Difference between revisions of "Pancreatitis"

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==Introduction==
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[[Image:Pancreatitis.jpg|right|thumb|200px|<small><center>Pancreatitis (Image sourced from Bristol Biomed Image Archive with permission)</center></small>]]
 +
Pancreatitis occurs following activation of digestive enzymes within the [[Pancreas - Anatomy & Physiology|pancreas]] leading to autodigestion of the gland. Can be referred to as acute or chronic pancreatitis.
  
−
+
'''Acute''' pancreatitis is rapid onset inflammation of the pancreas with little or no pathological changes occurring post recovery. This may completely resolve or 'wax and wane' in the future.  
−
==Description==
 
−
Occurs following activation of digestive enzymes within the [[Pancreas - Anatomy & Physiology|pancreas]] leading to autodigestion of the gland. Can be referred to as Acute or chronic pancreatitis.
 
−
Acute Pancreatitis is rapid onset inflammation of the pancreas with little or no pathological changes occuring post recovery. This may completely resolve or 'wax and wane' into the future.
 
−
Chronic Pancreatitis is continued inflammation leading to irreversible pathological changes (fibrosis, atrophy) and possible decreases in function.
 
  
−
The specific cause is usually idiopathic but several risk factors exist:
+
'''Chronic''' pancreatitis is continued inflammation leading to irreversible pathological changes (fibrosis, atrophy) and possible decreases in function.
  
−
'''Nutritional''': including obesity, low protein and high fat diets, feeding of ethionine, hypertriglyceridaemia and fatty meals.
+
The specific cause is usually idiopathic but several risk factors exist including:
  
−
'''Drugs and toxins''': including L-asparginase, oestrogen, azathioprine, potassium bromide, furosemide, thiazide diuretics, salicylates, [[Tetracyclines|tetracyclines]], [[Sulphonamides|sulphonamides]], vinca alkaloids, zinc toxicosis, cholinesterase inhibitor insecticides, cholinergic agonist and hypercalcaemia.
+
A '''Nutritional''' basis which refers to obesity, low protein and high fat diets, feeding of ethionine and hypertriglyceridaemia.
  
−
'''Pancreatic Duct obstruction''': caused by biliary calculi, sphincter spasm, duct wall oedema, duodenal wall oedema, neoplasia, parasites, trauma and iatrogenic reasons.
+
'''Drugs and toxins''' including L-asparginase, oestrogen, azathioprine, potassium bromide, furosemide, thiazide diuretics, salicylates, [[Tetracyclines|tetracyclines]], [[Sulphonamides|sulphonamides]], vinca alkaloids, zinc toxicosis, cholinesterase inhibitor insecticides, cholinergic agonist and hypercalcaemia.
  
−
'''Duodenal juice reflux, Pancreatic trauma, ischaemia and reperfusion''': including duodenal juice reflux into the pancreatic duct, surgical intervention, shock, anaemia, venous occlusion and hypotension.  
+
'''Pancreatic duct obstruction''' which is caused by biliary calculi, sphincter spasm, duct wall oedema, duodenal wall oedema, neoplasia, parasites, trauma and iatrogenic reasons.
  
−
'''Other''': including parasitic (babesiosis), viral, mycoplasmal, end stage renal disease, liver disease and auto-immune diseases.
+
'''Duodenal juice reflux, pancreatic trauma, ischaemia and reperfusion''' which includes duodenal juice reflux into the pancreatic duct, surgical intervention, [[shock]], [[Regenerative and Non-Regenerative Anaemias|anaemia]], venous occlusion and hypotension.
 +
 
 +
'''Other''' risk factors include parasitic (babesiosis), viral, mycoplasmal, end stage renal disease, liver disease and auto-immune diseases.
  
 
Cats mainly suffer from mild chronic interstitial pancreatitis.
 
Cats mainly suffer from mild chronic interstitial pancreatitis.
  
−
==Signalment==
 
−
Predisposed breeds include:
 
−
<gallery>
 
−
Image:Labrador.jpg|'''Labradors''' <br> Ellen Levy Finch (2004) WikiMedia Commons
 
−
Image:Miniature Poodle.jpg|'''Miniature Poodles''' <br> Belinda (2005) WikiMedia Commons
 
−
Image:Miniature schnauzer.jpg|'''Miniature Schnauzers''' <br> MagnusK (2006) WikiMedia Commons
 
−
Image:Yorkshire Terrier.jpg|'''Yorkshire terriers''' <br> Jlcerso (2007) WikiMedia Commons
 
−
</gallery>
 
  
 +
== Acute Haemorrhagic Pancreatitis ==
 +
 +
This term is often interchangeable with [[Pancreatic Necrosis, Acute|acute pancreatic necrosis]] or '''acute pancreatitis'''. The condition can be mild or severe, non-fatal or fatal. It usually occurs as a sudden onset condition, often after ingestion of a meal rich in fat, but this depends on what species the condition occurs.
 +
 +
The [[Pancreas - Anatomy & Physiology#Endocrine|Islets of Langerhans]] may become involved thus causing the signs if insulin insufficiency. Pancreatitis may be initiated by trauma which initiates the leakage of enzymes. It can also present as recurrent acute pancreatitis - repeated inflammation with minimal permanent pathology. In the disease process, proteolytic degradation of pancreatic parenchyma, vascular damage and haemorrhage occur as well as necrosis of fat by lipolytic enzymes in the pancreas and surrounding omentum. These changes are concentrated at the periphery of lobules and infiltration by leukocytes indicates inflammation. In mild cases oedema of the interstitial tissue occurs. In more severe cases the [[Pancreas - Anatomy & Physiology|pancreas]] is haemorrhagic and oedematous with greyish white areas of necrosis and this may be interspersed with normal parenchyma. The [[Peritoneal Cavity - Anatomy & Physiology|peritoneal cavity]] may contain blood-stained fluid sometimes with droplets of fat. Due to these large amounts of necrotic debris, infection by microorganisms from the [[Alimentary System Overview - Anatomy & Physiology|GIT]] is likely, causing abscesses.
  
−
Increased risk of disease occurs with obesity, [[Diabetes Mellitus|diabetes mellitus]], [[Adrenal Glands - Pathology#Adrenal Hyperfunction|hyperadrenocorticalism]], prior [[Alimentary - Anatomy & Physiology|GIT]] disease or epilepsy.
+
=== Cats and Dogs===
  
−
Additonally middle aged dogs are more commonly affected and Male and speyed females are affected more frequently than entire females.
+
See [[Pancreatitis - Cat]] and [[Pancreatitis - Dog]]
  
−
==Diagnosis==
+
=== Other Animals ===
−
===History and Clinical Signs===
 
−
There is often a history of eating a fatty meal.
 
  
−
Clinical signs include anorexia, vomiting, abdominal pain, lethargy, depression and Nausea.
+
In '''horses''', necrosis and inflammation results due to migration of parasites, usually strongyle larvae, releasing pancreatic enzymes causing autodigestion. Destructive granulomatous pancreatitis is a part of multisystemic eosinophilic epitheliotrophic syndrome.  
−
[[Diarrhoea|Diarrhoea]] is also a common feature sometimes with blood, fresh or melaena this occurs due to the proximity of inflamed pancreas to the [[Duodenum - Anatomy & Physiology|duodenum]] and [[Colon - Anatomy & Physiology|colon]].
 
−
More severe cases may present in [[Shock - Pathology|shock]], [[Kidney Renal Failure - Pathology#Acute|acute renal failure]], [[Icterus|jaundiced]] (due to focal hepatic necrosis), or with [[:Category:Altered Impulse Formations|cardiac arrhythmias]]. [[Lungs Circulatory - Pathology#Pulmonary oedema|pulmonary oedema]], pleural effusions, widespread haemorrhage, [[Disseminated Intravascular Coagulation|DIC]], mild ascites, dehydration (Mild to moderate) and pyrexia may also be present.
 
−
Acute haemorrhagic pancreatitis may present as [[Shock - Pathology|shock]] and collapse.
 
−
A cranial abdominal mass may be palpated. In cats hypothermia is a common sign occuring in 68% of affected cats.
 
  
−
+
In '''pigs''' suppuration of the pancreas can occasionally arise as an extension from nearby infection, eg. peritonitis and perforated oesophageal ulcers.
−
Affected cats have a very varied presentation. If severe, they present with lethargy and anorexia with vomiting and abdominal pain being reported less than in the dog. Mild chronic pancreatitis may show anorexia and weight loss.
 
  
−
===Laboratory Tests===
+
== Chronic Interstitial Pancreatitis ==
−
On Haematology there may be a leucocytosis, an increased PCV due to dehydration, thrombocytopaenia, neutrophilia and a left shift.
 
  
−
On Biochemistry changes may include azotaemia, increased liver enzymes, hyperbilirubinaemia
+
Chronic pancreatitis often occurs following ongoing inflammation with progression to irreversible damage and impaired function. There is usually fibrosis and reduction in acinar mass. This condition can occur in all species as a consequence of obstruction of the pancreatic ducts, [[Vitamin A Deficiency|vitamin A deficiency]] may predispose to this. The condition is most common in the dog, but also in cat, horse and cattle. The [[Pancreas - Anatomy & Physiology#Endocrine|islets of Langerhans]] tend to be preserved. If chronic pancreatitis persisits it can lead to [[Exocrine Pancreatic Insufficiency]] (EPI). In cats, chronic pancreatitis can also lead to [[Diabetes Mellitus]] developing.
−
hyperglycaemia in cases of nectrotizing pancreatitis, hypoglycaemia in cats with suppurative pancreatitis
 
−
In dogs hypercholesterolaemia and hypertriglyceridaemia are also common changes.  
 
  
 +
=== Cats and Dogs===
  
−
   
+
See [[Pancreatitis - Cat]] and [[Pancreatitis - Dog]]
−
An increase in pancreatic digestive enzymes (amylase, lipase, trypsin-like immunoreactivity (TLI), phospholipase A2 and pancreatic lipase immunoreactivity (PLI))
 
  
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===Pancreas-specific laboratory tests===
+
=== Other Animals ===
−
All pancreatic enzymes increase following renal failure (apart from PLI) making it difficult to determine the true cause of the increase. However increases of three fold are mainly due to pancreatitis, whereas five fold increases are rarely not found to be pancreatitis. Rises in lipase, amylase and phospholipase A2 may also be hepatic, gastric, intestinal or neoplastic in origin.
 
  
−
'''In cats:''' Amylase and lipase are of no diagnostic value. Serum fTLI is a specific test for exocrine pancreatic function without azotaemia buts the test's sensitivity varies between 30% and 60%. In comparison, the serum fPLI has been found to be more specific and sensitive in diagnosing feline pancreatitis.
+
'''In sheep'''
  
−
'''In dogs:''' Marked increases in serum lipase is a more reliable marker than amylase. However corticosteroid administration raises lipase activity by up to five fold. Serum cPLI is the most sensitive and specific test for diagnosing canine pancreatitis but serum cTLI can be used if there is no azotaemia.
+
Necrosis of [[Pancreas - Anatomy & Physiology#Exocrine|exocrine pancreatic cells]] followed by fibrosis can be caused by zinc toxicosis. Focal pancreatitis may occur during [[Foot_and_Mouth_Disease|Foot and Mouth disease]] resulting in [[DM|diabetes mellitus]] during recovery.
−
===Diagnostic Imaging===
 
−
'''Survey Radiography''': Rarely helpful but findings may include:
 
−
#In the right cranial abdomen:
 
−
##Increased density
 
−
##Decreased contrast
 
−
##Decreased granularity
 
−
#Stomach displaced to left
 
−
#Angle widened between pyloric antrum and proximal duodenum
 
−
#Involving the Descending duodenum:
 
−
##Displacement to the right
 
−
##Presence of a medial mass
 
−
##Gas pattern
 
−
##Thickened walls
 
−
#Gastric distension
 
−
#Delayed barium passage indicating abnormal peristalsis
 
−
However these findings are generally subjective so radiography is used to rule out differentials.
 
  
−
'''Abdominal Ultrasound''': Highly specific with a sensitivity of 70% in dogs and 30% in cats but is operator-dependant. Findings include:
+
'''In horses'''
−
*Pancreatic enlargement
 
−
*Peritoneal effusion
 
−
*Hypoechogenic pancreas (pancreatic necrosis)
 
−
*Hyperechogenic surrounding tissue
 
−
*Chronic pancreatitis and fibrosis may be hyperechogenic
 
  
−
===Exploratory Laparotomy/Necropsy Findings===
+
Chronic pancreatitis can occur sporadically and is usually a consequence of [[Pancreas - Parasitic Pathology|parasitic migration]] or from ascending bacterial infection of pancreatic ducts. It can occur alongside '''chronic eosinophilic gastroenteritis''' and is usually clinically silent. Organ tends to be replaced by scar tissue.
−
*The pancreas will be oedematous, soft with fibrinous attachments to surrounding organs
 
−
*Free fluid within the peritoneal cavity
 
−
*Pancreas liquefaction if severe enough
 
−
*Formation of pseudocysts
 
−
*Omental and pancreatic haemorrhages
 
−
*Areas of fat necrosis
 
  
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However a biopsy should be taken to provide evidence of inflammation.
+
'''In cattle'''
  
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==Treatment==
+
Focal pancreatitis may occur during [[Foot_and_Mouth_Disease|Foot and Mouth disease]] resulting in [[DM|diabetes mellitus]] during recovery.<br>{{Learning
−
===Acute Treatment===
+
|Vetstream = [https://www.vetstream.com/felis/search?s=pancreatitis Pancreatitis]
−
The general treatment involves fluid correction and maintenance while any underlying cause is treated. Support is then given to allow the inflammatory process to subside. Oral feeding should be witheld for a short a period as possible in patients that are vomiting but enteral and parenteral feeding can be well tolerated.
+
|literature search = [http://www.cabdirect.org/search.html?q=title%3A%28%22pancreatitis%22%29+AND+%28od%3A%28cats%29+OR+title%3A%28dogs%29%29&fq=sc%3A%22ve%22 Pancreatitis in cats and dogs publications]
 +
}}
  
−
'''Antibiotics''': if a pancreatic infection is suspected then [[Potentiated-Sulphonamides|trimethoprim-sulphonamide]] and [[Fluoroquinolones|enrofloxacin]] have good penetration to the pancreas.
+
{{Chapter}}
 +
{{Mansonchapter
 +
|chapterlink = http://www.mansonpublishing.co.uk/book-images/9781840761115_sample.pdf
 +
|chaptername = Acute Pancreatitis
 +
|book = Clinical Medicine of the Dog and Cat, 2nd edition
 +
|author = Michael Schaer
 +
|isbn = 9781840761115
 +
}}
  
−
'''Analgesia''': should be given even without signs of pain. Recommended options include: subcutaneous [[Opioids#Pethidine|pethidine]], intravenous or continuous rate infusion [[Opioids#Morphine|morphine]] or transdermal [[Opioids#Fentanyl|fentanyl]]. Dogs can also be given intraperitoneal [[Local Anaesthetics#Lidocaine|lidocaine]] or [[Local Anaesthetics#Bupivicaine|bupivicaine]].
+
==References==
  
−
'''Transfusion''': [[Plasma - WikiBlood|Plasma]] or whole blood can be given with severe disease to replace α-macroglobulins. Albumin also provides oncotic support and limits pancreatic ischaemia and oedema.
+
Andrews, A.H, Blowey, R.W, Boyd, H and Eddy, R.G. (2004) '''Bovine Medicine''' (Second edition), ''Blackwell Publishing''
  
−
'''[[Steroids|Corticosteroids]]''': for short term use in fulminating pancreatitis to be given alongside fluids. Long term treatment may lead to unwanted complications.
+
Bertone, J. (2006) '''Equine Geriatric Medicine and Surgery''', ''Elsevier''
  
−
'''[[Dopamine]]''': helps reduce feline pancreatitis.
+
Blood, D.C. and Studdert, V. P. (1999) '''Saunders Comprehensive Veterinary Dictionary''' (2nd Edition), ''Elsevier Science''
  
−
'''Secretion prevention''': Has been found to have limited clinical use but high intravenous doses of secretin has been beneficial in rat models of pancreatitis.
+
Brown, C.M, Bertone, J.J. (2002) '''The 5-Minute Veterinary Consult- Equine''', Lippincott, ''Williams & Wilkins''
  
−
'''Enzyme inhibitors''': are at the experimental stage.
+
Cowart, R.P. and Casteel, S.W. (2001) '''An Outline of Swine diseases: a handbook,''' ''Wiley-Blackwell''
  
−
'''Peritoneal dialysis''': May be of value in removing toxic material in certain cases, especially if pancreatitis has been diagnosed by exploratory laparotomy.
+
Ettinger, S.J. and Feldman, E. C. (2000) '''Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat''' Volume 2 (Fifth Edition), ''W.B. Saunders Company''
  
−
'''Diet changes''': Small amounts of water offered once the patient has stopped vomiting. Food can be gradually introduced with a low protein and fat content as these are more likely to cause signs. Fat can be further introduced if symptoms have still not returned. If signs reoccur then further starvation should be carried out. Total parenteral nutrition can be used to sustain animals that are unable to tolerate food at all.
+
Ettinger, S.J, Feldman, E.C. (2005) '''Textbook of Veterinary Internal Medicine''' (6th edition, volume 2), ''W.B. Saunders Company''
  
−
'''Supportive care''':
+
Fossum, T. W. et. al. (2007) '''Small Animal Surgery''' (Third Edition), ''Mosby Elsevier''
−
Mild cases may only require 1 or 2 days of supportive treatment. Aggressive [[Fluid Therapy|fluid therapy]] will be needed to treat dehydration and fluid loss from [[Diarrhoea|diarrhoea]] and [[Control of Feeding - Anatomy & Physiology#The Vomit Reflex|vomiting]]. Monitoring of renal function and potassium levels which may need supplementing. Patients may also have metabolic acidosis in acute pancreatitis or be alkalotic due to [[Control of Feeding - Anatomy & Physiology#The Vomit Reflex|vomiting]]. Should [[Diabetes Mellitus|diabetes mellitus]] develop, this may require treatment with insulin. Further management may be required for respiratory distress, bleeding disorders, renal failure, cardiovascular problems and neurological disorders although these all carry a poor prognosis.
 
  
−
===Long-term treatment===
+
Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition),''' ''BSAVA''
−
In most patients that have one episode, they may only need to avoid fatty foods. Recurrent hypertriglyceridaemia may need pharmacological intervention.
+
 
−
==Prognosis==
+
Jackson, G.G. and Cockcroft, P.D. (2007) '''Handbook of Pig Medicine,''' ''Saunders Elsevier''
−
The disease varies widely and the prognosis can vary from full recovery to death despite the presenting signs. Generally if the case is single episode and uncomplicated then most patients make a good recovery.
+
 
−
==References==
+
Knottenbelt, D.C. '''A Handbook of Equine Medicine for Final Year Students University of Liverpool'''
 +
 
 +
Merck & Co (2008) '''The Merck Veterinary Manual''' ''Merial''
 +
 
 +
Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine''' (Fourth Edition) ''Mosby Elsevier''
 +
 
 +
Sturgess, K. (2003) '''Notes on Feline Internal Medicine''' ''Blackwell Publishing''
 +
 
 +
Tilley, L.P. and Smith, F.W.K.(2004) '''The 5-minute Veterinary Consult''' (Third edition) Lippincott, ''Williams & Wilkins''
 +
 
 +
 
 +
{{review}}
  
−
For further information on canine pancreatitis see: [http://inpractice.bvapublications.com/cgi/reprint/26/2/64?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=feline+pancreatitis&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT Pancreatitis in the dog:. dealing with a spectrum of disease] In Practice article
+
{{OpenPages}}
  
−
For further information on feline pancreatitis see: [http://inpractice.bvapublications.com/cgi/reprint/29/8/470?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=feline+pancreatitis&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT Feline pancreatitis: current concepts and treatment guidelines] In Practice article
+
[[Category:Pancreas_-_Inflammatory_Pathology]][[Category:Pancreatic Diseases - Dog]][[Category:Pancreatic Diseases - Cat]]
  
−
Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA''
 
  
−
Merck & Co (2008) '''The Merck Veterinary Manual'''
+
[[Category:Pancreatic_Diseases_-_Pig]] [[Category:To_Do_-_Review]] [[Category:Pancreatic_Diseases_-_Horse]][[Category:Pancreatic_Diseases_-_Sheep]]
−
[[Category:Pancreas_-_Inflammatory_Pathology]][[Category:Dog]][[Category:Cat]]
 
−
[[Category:To_Do_-_Caz]]
 

Latest revision as of 14:15, 16 March 2022


Introduction

Pancreatitis (Image sourced from Bristol Biomed Image Archive with permission)

Pancreatitis occurs following activation of digestive enzymes within the pancreas leading to autodigestion of the gland. Can be referred to as acute or chronic pancreatitis.

Acute pancreatitis is rapid onset inflammation of the pancreas with little or no pathological changes occurring post recovery. This may completely resolve or 'wax and wane' in the future.

Chronic pancreatitis is continued inflammation leading to irreversible pathological changes (fibrosis, atrophy) and possible decreases in function.

The specific cause is usually idiopathic but several risk factors exist including:

A Nutritional basis which refers to obesity, low protein and high fat diets, feeding of ethionine and hypertriglyceridaemia.

Drugs and toxins including L-asparginase, oestrogen, azathioprine, potassium bromide, furosemide, thiazide diuretics, salicylates, tetracyclines, sulphonamides, vinca alkaloids, zinc toxicosis, cholinesterase inhibitor insecticides, cholinergic agonist and hypercalcaemia.

Pancreatic duct obstruction which is caused by biliary calculi, sphincter spasm, duct wall oedema, duodenal wall oedema, neoplasia, parasites, trauma and iatrogenic reasons.

Duodenal juice reflux, pancreatic trauma, ischaemia and reperfusion which includes duodenal juice reflux into the pancreatic duct, surgical intervention, shock, anaemia, venous occlusion and hypotension.

Other risk factors include parasitic (babesiosis), viral, mycoplasmal, end stage renal disease, liver disease and auto-immune diseases.

Cats mainly suffer from mild chronic interstitial pancreatitis.


Acute Haemorrhagic Pancreatitis

This term is often interchangeable with acute pancreatic necrosis or acute pancreatitis. The condition can be mild or severe, non-fatal or fatal. It usually occurs as a sudden onset condition, often after ingestion of a meal rich in fat, but this depends on what species the condition occurs.

The Islets of Langerhans may become involved thus causing the signs if insulin insufficiency. Pancreatitis may be initiated by trauma which initiates the leakage of enzymes. It can also present as recurrent acute pancreatitis - repeated inflammation with minimal permanent pathology. In the disease process, proteolytic degradation of pancreatic parenchyma, vascular damage and haemorrhage occur as well as necrosis of fat by lipolytic enzymes in the pancreas and surrounding omentum. These changes are concentrated at the periphery of lobules and infiltration by leukocytes indicates inflammation. In mild cases oedema of the interstitial tissue occurs. In more severe cases the pancreas is haemorrhagic and oedematous with greyish white areas of necrosis and this may be interspersed with normal parenchyma. The peritoneal cavity may contain blood-stained fluid sometimes with droplets of fat. Due to these large amounts of necrotic debris, infection by microorganisms from the GIT is likely, causing abscesses.

Cats and Dogs

See Pancreatitis - Cat and Pancreatitis - Dog

Other Animals

In horses, necrosis and inflammation results due to migration of parasites, usually strongyle larvae, releasing pancreatic enzymes causing autodigestion. Destructive granulomatous pancreatitis is a part of multisystemic eosinophilic epitheliotrophic syndrome.

In pigs suppuration of the pancreas can occasionally arise as an extension from nearby infection, eg. peritonitis and perforated oesophageal ulcers.

Chronic Interstitial Pancreatitis

Chronic pancreatitis often occurs following ongoing inflammation with progression to irreversible damage and impaired function. There is usually fibrosis and reduction in acinar mass. This condition can occur in all species as a consequence of obstruction of the pancreatic ducts, vitamin A deficiency may predispose to this. The condition is most common in the dog, but also in cat, horse and cattle. The islets of Langerhans tend to be preserved. If chronic pancreatitis persisits it can lead to Exocrine Pancreatic Insufficiency (EPI). In cats, chronic pancreatitis can also lead to Diabetes Mellitus developing.

Cats and Dogs

See Pancreatitis - Cat and Pancreatitis - Dog

Other Animals

In sheep

Necrosis of exocrine pancreatic cells followed by fibrosis can be caused by zinc toxicosis. Focal pancreatitis may occur during Foot and Mouth disease resulting in diabetes mellitus during recovery.

In horses

Chronic pancreatitis can occur sporadically and is usually a consequence of parasitic migration or from ascending bacterial infection of pancreatic ducts. It can occur alongside chronic eosinophilic gastroenteritis and is usually clinically silent. Organ tends to be replaced by scar tissue.

In cattle

Focal pancreatitis may occur during Foot and Mouth disease resulting in diabetes mellitus during recovery.

Pancreatitis Learning Resources
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Acute Pancreatitis
Clinical Medicine of the Dog and Cat, 2nd edition
Michael Schaer
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References

Andrews, A.H, Blowey, R.W, Boyd, H and Eddy, R.G. (2004) Bovine Medicine (Second edition), Blackwell Publishing

Bertone, J. (2006) Equine Geriatric Medicine and Surgery, Elsevier

Blood, D.C. and Studdert, V. P. (1999) Saunders Comprehensive Veterinary Dictionary (2nd Edition), Elsevier Science

Brown, C.M, Bertone, J.J. (2002) The 5-Minute Veterinary Consult- Equine, Lippincott, Williams & Wilkins

Cowart, R.P. and Casteel, S.W. (2001) An Outline of Swine diseases: a handbook, Wiley-Blackwell

Ettinger, S.J. and Feldman, E. C. (2000) Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2 (Fifth Edition), W.B. Saunders Company

Ettinger, S.J, Feldman, E.C. (2005) Textbook of Veterinary Internal Medicine (6th edition, volume 2), W.B. Saunders Company

Fossum, T. W. et. al. (2007) Small Animal Surgery (Third Edition), Mosby Elsevier

Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition), BSAVA

Jackson, G.G. and Cockcroft, P.D. (2007) Handbook of Pig Medicine, Saunders Elsevier

Knottenbelt, D.C. A Handbook of Equine Medicine for Final Year Students University of Liverpool

Merck & Co (2008) The Merck Veterinary Manual Merial

Nelson, R.W. and Couto, C.G. (2009) Small Animal Internal Medicine (Fourth Edition) Mosby Elsevier

Sturgess, K. (2003) Notes on Feline Internal Medicine Blackwell Publishing

Tilley, L.P. and Smith, F.W.K.(2004) The 5-minute Veterinary Consult (Third edition) Lippincott, Williams & Wilkins


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