Pancreatitis - Dog

Signalment

Predisposed breeds include: Labradors, Miniature Poodles, Miniature Schnauzers, Yorkshire Terriers

Increased risk of disease occurs with obesity, diabetes mellitus, hyperadrenocorticalism, prior gastrointestinal disease or recurrent seizures.

Additionally, middle aged dogs are more commonly affected and male and spayed females are affected more frequently than entire females.

Acute Pancreatitis in Dogs

Introduction

In dogs, the condition is possibly caused by reflux of duodenal content into pancreatic duct causing release and activation of enzymes through inflammation and therefore leakage . Most cases show necrosis and fibrosis and only 3% had acute suppurative pancreatitis.

This condition is quite common in dogs and is caused by the sudden ingestion of a fatty meal. The risk, however, is increased when concurrent conditions such as obesity, diabetes mellitus, hyperadrenocorticalism, prior GIT disease or epilepsy are present as these have a relationship with the pancreas in some way.

Signalment

Yorkshire terriers, labs, minature poodles are predisposed. It is most common in middle-old dogs. Males and speyed females are of greater risk than intact females.

Clinical Signs

Clinical signs are acute in onset and include severe abdominal pain, vomiting, diarrhoea and anorexia. There may or may not be a presence of icterus.

Diagnosis

Clinical signs and history e.g. if the dog is a scavenger etc, or knowledge of underlying conditions are suggestive of the disease.

Measuring lipase may produce normal or raised results in pancreatitis. In dogs, you would expect to see a 3- 5 fold increase in lipase i acute pancreatitis and this is indicative of the disease.

Amylase is non-specific in dogs and is not commonly used to diagnose this disease. Serum trypsin-like immunoreactivity (TLI) is also of limited value. Serum pancreatic lipase immunoreactivity (PLI) will usually be raised and cPLI & fPLI look promising as sensitive and specific markers for pancreatic inflammation.

Treatment and Control

Intitially the animal should be starved for 1- 2 days maximum and placed on intravenous fluid therapy (crystalloids, colloids or plasma). Stop precipitating therapies (azathioprine) and anti-emetics and gut protectants may be given.

The dog will need analgesia. If the condition is very severe, surgery may be indicated to remove necrotic tissue.

Control may include changing the diet to a low fat diet

Chronic Pancreatitis in Dogs

Repeated mild episodes of acute pancreatitis and pancreatic necrosis results in progressive destruction and pancreatic fibrosis and chronic pancreatitis. If a significant proportion of pancreas is affected, signs of EPI develop +/- DM. the pancreas appears distorted ans shrunken. A nodular mass with fibrous adhesions to adjacent tissue may be present. The condition may be an incidental finding on necropsy. Focal pancreatitis may occur during canine parvovirus and distemper virus infection.

Clinical Signs

Clinical Signs include chronic abdominal pain, anorexia and intermitant vomiting and diarrhoea. There may also be there presence of icterus.

Diagnosis

Diagnosis is usually by blood tests. These may show lipase to be normal or elevated. In dogs a 3-5 fold increase in lipase is indicative of pancreatitis. Amylase levels are usually normal and not much help. Serum trypsin-like immunoreactivity (TLI) is normal or raised in chronic disease and is also of limited value. Serum pancreatic lipase immunoreactivity (PLI) will be raised and cPLI & fPLI look promising as sensitive and specific markers for pancreatic inflammation.

Treatment and Control

Fluids may be required and analgesia. Placing the dog onto a low fat diet is useful in controlling the disease. It may be important to perform follow up blood tests at a later date to test for EPI as this is often a consequence of chronic pancreatitis.

References

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