Pancreatitis

Pancreatitis literally means 'inflammation of the pancreas'. The pancreas is an organ in the body that is involved in the production of insulin as well as enzymes needed for digestion and absorption of food.

When an animal develops pancreatitis the enzymes involved in digestion and absorption are prematurely activated and this results in localized inflammation. This inflammation can also involve the stomach and intestines. In severe cases the inflammation can be spread systemically and can lead to problems with the heart, lungs, kidneys and liver. Pancreatitis can be fatal.

There is some controversy as to the cause of pancreatitis. Some of the factors that have been implicated in the development of pancreatitis include:
*obesity and ingestion of a high fat diet,
*shock resulting in hypotension and poor blood circulation to the bodys organs (including the pancreas),
*drug induced for example high doses of corticosteroids,
*severe vomiting,
*Cushings disease (or hyperadrenocorticism),
*infection,
*some breeds of dogs appear to be predisposed to the development of pancreatitis these include cocker spaniels, poodles and schnauzers.

The most common signs that we see associated with pancreatitis are depression, vomiting and a lack of interest in food. A painful gut is another typical sign the dog is often unable to settle and may cry out or whimper when pressure is placed around the abdomen.

Diagnosis involves running a blood test. We routinely measure the lipase level in the animals blood this is one of the enzymes produced by the pancreas. An elevated lipase level indicates that the dog has pancreatitis. We also recommend that a complete blood count be performed as this can give us an indication of the severity of the condition.

We regard pancreatitis as a potentially devastating disease and we recommend immediate and aggressive treatment. The basic treatment for pancreatitis involves giving fluids (via an intravenous drip) and nothing by mouth. By withholding food and water the release of the pancreatic enzymes is stopped. Animals are also given antibiotics while being treated for pancreatitis. When the pancreas is inflamed, bacteria may take advantage of the situation and set up an infection. To avoid this we give antibiotics by injection while the animal is being fasted, and in tablet form once food and water are reintroduced.

We measure the lipase level daily and once it returns to the normal range we then introduce small amounts of water and bland low fat food. If the animal tolerates this and there is no recurrence of signs then the dog can go home.

For animals that have atypical levels of lipase there is a test we can request from the laboratory that takes 4 days to get back but this test is necessary for some animals as - instead of eliminating lipase via the kidneys - they retain it giving a false high reading. 

Prognosis for animals with a single bout of mild pancreatitis is good. However, any animal that has had a bout of pancreatitis appears to be predisposed to further attacks and consequently we strongly recommend that the dog be fed on a low fat diet only, access to table scraps and fatty foods etc is to be strictly avoided. Obese dogs MUST lose weight. Animals that have had repeated bouts of pancreatitis will need to be carefully managed it is imperative that these animals be maintained on a diet with very low fat levels.

Severe pancreatitis can, as mentioned before, be fatal. Repeated bouts of pancreatitis can also result in irreversible damage to the pancreas and a reduction in insulin production the animal may then develop diabetes. Other complications that can occur in animals with severe pancreatitis include:
*heart problems
*lung problems
*bile duct obstruction and liver damage
*abscess formation
*obstruction of the gut

These complications are rare but if the animal is not responding to routine treatment, we may need to investigate further. In the first instance we would recommend an exploratory surgery. This enables us to look at the pancreas directly. It may be necessary to take a biopsy of the pancreas to determine exactly what is going on.

Although every case is somewhat different, the important thing to remember is that any animal that has a bout of pancreatitis MUST be maintained on a LOW FAT diet indefinitely. Furthermore, animals that are overweight MUST lose weight.
 
Dr Micklethwaite