What is pancreatitis?
Pancreatitis means inflammation of the pancreas gland. The pancreas is a special organ that makes many different chemicals such as insulin, acids and alkalis which help digest and process foods. When a normal animal smells or swallows food, signals are sent to the pancreas telling it to start making these chemicals in preparation for the meal "on the way down"
These chemicals travel down a special tube from the pancreas into the first part of the small intestines (the Duodenum). Food on its way out of the stomach meets the chemicals and digestion gets under way.
Sometimes as pets get older and fatter, the pancreas gets inflamed or worn out from too much of a workload e.g. too many fatty meals. This small amount of inflammation results in leakage of acids and alkalis both inside and adjacent to the pancreas. Needless to say, these chemicals are very caustic. Further damage occurs to adjacent organs e.g. liver, intestines and more of the pancreas is digested by its very own chemicals. More damage to the pancreas means more leakage and it does not take long for massive inflammation and tissue destruction to occur.
Traveling through the pancreas is the bile duct- a tube connecting the gall bladder in the liver to the duodenum. Bile traveling down this tube also helps to digest food. If the pancreas is inflamed and swollen, the bile duct can become blocked. As a result, bile "backs up" in the liver and can cause a yellow staining of the blood, skin and gums (jaundice).
We normally see pancreatitis in older overweight dogs or dogs being fed too many fatty meals e.g. lamb chops, marrow bones, scraps off the ham bone, cooked chicken, dairy products. Some older dogs can develop pancreatic cancer which looks just the same as normal pancreatitis.
Some breeds of dogs, e.g. Beagles, suffer from chronic low grade pancreatitis with just the occasional unexplained vomit and/or abdominal discomfort.
From the history, breed, sex, age, symptoms and clinical examination, a vet usually has a pretty good idea the pet is suffering from pancreatitis. There are some specific blood tests that can confirm pancreatitis: elevated Lipase and/or Amylase and the presence of fatty and or yellow (jaundiced) serum.
A special in-house blood test ( Idexx SNAP CPL) gives an accurate positive result in pancreatitis cases (blue dot on the right is the same or darker than the dot on the left- see picture). Repeating these tests during the dog's stay in hospital gives the vet an good idea on how the dog is going.
Other blood tests may show elevated white blood cells combating inflammation and infection and elevated liver enzymes if the bile duct becomes blocked.
Affected dogs are suddenly extremely ill. They vomit just about anything they eat or drink. There is a lot of inflammation and pain in the abdomen. Dehydration and shock quickly follow, making the dog thirsty, however each time it drinks, more leakage of the acids and alkalis occurs. Acute secondary kidney failure can occur due to the large amount of fluid loss causing thickening of the blood and decreased blood flow to vital organs.
As mentioned above, the inflamed pancreas can block the bile duct, so jaundice is a common symptom, sometimes seen 1-2 days after the start of the condition.
The main treatment is nothing by mouth for 12-24 hours. Even the smell of food can trigger of further release of leaking acids and alkalis. Dogs must go onto an IV drip to correct dehydration and reverse shock and damage to the kidneys.
Newer anti-vomiting drugs (e.g. Cerenia) allow early administration of food and/or fluids. This is important to provide fluid and nutrition to the cells lining the stomach and intestines.
Pain killers are an essential part of therapy as pancreatitis is very painful.
Cases failing to respond to therapy may require surgery to rule out pancreatic cancer or to gently flush the affected area to try and settle the inflammation.
Severe cases can obliterate the insulin making capability of the pancreas. Diabetes and all of its associated complications (keto-acidosis) can be a life threatening presenting sign. Cases of acute onset diabetes should have pancreatitis ruled out as an underling cause.
Repeated episodes of pancreatitis can destroy the ability of the pancreas to produce food digesting acids and alkalis, resulting in chronic diarrhoea.
In humans, there is an overall 20% fatality rate, usually due to a secondary infection developing in the affected areas of the abdomen.
Dogs with pancreatitis and diabetic keto-acidosis have a poor prognosis and despite the best of efforts, may die from complications.
Treatment can be very costly due to the length of stay in hospital with intensive care, drugs, repeat blood tests and fluid therapy.
Normal dogs should not receive excessive amounts of fat and/or scraps in their diet especially around the festive season when trimming the fat off ham or roasts.
Make the majority of the diet a balanced dry dog food e.g. Hills VE Essentials.
Feed raw bones 2-3 times a week but try to avoid excessive marrow consumption e.g. ask the butcher to cut the large bines length ways so you can remove the marrow.
Dogs who have suffered from pancreatitis need to go on special low fat dry foods (e.g. Hills W/D dry) to prevent it re-occurring. It is vital that repeat episodes are avoided as too much damage to the pancreas can result in lack of insulin (diabetes) or the inability to digest and absorb foods (pancreatic exocrine insufficiency).