disease progresses, one or more of the following may also occur:
Abnormal stool color and consistency (odd yellow color; "greasy")
Difficulty breathing (dyspnea)
Inflammation of the organs surrounding the pancreas
Pancreatitis can be an extremely serious condition and usually requires immediate medical attention. The most severe form of the disorder, called fulminant necrotizing pancreatits, can be fatal in a matter of hours.
Dogs at Increased Risk
There is no confirmed age or sex predisposition to the development of this disease in domestic dogs, although many authorities suggest that older dogs and females are most commonly affected. Some breeds appear genetically predisposed to developing pancreatitis, particularly Miniature Schnauzers, Miniature Poodles and Cocker Spaniels. Dogs that are taking certain medication, as well as those with Cushing's disease (hyperadrenocorticism), diabetes mellitus, hyperlipemia and/or hypothyroidism, reportedly have an increased chance of developing pancreatitis. Obese spayed females and dogs fed a fatty diet also seem predisposed.
The symptoms of acute pancreatitis typically occur suddenly and are severe. Chronic pancreatitis normally causes more mild symptoms that wax and wane. Pancreatitis is not particularly difficult to diagnose. In some cases, advanced diagnostic tools may be necessary.
How Canine Pancreatitis is Diagnosed
Many dogs that develop pancreatitis are overweight, are fed a high fat diet, recently ate a single especially fatty meal or are being given a medication that has been linked to pancreatitis. The attending veterinarian will take the dog's history, conduct a thorough physical examination and assess the dog's presenting symptoms. All of these findings will be taken into consideration when diagnosing pancreatitis. Often, these factors will lead to a presumptive diagnosis of pancreatitis, which can be strengthened by the results of blood work. The results of a routine serum chemistry profile and complete blood count are usually unremarkable in dogs with pancreatitis. Serum amylase and lipase levels can be suggestive of pancreatitis, but are not diagnostic. Newer blood tests, such as the canine serum pancreatic lipase immunoreactivity (PLI) concentration and the trypsinogen activation peptide (TAP) tests, are now commercially available to assist with the definitive diagnosis of this disease.
Abdominal radiographs (X-rays) will not reveal inflammation of the pancreas. However, they can be helpful to rule in or out other causes of severe abdominal pain. Abdominal ultrasound is also a useful diagnostic tool, because it can disclose enlargement of the pancreas, fluid accumulation and other diagnostic indicators. Ultrasonography can be expensive, and the accuracy of the results depends almost entirely upon the skill of the ultrasonographer and the quality of the ultrasound equipment. The pancreas also can be biopsied. However, biopsy is not often used to diagnose pancreatitis, because most dogs with pancreatic symptoms are too ill to undergo this surgical procedure.
Pancreatitis in domestic dogs is being diagnosed with increasing frequency. Because its symptoms can mimic those of many other painful gastrointestinal disorders, it is important that the appropriate steps be taken to confirm a definitive diagnosis of pancreatitis.
Pancreatitis is a serious and painful disease of domestic dogs. Owners play an important role in their dog's successful recovery, as special diets and feeding protocols must be followed at home after the dog's hospital stay. The treatment choices for dogs with pancreatitis will vary depending upon whether the condition is chronic or acute. The guiding therapeutic goals are to treat any identifiable underlying causes of the condition, relieve the dog's pain, provide sound dietary support and address any complications that may arise.
Dogs suffering from acute pancreatitis are normally treated on an in-patient basis to immediately address dehydration and shock. Aggressive intravenous fluid therapy and supportive nursing care are key components of the treatment protocol. Other important therapies include pain management (typically with intravenous or intramuscular analgesic medications) and administration of medication to address vomiting and/or diarrhea.
Historically, one of the most common treatment protocols for canine pancreatitis was to withhold food for several days, purportedly to give the pancreas time to rest and repair. This is called "nothing per os" (NPO), which means "nothing by mouth." Current thought is that NPO therapy should only be used when a dog is vomiting severely and persistently. Obviously, this must be done under the strict supervision of a veterinarian, as fluid, electrolyte and nutritional support must be managed and maintained intravenously at a veterinary clinic. If the dog is not actively vomiting and is willing to eat on its own, many veterinarians will recommend feeding a low-fat, low-protein, high-fiber diet, in small amounts, multiple times a day. Blood transfusions may also be necessary in certain cases.
Dogs with chronic pancreatitis typically will be placed on a low-fat, high-fiber diet for life. Owners can also supplement their dog with pancreatic enzymes to help provide relief from abdominal pain. Unfortunately, pancreatic enzyme supplementation probably will not alter the course of the disease.
Pancreatitis can have a prognosis ranging from good to guarded to grave. Dogs with acute onset of pancreatitis usually have a better prognosis than those with chronic forms of the disease. Unfortunately, there is no reliable way to predict the outcome of pancreatitis in any given animal.