Difference between revisions of "Pancreatitis"
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Cats mainly suffer from mild chronic interstitial pancreatitis. | Cats mainly suffer from mild chronic interstitial pancreatitis. | ||
==Diagnosis== | ==Diagnosis== | ||
| − | ===History | + | ===History and Clinical Signs=== |
| − | + | *History of eating a fatty meal | |
*Anorexia | *Anorexia | ||
*[[Control of Feeding - Anatomy & Physiology#The Vomit Reflex|Vomiting]] | *[[Control of Feeding - Anatomy & Physiology#The Vomit Reflex|Vomiting]] | ||
| Line 32: | Line 32: | ||
*[[Intestine Diarrhoea - Pathology|Diarrhoea]] (sometimes with blood, fresh or melaena, due to the proximity of inflamed pancreas to the [[Duodenum - Anatomy & Physiology|duodenum]] and [[Colon - Anatomy & Physiology|colon]]) | *[[Intestine Diarrhoea - Pathology|Diarrhoea]] (sometimes with blood, fresh or melaena, 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, acute renal failure, jaundiced (due to focal hepatic necrosis), or with cardiac arrhythmias or pulmonary oedema or pleural effusions, widespread haemorrhage or DIC | *More severe cases may present in shock, acute renal failure, jaundiced (due to focal hepatic necrosis), or with cardiac arrhythmias or pulmonary oedema or pleural effusions, widespread haemorrhage or DIC | ||
| − | *Acute haemorrhagic pancreatitis may present as | + | *Acute haemorrhagic pancreatitis may present as shock and collapse. |
| + | *Cranial abdominal mass | ||
| + | *Mild ascites | ||
| + | *Dehydration (Mild to moderate) | ||
| + | *Febrile | ||
| + | *A cats presentation is more variable. If severe, they present with lethargy and anorexia with vomiting (35%) and abdominal pain (25%) being reported less than in the dog. Mild chronic pancreatitis may show anorexia and weight loss. | ||
| + | |||
===Laboratory Tests=== | ===Laboratory Tests=== | ||
Revision as of 14:45, 12 August 2009
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This article is still under construction. |
Signalment
- Yorkshire terriers, Labradors, Miniature Schnauzers and Miniature Poodles are predisposed
- Middle-old aged dogs
- Increased risk with obesity, diabetes mellitus, hyperadrenocorticalism, prior GIT disease or epilepsy (?treatment associated).
- Male and speyed females > intact females.
Description
Is due to the 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 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:
- Nutritional: including obesity, low protein and high fat diets, feeding of ethionine, hypertriglyceridaemia and fatty meals.
- 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: 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: including duodenal juice reflux into the pancreatic duct, surgical intervention, shock, anaemia, venous occlusion and hypotension.
- Other: including parasitic (babesiosis), viral, mycoplasmal, end stage renal disease, liver disease and auto-immune diseases.
Cats mainly suffer from mild chronic interstitial pancreatitis.
Diagnosis
History and Clinical Signs
- History of eating a fatty meal
- Anorexia
- Vomiting
- Abdominal pain
- Lethargy
- Depression
- Nausea
- Diarrhoea (sometimes with blood, fresh or melaena, due to the proximity of inflamed pancreas to the duodenum and colon)
- More severe cases may present in shock, acute renal failure, jaundiced (due to focal hepatic necrosis), or with cardiac arrhythmias or pulmonary oedema or pleural effusions, widespread haemorrhage or DIC
- Acute haemorrhagic pancreatitis may present as shock and collapse.
- Cranial abdominal mass
- Mild ascites
- Dehydration (Mild to moderate)
- Febrile
- A cats presentation is more variable. If severe, they present with lethargy and anorexia with vomiting (35%) and abdominal pain (25%) being reported less than in the dog. Mild chronic pancreatitis may show anorexia and weight loss.
Laboratory Tests
Diagnostic Imaging
Exploratory Laparotomy/Necropsy Findings
- 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
Treatment
Prognosis
References
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