Acute Pancreatitis

Introduction


To understand what Canine Pancreatitis is we first need to understand a little about the pancreas.


The pancreas is a large elongated gland located in the upper abdomen closely associated with the duodenum (upper small intestine).


It is made up of a number of different cells with numerous functions. The cells that make up the pancreas can be divided into two basic types; endocrine and exocrine.

• The endocrine pancreatic cells are the cells involved in insulin production and blood glucose regulation and is important in diabetes mellitus.



• The exocrine pancreatic cells secrete digestive enzymes to digest the food in the duodenum (upper small intestine). These are the cells that are important in Canine Pancreatitis.

In a normal healthy pancreas the digestive enzymes are produced in an inactive form and they are activated in the duodenum. This prevents the pancreas from digesting itself.


What is Canine Pancreatitis?


Pancreatitis is inflammation of the pancreas and results in the activation of the pancreatic enzymes in the pancreas rather than in the duodenum.


This causes local damage to the pancreas with severe swelling of the pancreatic tissue, pancreatic oedema, pancreatic bleeding, pancreatic necrosis (cell death), and also necrosis is the fat tissue surrounding the pancreas.


This process causes the release of certain chemicals called cytokines which circulate in the bloodstream and cause disease in other organs such as

• renal failure (kidney),



• pulmonary failure (lungs),



• pancreatic encephalopathy (brain),



• multi-organ failure,



• generalized inflammation (whole body), and



• Disseminated Intravascular Coagulopathy which causes widespread clots in the capillaries and often leads to sudden death.

Because the pancreas also contains cells that produce insulin, a common complication of Canine Pancreatitis is that they develop diabetes mellitus and may require insulin therapy.

There are two forms of Canine Pancreatitis; acute and chronic. Although they do not always follow this rule, for the most part acute pancreatitis causes a more severe disease whilst the chronic form is usually milder.

What Causes Canine Pancreatitis?

Canine Pancreatitis is caused by a variety of factors. These include:

• pancreatic trauma,








• high fat diets,








• diets suddenly different from normal,








• infections,








• toxins, and








• cancer.

The most common animals that we see Canine Pancreatitis in are dogs that are a bit overweight and have been given a high fat food.

Most veterinary clinics see more cases of Canine Pancreatitis around Christmas due to owners feeding a little bit of ham or turkey at this time.

What are the Clinical Signs of Canine Pancreatitis?

The clinical signs associated with Canine Pancreatitis are:

• Anorexia,








• Vomiting,








• Weakness,








• Abdominal pain,








• Dehydration,








• Diarrhoea.

How Is Canine Pancreatitis Diagnosed?

The veterinarian will start by obtaining a complete history. This includes diet, environment and any medications (particularly any cortisone).

This is followed by a general physical examination.

The veterinarian will then advise a blood test. There are generally two components to the blood test.

The first is a general profile which tells us what is happening in the kidneys, liver, pancreas, and in the red and white blood cells.

The second part is called a canine pancreas-specific lipase test which confirms Canine Pancreatitis.

Occasionally, radiographs (x-rays) are required to get a better idea of what is happening inside the abdomen and in cases which are prolonged then an abdominal ultrasound will be advised.

Very occasionally an abdominal exploratory laparotomy will be required. This is where the veterinarian is able to look at the pancreas through a surgical incision in the abdomen. If need be at this time the veterinarian can also take a pancreatic biopsy.

How is Canine Pancreatitis Treated?

Anything given orally (via the mouth) ends up in the stomach and anything in the stomach can cause more irritation to the exocrine pancreatic cells.

Thus the first part of treatment is having no food or water or medication via the mouth. This is termed nil per os. This often is required for 24 hours. If the period of nil per os is to be longer then an enteral feeding tube (jejunostomy tube) is often placed to bypass the stomach.

Fluid therapy is still the mainstay of treatment of Canine Pancreatitis. This keeps hydration up and also flushes out toxins. It also provides the appropriate electrolytes particularly required in animals that have been vomiting or having diarrhoea. Dogs normally stay in the veterinary hospital on a fluid pump for 3-4 days.

Antibiotics are given either primary or secondary bacterial infections.

Also Canine Pancreatitis is very painful. Pain relief should always be administered.

Anti-Emetics are also an important part of treatment as often the dog will be vomiting, or at least feeling nauseous.

How do you Prevent Canine Pancreatitis?

Canine Pancreatitis is known to be a recurrent problem if measures are not taken to try and prevent it. The best prevention that you can use is through the diet. No fatty meals! No fatty treats! There are diets made specifically for Canine Pancreatitis.

One such diet is Hill’s Prescription Diet Canine i/d. The benefits of this diet are:

• It provides complete balanced nutrition.


• It is highly digestible which both ensures availability of nutrients and also assists in healing of the digestive tract.


• It has reduced fat which encourages stomach emptying.


• It has increased fibre to aide in restoring normal intestinal flora.


• It contains balanced electrolytes and B vitamins to replace those lost from vomiting and diarrhoea.


• It has a superior antioxidant formula to aide in healing of damaged tissue.

This diet can be used for dogs with Canine Pancreatitis which are not hyperlipaemic (excess fat in the blood).

For those dogs that are hyperlipaemic there is Hill’s Prescription Diet Canine w/d which has lower fat levels and also an enzyme called L-carnitine which increases the conversion of fat to energy.