Inflammation of the Pancreas in Dogs: Diagnosis and Treatment

a.k.a. Pancreatitis, inflammation of the pancreas

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Updated on September 26, 2024
SUMMARY OF CONTENT
Inflammation of the pancreas that varies greatly in severity.
SEVERITY:
Severity is mild to moderate to severe.

  • Diagnosis Icon
    Requires a diagnosis by a veterinarian
  • Time to Cure
    Resolves within days to weeks, or is a chronic condition
  • Treatment Icon
    Treatable by a veterinarian, by the pet parent
  • Prevention Icon
    Avoiding fatty foods and maintaining a healthy body weight are the best ways to try to prevent pancreatitis
  • Spread Icon
    Not contagious to other pets or people
  • Lab Icon
    Physical exam, lab tests, abdominal ultrasound, surgical biopsy (rare)

VERY COMMON IN
Middle-aged to older dogs, dogs that eat an excessively fatty meals, overweight dogs, dogs with hyperlipidemia.

Symptoms & Signs

Most dogs with pancreatitis experience vomiting, anorexia (not eating) and lethargy. Some dogs display signs of abdominal pain (posing in a “prayer position” with forelimbs and head down while the hind end is positioned upwards, hunched posture, crying out or whining when the abdomen is palpated), dehydration and diarrhea. All of the signs for pancreatitis are considered non-specific, as they occur in a large number of other conditions and can vary widely in severity. Severely ill dogs with pancreatitis can present with severe dehydration, ascites (fluid in the abdomen), tachycardia (elevated heart rate), icterus (yellow gums, skin, white parts of the eye) or signs of petechiation (red lesions on the skin from broken blood vessels). In severe cases, pancreatitis can progress to a life threatening systemic inflammation.

Diagnosis

There is no single test that is definitive for all cases of pancreatitis. The diagnosis is based upon compatible results of exam findings, lab tests, diagnostic imaging, and rarely, surgical pancreatic biopsy. Common exam findings include abdominal pain, a low-grade fever and dehydration in the presence of vomiting, anorexia and diarrhea. More severely ill dogs can display signs of shock, bleeding issues, or icterus. Necessary lab tests include a CBC (complete blood count to evaluate red and white blood cells and platelets), blood chemistry (to evaluate organ function, lipase and amylase) and urinalysis (to evaluate kidney function and look for signs of infection). In the past few years, more specific tests for pancreatitis have become available and include the cPLI and Spec cPL blood tests. If these tests results are normal, pancreatitis can be excluded as a possible diagnosis with a great deal of certainty. However, if the test results are abnormal, this indicates that pancreatitis should be highly suspected. The cPLI and Spec cPL tests do not provide a definitive diagnosis of pancreatitis and must be interpreted in light of all other findings. Abdominal ultrasound can indicate inflammation of the pancreas and other consistent changes in the abdomen. Again, this is not a definitive diagnostic test and serves to raise or lower suspicion of pancreatitis. Abdominal x-rays can indicate changes in some cases, such as decreased abdominal detail or the presence of fluid. A definitive diagnosis of pancreatitis can only be made by means of a surgical pancreatic biopsy. This procedure is only performed in very severe cases of pancreatitis that are not responding to therapy, because it poses a number of risks and complications.

Causation

The pancreas is a glandular organ that is located near the stomach and upper small intestine (duodenum). It is responsible for releasing digestive enzymes, which aid in breaking down food, as well as producing insulin, which is a hormone that causes glucose (sugar) to be utilized for energy at a cellular level. The exact cause of pancreatitis is not fully understood, but it is thought that when the pancreas’ digestive enzyme levels are altered, the pancreas begins to damage itself (autodigestion) and cause significant inflammation.

Pancreatic enzyme alteration is suspected to occur due to a variety of risk factors. These include: obesity, eating a high fat meal, administration of certain medications (potassium bromide, certain chemotherapeutic drugs, trimethoprim-sulfa antibiotics, phenobarbital, or exposure to organophosphate insecticides), trauma to the pancreas (i.e. being hit by a car), endocrine disorders (hypothyroidism, Cushing’s disease or diabetes mellitus), hyperlipidemia, or pancreatic tumors.

Some of the bigger clinical concerns with pancreatitis are related of the changes it causes with other organ systems in the body. The pancreatic inflammation can extend to the liver and cause inflammation of the bile duct going to the gallbladder. The enzyme abnormalities can destroy blood clotting factors, which can cause DIC (disseminated intravascular coagulation) or other bleeding disorders, which can progress to multiple organ dysfunction syndrome (MODS). Abscesses (infection) can develop in the pancreas and can lead to a septic (severely infected) abdomen.

Diabetes mellitus can occur if a significant portion of the pancreas has been damaged, because the pancreas also produces insulin, and the destruction of insulin-producing cells leads to diabetes.

Treatments

icon AT-HOME CARE
For mild cases of acute pancreatitis or in cases of chronic pancreatitis, feeding a veterinary therapeutic low-fat diet or a home-made low-fat diet (for short-term) is the mainstay of management. Some dogs require anti-nausea medications or antacids. Antibiotics are sometimes needed in cases of acute pancreatitis. In the long term, keeping dogs at a healthy body weight and avoiding pancreatitis triggers, such as fatty foods or table foods, is the goal to prevent recurrence.
icon SUPPORTIVE CARE
Most cases of pancreatitis require hospitalization for intravenous (IV) fluids to restore hydration and improve blood flow to the pancreas, which can promote healing. Dogs are often hospitalized for IV fluid therapy for a period of several days to a week or more, depending upon their individual responses. An older school of thought withheld early nutritional support or feeding in dogs with pancreatitis. More recently, it has been discovered that feeding dogs that are not vomiting as soon as possible with a low-fat diet is beneficial. Plasma or fresh frozen plasma therapy (a protein and clotting factor-rich blood product) is used in cases of coagulopathies (bleeding disorders), and has questionable value if coagulopathies are not present.
icon MEDICATIONS
There is no definitive medication to treat pancreatitis. Instead, this condition is treated supportively by managing the clinical signs and trying to prevent progression of the condition. Medications are given to manage clinical signs, such as anti-nausea medications (maropitant, metaclopramide, ondansetron, dolasetron), antacids (famotidine, omeprazole) and pain medications. Antibiotics are administered if infection is suspected.
icon DEVICES
None
icon SURGERY
Surgery is rarely performed in cases of pancreatitis. However, if a bile duct obstruction, pancreatic abscess or septic abdomen are suspected, surgery is occasionally performed to flush the abdomen with fluid and correct any obstructions. Pancreatic biopsy is occasionally performed in these cases
icon SPECIALISTS
Mild to moderate cases of pancreatitis can be managed by a competent general practitioner, but some moderate to severe cases require referral to veterinary specialists in emergency and critical care medicine, internal medicine, nutrition or soft tissue surgery.

Cost Of Treatment

$200 and $1,000+ per episode This will depend on the size of the dog, the severity of the condition and how many days of hospitalization/treatment are required.

Recovery

Recovery for mild cases of pancreatitis can take several days to a week. More moderate to severe cases of pancreatitis can take several weeks to achieve full resolution. Some of the most severe cases of pancreatitis do not recover due to organ dysfunction and DIC, and those dogs succumb to disease or are humanely euthanized.

Monitoring

During hospitalization, dogs are monitored for changes in clinical signs (vomiting, appetite, lethargy, diarrhea), blood values (chemistry panels, coagulation tests, electrolyte levels), blood pressure and fluid input/urine output. At home, monitoring a dog’s appetite, energy level and for the presence of any vomiting or diarrhea are crucial to identify the recurrence of pancreatitis. The frequency of recheck appointments is based upon the severity of each individual case, as well as the response to initial treatment.

Prevention

For a dog that has never had a case of pancreatitis, avoiding fatty foods and maintaining a healthy body weight are the best ways to try to prevent pancreatitis. If a dog has previously been diagnosed with pancreatitis, feeding a low-fat diet for the long term, avoiding any known individual risk factors (certain medications, for example) or table foods are the mainstay of preventing recurrence of pancreatitis.

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Disclaimer

The information contained on this page is for educational purposes only. This medication should only be given under the advice of a veterinarian who has examined your pet under the laws applicable to your state of residence.