What is Pancreatitis?
Pancreatitis is defined as inflammation of the pancreas. The pancreas is a part of the digestive system that produces enzymes that aid in digesting foods. The pancreas is also responsible for the production of insulin. When it becomes inflamed, it can cause damage to the adjacent tissues such as the liver, gall bladder, intestines, and omentum.
Pancreatitis can be either acute (sudden onset) or chronic. Acute pancreatitis can range in severity from mild to very severe. A small number of dogs recovering from acute pancreatitis can go on to have recurrent disease or chronic pancreatitis. In some cases, these dogs can develop other problems, such as liver damage, blockage of the bile duct, or in rare cases, diabetes and maldigestion.
The cause of pancreatitis is unknown but it can be associated with fatty meals or certain medications. We also see an increased incidence in overweight patients or those with Cushing’s disease.
Clinical signs of pancreatitis include a sudden onset of vomiting, diarrhea, fever, decreased appetite, abdominal pain, and lethargy. Some patients will have blood in either the vomitus or diarrhea. In severe cases, these signs can lead to shock and death. Laboratory tests often show increased white blood cell count, along with elevations in pancreatic and liver enzyme levels. Radiographs (x-rays) may show decreased detail in the area of the pancreas. Ultrasound can often show an enlarged pancreas with inflammation of the surrounding tissues. In some dogs with all the clinical signs of pancreatitis, the laboratory tests will be negative, making the diagnosis of pancreatitis difficult.
The type of treatment will depend on the severity of the disease. The goal behind therapy is to rest the pancreas and allow it to heal itself. Withholding all oral food, fluids, and medications will allow the pancreas to remain quiet. Intravenous fluids are administered to maintain hydration. Vomiting and discomfort are controlled with medications. Often antibiotics are administered to prevent secondary infections. In severe cases, a transfusion of a blood component called plasma may be recommended to help control inflammation.
Most mild cases of pancreatitis recover after 2 to 3 days of therapy and have a good prognosis. The more severe cases have a guarded prognosis and often require a hospital stay of a week or longer. Some patients can develop an abscess of the pancreas requiring surgery. The prognosis for those cases requiring surgery is very guarded.
The long term effects following recovery from pancreatitis are few. Most patients will require a low-fat diet to help prevent recurrence. In a very small number of cases, the patient may become diabetic and require insulin injections. In others, they may lose the ability to produce the necessary digestive enzymes and need supplementation. The vast majority of patients go on to live normal, healthy lives.
Feline pancreatitis is a different disease than canine pancreatitis.
The cause of feline pancreatitis is even more of a mystery. The clinical signs of pancreatitis in cats can vary from very mild to more severe signs of vomiting, diarrhea, abdominal pain, and shock. The diagnosis of pancreatitis in cats is very difficult as laboratory testing is often negative. Also, the pancreas is less reliably found on radiographs and ultrasound examination. The treatment for feline pancreatitis differs as well in that fasting may be contraindicated in some patients.