Download cardiology - Saint Francis Veterinary Center

PANCREATITIS
The pancreas is a pale pink, glandular organ nestled just under the stomach. It has two main functions:
 Production of hormones, including insulin
 Production of digestive enzymes
The normal pancreas has a number of protective mechanisms to keep its
stored digestive enzymes from damaging body tissues, including the
pancreas itself. However, with pancreatitis, these protective
mechanisms are overcome, causing profound inflammation. If this
inflammatory process progresses, other tissues and/or organs may
become inflamed as well, most notably the liver and gastrointestinal
tract. Furthermore, toxins released from the inflammation are released
into the body’s circulation, potentially causing a body-wide inflammatory response. If pancreatic
damage disrupts its ability to produce insulin (a hormone involved in the body’s regulation of sugar),
diabetes mellitus may result.
What causes pancreatitis in animals? Unfortunately, 90% of the time, a definitive cause is never
discovered. However, we have some idea of possible risk factors. These include:





Genetic predisposition
o Schnauzer dogs have been repeatedly documented as a breed over-represented for
developing pancreatitis
Other underlying diseases
o A variety of other systemic diseases may predispose a pet to develop pancreatitis,
including hyperadrenocorticism (Cushing’s Disease), hyperlipidemia, obesity, and
diabetes mellitus
Dietary indiscretion
o Fatty/spicy meals, and “garbage raids” are both thought to predispose animals to
developing pancreatitis
Trauma
o Being hit by a vehicle or falling from a great height may damage the pancreas,
predisposing to pancreatic inflammation
Use of certain medications
o Various medications currently used in veterinary medicine have been shown to
predispose human patients to pancreatitis, including thiazide diuretics, furosemide,
estrogens, azathioprine, ranitidine (Zantac™), acetominophen (Tylenol™), sulfonamides,
tetracyclines, L-asparaginase, metronidazole, procainamide, and nitrofurantoin.
o Corticosteroids do not appear to induce pancreatitis, although these medications do
potentially cause alterations in levels of pancreatic enzymes
Clinical signs associated with pancreatitis are variable, and often include:
A. Vomiting
B. Loss of appetite (especially in cats)
C. Lethargy (especially in cats)
D. Diarrhea
E. Abdominal discomfort
F. Fluid accumulation in the abdominal and/or chest cavities
These symptoms may range from very mild to severe  they may recur over months to years, or an
animal may be presented to a veterinarian in severe shock. Additionally, various complications may
occur secondary to pancreatitis, including diabetes mellitus, dietary maldigestion, and bile duct
obstruction.
Pancreatitis may be difficult to diagnose. Obtaining an accurate patient history is invaluable to help
eliminate potential predisposing factors. Thorough diagnostic evaluation is essential, and includes
blood/urine tests, fecal tests, abdominal radiography and/or ultrasonography. Occasionally, surgery is
needed (i.e.: to correct a bile duct obstruction), and allows the surgeon to biopsy adjacent organs to
rule out additional problems, such as inflammatory bowel disease.
There are three key elements to treatment of pancreatitis. They are:



Removing the cause of the pancreatitis (if possible)
Monitoring and instituting protection against potential complications listed above
Providing supportive care and symptomatic relief, including pain medications, gastroprotectant
medications, anti-nausea medications, nutritional support
Fluid therapy is used to support the vasculature (blood supply) and correct dehydration from vomiting
and/or diarrhea. Plasma transfusions may be helpful in dogs, as these fluids help to replace important
clotting proteins and enzymes to help fight inflammation. Food and water are withheld for a variable
period of time to help reduce inflammation, and often a temporary supplemental feeding tube may be
used to ensure an animal receives adequate nutritional support at an appropriate time. Specific
treatment of pancreatitis is very variable, and is tailored to the unique needs of each patient.
The risk of recurrence of pancreatitis is very difficult to predict. However, appropriate treatment of
any predisposing conditions, avoidance of sudden dietary changes, and feeding a low fat diet may help
to reduce the likelihood of recurrence.