The pancreas is a gland within the abdomen located along the stomach and the first part of the small intestine. It performs both endocrine and exocrine functions.
How the Pancreas Functions
The endocrine function of the pancreas includes the production of insulin, which is secreted into the blood in response to carbohydrate and protein ingestion.
The exocrine function involves the secretion of inactive digestive enzymes and bicarbonate into the intestine where they become activated to help break down ingested foodstuffs.
What is Pancreatitis?
Pancreatitis refers to the inflammation of the pancreas and is caused by activation of the digestive enzymes within the pancreas due to pancreatic damage or blockage of its outflow duct. This results in pancreatic auto-digestion, whereby the enzymes destroy the pancreatic tissue.
Acute pancreatitis is defined as reversible pancreatic inflammation, while chronic pancreatitis refers to permanent changes in the pancreatic tissue. These two forms of pancreatitis cannot be differentiated clinically, although, clinical signs in acute pancreatitis are usually more severe than those seen with chronic pancreatitis.
Acute pancreatitis can quickly lead to systemic inflammation, shock and death and must be treated aggressively. Chronic manifestations of pancreatitis include diabetes mellitus (30-40% of dogs with diabetes have pancreatitis) or loss of digestive enzyme production (exocrine pancreatic insufficiency).
Other potential complications include pancreatic pseudocysts and abscesses.
Causes of Pancreatitis in Dogs
The cause of pancreatitis is usually unknown, although these factors have all been associated with its development:
- Diet, particularly high fat diets
- Hereditary disorders associated with fat metabolism
- Medications
- Prior surgery
- Obesity
- Trauma
- Toxins including chocolate, lilies, zinc and organophosphates
- Cancer
- Obstruction of the pancreatic outflow tract because of biliary stones
- Inflammation
- Masses
Diagnosis
Clinical signs of pancreatitis in dogs usually include some or all of the following:
- Vomiting
- Anorexia
- Depression
- Abdominal pain
- Diarrhea
In severe cases, dogs may be recumbent and in shock.
Diagnostics that may be recommended include:
- Abdominal radiographs (X-rays): While these images are not usually very helpful in establishing a diagnosis of pancreatitis, they are important in ruling out other causes of disease.
- Abdominal ultrasound: This test can be very specific in identifying pancreatitis, but the pancreas may appear normal in up to 32% of dogs with pancreatic inflammation.
- Blood work including a complete blood count (CBC) and biochemical profile: Blood work can be normal or demonstrate diseases of other organ systems either unrelated to or caused by the pancreatitis
- Urinalysis
- Urine culture
- A canine pancreatic lipase immunoreactivity (cPLI) test: The cPLI test is a highly accurate test in diagnosing pancreatitis, but the presence of an abnormal cPLI test does not definitely rule in pancreatitis as the sole cause of the clinical signs. This is an important concept, as resolution of the pancreatitis may not lead to resolution of the clinical signs.
Currently, the combination of the tests above is usually recommended to obtain a presumptive diagnosis of pancreatitis. The only definitive way to diagnose pancreatitis is to obtain a biopsy via surgery or laparoscopy, although, many times the patient is too unstable to undergo anesthesia.
Treatments
Treatment is truly supportive in nature, and its aggressiveness depends on the severity of the pancreatitis. In severe cases, hospitalization is required for restoration and maintenance of hydration, control of pain and vomiting, nutritional support and possibly antibiotic administration.
If the patient is vomiting, food and water are withheld. Otherwise, an ultra low-fat diet can be offered. The use of very low-fat diets in dogs is to decrease the workload on the pancreas.
In less severe chronic cases, hospitalization may not be required if the patient is hydrated and not vomiting. An extremely low-fat diet will be recommended for home use, as well as regular monitoring of blood work such as the cPLI and/or abdominal ultrasound.
Prognosis
Prognosis is dependent on:
- The severity of clinical signs
- The degree of pancreatic tissue damage
- The duration of illness
- The presence of concurrent disease
In uncomplicated cases, continuous use of a low-fat diet may prevent any future recurrences of pancreatitis. Conversely, some dogs will experience repeated bouts of pancreatitis, which will progress to chronic pancreatic changes and persistent disease accompanied by unrelenting clinical signs.
An acute severe episode of pancreatitis can quickly lead to shock and death if aggressive treatment is not started promptly. Unfortunately, even with aggressive treatment, some patients may still die.
Because of the complexity in diagnosis and unpredictability of response to treatment, suggesting a prognosis is difficult. In severe cases, hospitalization may be required for several weeks before the patient is stable enough to be discharged.
For more information on this subject, speak with the veterinarian who’s treating your pet.
Overview
The pancreas has many functions, including the production and secretion of digestive enzymes and the production of insulin. Digestive enzymes are critical for the absorption of food. Insulin aids in the control of the metabolism and blood-sugar levels. Pancreatitis refers to “inflammation of the pancreas” and there are two types of this disease: chronic, which means “recurring,” and acute, which means “sudden.” When the pancreas becomes inflamed, digestive enzymes that are normally inactive until they reach the small intestine become activated in the pancreas instead, resulting in pain and swelling as the pancreas actually begins to digest itself. Dogs with chronic pancreatitis essentially have multiple attacks of acute pancreatitis. In some situations, the symptoms can be less severe but because the condition is chronic, the long-term impact can be more severe. The pancreas is located in the upper abdomen, near the stomach, liver and right kidney.
Risks
There are many suggested causes of pancreatitis including obesity, high-fat diets, liver disease, certain medications, toxins, and infection. Even if your dog doesn’t normally eat a high-fat diet, the introduction of a large amount of fatty food all at once can cause pancreatitis. Pancreatitis can occur in any dog but some breeds are more susceptible to this disease than others, including the miniature schnauzer, miniature poodle, and cocker spaniel. Additionally, pancreatitis is more common in older dogs, overweight dogs, and females. Dogs that get into garbage are much more likely to develop pancreatitis, so be sure to keep trash out of your dog’s reach!
Symptoms
Dogs with pancreatitis will often stop eating and drinking because of the pain associated with this disease.
Other symptoms you may see are:
- Upset stomach and abdominal pain
- Swollen abdomen
- Abnormal posture; arching of the back
- Diarrhea
- Vomiting
- Lethargy
- Fever
- Restlessness
- Gagging
Diagnosis
Your veterinarian will take a complete history and perform a thorough physical exam of your pooch. Additionally, diagnostic tests will be required to identify if your pet has acute pancreatitis. These may include:
- Chemistry tests to evaluate kidney, liver, and pancreatic disease and dysfunction, as well as sugar levels
- A complete blood count to screen your dog for infection, inflammation, or anemia and other blood-related conditions
- Electrolyte tests to ensure your dog isn’t dehydrated or suffering from an electrolyte imbalance
- Pancreas-specific tests to help diagnose or rule out the disease
- X-rays of the abdomen and intestinal tract
- Ultrasound to image the pancreas and other abdominal organs
- Endoscopy to evaluate the lining of the gastrointestinal tract
Treatment
The treatment of pancreatitis depends on the severity of the disease and may include:
- Hospitalization at the veterinary clinic
- Fluid therapy and electrolytes
- Pain medicine
- Antivomiting medication (antiemetics)
- Antibiotics, if a secondary bacterial infection is suspected
- Other medications, depending on your dog’s symptoms
- Keep in mind that your veterinarian may recommend that some diagnostic tests—such as the CBC, chemistry tests, and pancreas-specific tests—be repeated to monitor your dog’s progress during treatment.
Your veterinarian will recommend a treatment plan that is specific for your pet. Make sure you give all medications as directed and carefully follow any dietary recommendations. Keep a close eye on your best friend; if she becomes lethargic or stops eating, call your veterinarian right away.
Prevention
While you can’t completely prevent pancreatitis, the following will help reduce the risk of your dog developing this disease and will help ensure her health and well-being:
- Follow all nutritional recommendations.
- Feed your dog a diet recommended for the prevention of pancreatitis.
- Don’t let your dog become overweight—weight management is just as important for our four-legged friends as it is for us!
- Avoid high-fat diets.
- Avoid giving your dog table scraps, especially if she isn’t accustomed to eating people food.
- Make sure you discuss all medications for your dog with your veterinarian. They will help you avoid any unnecessary medications that may cause pancreatitis.
- Don’t let your dog have access to garbage!
Want more info? Learn about acute pancreatitis in dogs.
If you have any questions or concerns, you should always visit or call your veterinarian – they are your best resource to ensure the health and well-being of your pets.