Pancreatic Necrosis, Acute

Pancreatic necrosis (Image sourced from Bristol Biomed Image Archive with permission)

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