Pancreatic Necrosis, Acute
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- (Often interchangable with acute pancreatitis or atrophy)
Clinical signs
- Occurs mainly in the dog, especially obese bitches, less often in cats
- Severe abdominal pain
- Cardiovascular collapse
- Disease may be unnoticed until signs of EPI and/or DM appear terminally
- Death often soon follows
Pathology
- Pathological changes occur in interstitial tissue and peripancreatic adipose tissue
- Necrosis caused by destructive action of pancreatic enzymes (mainly phospholipase A and elastase) activated within ducts, or released into pancreatic parenchyma by rupture of ducts and then activated
- Followed by the release of inflammatory mediators which attracts inflammatory cells
- The Islets of Langerhans may become involved thus causing the signs if insulin insufficiency
- Adhesions are absent or minimal
- Gross appearance
- Oedematous
- Blood stained fluid containing droplets of fat in the abdominal cavity
- Haemorrhages in the omentum may be present
- Areas of fat necrosis
- Unusually greasy texture
- Microscopic appearance
- Necrosis of adipose and parenchymal tissue
- Inflammatory infiltrate forming a border between viable and necrotic tissue
- Necrosis is initially perilobular at the periphery of affected pancreatic lobules
- Foci of acinar tissue shrunken and acidophilic, undergoing coagulative necrosis
- Occlusion of capillaries, sometimes veins and small arteries, by fibrin thrombi
Predisposing factors
- are unclear
- Prolonged corticosteroid therapy
- Surgical manipulation or trauma which initiates the leakage of enzymes
- Obese bitches
- Dogs fed high fat and low protein diet