What is pancreatitis?
As far as veterinary internal medicine conditions go, one of the more common conditions treated is pancreatitis – the inflammation of the pancreas. The pancreas is a glandular organ tucked between the stomach and duodenum which is the first part of the small intestine. The pancreas has two functions: endocrine (insulin secretion to facilitate metabolism of glucose) and exocrine (production of digestive enzymes).
Pancreatitis causes leakage and premature release of the digestive enzymes. This leakage causes the pancreas to digest itself and the surrounding intra-abdominal tissues, which in turn leads to even more severe inflammation. Pancreatitis can be acute or chronic, and both forms can be serious and potentially life-threatening.
In most cases of pancreatitis, the underlying cause is not apparent. There are several potential causes and risk factors for pancreatitis. These include: ingestion of high fat foods (eating certain people food or garbage ingestion), fat metabolism abnormalities (hyperlipidemia), hormonal influences (such as diabetes mellitus, hypothyroidism, and Cushing’s disease), viral or bacterial infections, certain medications (such as prednisone and azathioprine and others), and trauma/injury. Some breed types (such as Miniature Schnauzers) and overweight pets are at higher risk of developing pancreatitis.
What are the symptoms of pancreatitis?
The clinical signs associated with pancreatitis may vary from mild to severe.
Clinical signs may include:
- Lack of appetite
- Painful abdomen
- Depressed behavior
All, or only some of the signs, may develop in an individual patient. Pancreatitis may occur in both cats and dogs. Cats may be especially difficult to diagnose due to the vague clinical signs they may exhibit. These symptoms are not necessarily specific for pancreatitis and may look like other disease processes such as gastroenteritis, intestinal foreign body obstruction, or peritonitis.
How is pancreatitis diagnosed?
Even for the most competent veterinarian, the diagnosis of pancreatitis may sometimes be complicated as there is no single test available to reliably diagnose pancreatitis in all cases. It is usually a combination of findings and test results that lead to a diagnosis of pancreatitis. Initial diagnostic testing may include blood work (complete blood count and chemistry panel), abdominal radiographs and abdominal ultrasound. These tests are performed to evaluate internal organ function (liver, kidneys, pancreas, protein levels, and electrolyte balance) and to rule out intestinal blockage or other causes of the clinical signs. When used in combination with other supporting information, there are also specific blood tests available that may help diagnose pancreatitis.
What is the treatment for pancreatitis?
Pancreatitis may be a challenging condition to treat, and unfortunately, there is no specific treatment that will reverse the condition. Once diagnosed, the patient should have nothing orally until the vomiting has resolved (one to four days). Fasting allows the pancreas to “rest” and reduces stimulation of pancreatic secretions Therapy is generally symptomatic and supportive to minimize and control the clinical signs until the condition can resolve on its own.
Therapy may include:
- Intravenous fluids
- Anti-nausea medications
- Antibiotics and
- Pain medications
Other ancillary treatments that may be beneficial in some patients include plasma administration and hyperbaric oxygen therapy. Once the vomiting has resolved, dietary management is important to aid in recovery and to help prevent future bouts of pancreatitis. A fat-restricted and highly digestible diet is generally recommended.
After-care and recovery from pancreatitis:
Potential side effects of pancreatitis may include bile duct obstruction, diabetes mellitus, or exocrine pancreatic insufficiency. Bile duct obstruction may resolve on its own as the pancreatitis improves or it may require surgical intervention. Diabetes mellitus may require insulin therapy and pancreatic insufficiency can be managed with pancreatic enzyme supplementation.
When a patient recovers from an episode of acute pancreatitis, that patient may remain at higher risk of the condition recurring. Dietary changes may be necessary for the life of the pet. Because of the nature of the condition, the overall long term outcome of patients with pancreatitis may be difficult to predict, but with a proper diet and monitoring, pets may continue to live a comfortable life.
Inflammation of the pancreas is painful and can be life threatening. If you believe your pet may be suffering from pancreatitis, please seek veterinary attention.
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