Pancreatitis in Dogs

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Pancreatitis in dogs is an inflammatory condition of the pancreas, a gland that is located in the abdomen underneath the stomach. The pancreas' job is to produce and secrete some very important substances that aid in many bodily processes.

Substances Made and Secreted by the Pancreas

Digestive enzymes are produced by the pancreas and deposited into the duodenum, the part of the small intestine that is attached to the stomach. These enzymes help to continue the breakdown of proteins and starches that the stomach begins.

The pancreas also secretes insulin and glucagon into the bloodstream. These hormones help regulate the metabolism of sugar in the body.

What Is Pancreatitis and How Is It Damaging to the Body?

When a dog's pancreas becomes inflamed, the digestive enzymes that it stores are released early, before reaching the small intestine. They begin to digest the surrounding body tissues such as the liver and the pancreas itself instead of breaking down food as designed.

The body tissues that are damaged by the pancreatic enzymes release toxins that begin to circulate throughout the body, wreaking havoc and causing massive effects such as:

• Respiratory failure. This is the result of damage to the lungs by circulating toxins.
• DIC (disseminated intravascular coagulation). This is a dangerous condition that is a disturbance of a dog's blood clotting system. In this case, it is the result of blood clotting factors in the body being disrupted by pancreatic enzymes and toxins from damaged tissues. DIC leads to abnormal bleeding and blood clotting throughout the body, and it is a life-threatening situation.
• Liver damage. Liver damage from pancreatic enzymes can lead to failure of that organ, resulting in life-threatening toxin build up in a dog's system.
• More pancreas damage. The pancreas itself becomes further damaged during pancreatitis, resulting in more dysfunction. Insulin production may be disrupted, resulting in diabetes.

Presentation and Signs of Canine Pancreatitis

This is an illness that usually causes dogs to act quite sick. The following signs of pancreatitis are often present in affected dogs:

• Anorexia (loss of appetite)
• Vomiting
• Diarrhea
• Weakness
• Dehydration
• Fever
• Abdominal pain: in severe cases, dogs may adopt a "praying posture," where they lie on their elbows, with their rear ends up in the air.

Causes of Pancreatitis in Dogs

The causes of pancreatitis in dogs are not all known or understood. However, some of those that are known include:

• Dietary indiscretion. This means that the dog has eaten something that he shouldn't have. In the case of pancreatitis, this is often something fatty. Pork products (including pigs' ears), French fries, potato chips, and steak are all common culprits for causing canine pancreatitis.
• Hypertriglyceridemia. This is a condition in which a dog's triglyceride levels are high. It is usually the result of a genetic propensity, but it can also occur from a prolonged fatty diet. High triglyceride levels are associated with the development of pancreatitis in dogs.
• Severe blunt trauma. Most often, this type of pancreatitis is the result of a dog being hit by a car.
• Abdominal surgery. During certain abdominal surgeries, the pancreas must be handled by the surgeon. The pancreas is a delicate gland, and it is remarkably easy to damage its tissue and cause pancreatitis secondary to such handling. Decreased blood flow to the pancreas as a result of anesthesia can also cause pancreatitis.
• Certain medications. Some antibiotics such as trimethoprim-sulfa, chemotherapy agents like azathioprine, and the anti-seizure medication potassium bromide have all been associated with the development of pancreatitis in dogs.
• Tumors. Cancer in the liver, intestines, or pancreas itself can all result in pancreatitis.

Breeds, Gender, and Age Most Commonly Affected by Pancreatitis in Dogs

Miniature schnauzers and beagles have a predisposition to hypertriglyceridemia with secondary pancreatitis.

Diagnosis of Pancreatitis in Dogs

In order to reach a diagnosis of pancreatitis, your veterinarian will begin with by taking a thorough history from you. You should be prepared to tell the doctor all of the signs of illness that you've noticed your dog displaying at home, how long they've gone on, and whether your dog got into or was given any human foods or garbage prior to the beginning of the signs.

The doctor will then do a complete physical examination on your dog, checking hydration levels, feeling for abdominal pain, taking a temperature, and generally looking at and feeling your dog all over.

Next, the veterinarian may wish to order some blood tests. A complete blood count (CBC) sometimes reveals an increased white blood cell count in dogs affected by pancreatitis. Blood chemistry values may show high triglycerides or cholesterol or increases in the enzymes amylase and lipase. A specialized test, the spec cPL, may be ordered from the laboratory or performed as an in-house test. This test is more specific for pancreatitis than amylase, lipase, or triglyceride levels are.

Sometimes an X-ray or ultrasound may be necessary to help diagnose pancreatitis. Although there is no diagnostic way to see pancreatitis on these tests, inflammation of the pancreas and fluid in the abdomen may be noted, and other disorders that may cause similar signs can be ruled out.

A fine needle aspirate (FNA) of the pancreas may be done in some cases. This involves inserting a fine gauge needle into the gland to remove some cells for microscopic examination. Because the pancreas is a delicate gland, this test isn't performed too often.

Treatment of Pancreatitis in Dogs

Treatment of canine pancreatitis is generally supportive. The dog's body systems must be supported and the toxins flushed out of the system as much as possible. To this end, any or all of the following treatments may be necessary:

• Resting the gut. Many veterinarians will treat pancreatitis in dogs by stopping any oral intake of food or water for a period of time. This allows the gut to settle and decreases the amount of digestive enzymes being pumped out by the pancreas.
• Aggressive fluid therapy. Intravenous (IV: into a vein) fluids are usually needed to treat dogs with pancreatitis. The fluids flush detrimental toxins from the system and also support the dog while he is unable to take in food or water.
• Pain medications and anti-nausea drugs. Pancreatitis is usually quite painful for dogs. Pain medications are required to keep the dog comfortable while the illness is being treated. Anti-nausea medications are also helpful in calming down the urge to vomit because some dogs will continue to heave and bring up stomach fluids even when they are not being fed or given any water, further dehydrating them.
• Antibiotics. Antibiotic use for pancreatitis is a bit controversial because the cause of pancreatitis is not normally bacterial, but many veterinarians do treat pancreatitis supportively with antibiotics and feel that it improves recovery rates.
• Plasma transfusion. Dogs with liver failure secondary to pancreatitis may need plasma transfusions to recover.
• Early intervention. This is probably the single most important factor in whether a dog will recover fully from a bout of pancreatitis. Owners should be aware of the signs of the illness and be ready to visit the veterinarian quickly.
• Ultra low-fat diet. Once the veterinarian is comfortable starting food in the pancreatitis dog, a low-fat diet is usually begun in an attempt to decrease the dog's pancreatic work-load. These diets may be short- or long-term depending on the severity of the dog's illness and how well and thoroughly he recovers.

Chronic Pancreatitis

Some dogs do not recover completely from a severe bout of pancreatitis. They may develop a low-grade form of the illness that is chronic. These dogs are easily pushed over the edge into a major pancreatitis episode again if they get the wrong food. These dogs may need periodic blood work and will probably need to stay on a long-term low-fat diet with extreme attention to the treats they are allowed to have.

Home Care for Canine Pancreatitis

Most cases of pancreatitis in dogs need to be managed in the veterinary hospital. In extremely mild cases that are caught very early, your veterinarian may agree to give subcutaneous fluids, injectable anti-nausea and pain medications on an outpatient basis, and allow you to begin a regimen of slowly reintroducing a low-fat diet at home. This requires close monitoring for worsening of signs with repeat visits to the veterinarian daily for a period of time.

Prevention of Pancreatitis in Dogs

Some episodes of pancreatitis in dogs can't be avoided. This is the case with dogs that are genetically predisposed to developing it. However, most pancreatitis cases can be avoided by diligent avoidance of fatty foods and treats. Care should always be taken that garbage is kept secured out of reach of your dog, as well.

Prognosis for Canine Pancreatitis

Most cases of pancreatitis caught early carry a good prognosis if it is treated aggressively. Severe cases or those that aren't treated aggressively have a poor prognosis. Chronic pancreatitis as described above is a possible complication in severe cases, even if it is treated aggressively. In some cases, scarring of the pancreas may result in permanent diabetes.

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