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Increased risk of disease occurs with obesity, [[Diabetes Mellitus|diabetes mellitus]], [[Hyperadrenocorticism|hyperadrenocorticalism]], prior gastrointestinal disease or [[Seizures|recurrent seizures]].
Increased risk of disease occurs with obesity, [[Diabetes Mellitus|diabetes mellitus]], [[Hyperadrenocorticism|hyperadrenocorticalism]], prior gastrointestinal disease or [[Seizures|recurrent seizures]].
==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.
[[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|shock]], [[Kidney Renal Failure - Pathology#Acute|acute renal failure]], [[Icterus|jaundiced]] (due to focal hepatic necrosis), or with cardiac arrhythmias. 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 and collapse.
A cranial abdominal mass may be palpated.
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, hypothermia is also common sign occurring in 68% of affected cats. Mild chronic pancreatitis may show anorexia and weight loss.
==Laboratory Tests==
On Haematology there may be a leucocytosis, an increased [[Packed Cell Volume]] due to dehydration, [[Platelet Abnormalities#Thrombocytopaenia|thrombocytopaenia]], [[Neutrophilia|neutrophilia]] and a left shift.
On Biochemistry changes may include an [[Azotaemia|azotaemia]], increased liver enzymes, hyperbilirubinaemia,
hyperglycaemia in cases of nectrotizing pancreatitis and hypoglycaemia in cats with suppurative pancreatitis.
In dogs hypercholesterolaemia and hypertriglyceridaemia are also common changes.
An increase in pancreatic digestive enzymes (amylase, lipase, trypsin-like immunoreactivity (TLI), phospholipase A2 and pancreatic lipase immunoreactivity (PLI) will also be present.
===Pancreas-specific laboratory tests===
All pancreatic enzymes increase following [[Kidney Renal Failure - Pathology|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 feline trypsin-like immunoreactivity (fTLI) is a specific test for exocrine pancreatic function but the test's sensitivity varies between 30% and 60%. In comparison, the serum feline pancreatic lipase immunoreactivity test (fPLI) has been found to be more specific and sensitive in diagnosing feline pancreatitis.
'''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 canine pancreatic lipase immunoreactivity (cPLI) is the most sensitive and specific test for diagnosing canine pancreatitis.
==Diagnostic Imaging==
'''Survey Radiographs''' are rarely helpful but findings may include an increased density in the right cranial abdomen, decreased contrast, decreased granularity and the stomach may be displaced to the left.
Additionally the descending duodenum may be displaced to the right, with the presence of a medial mass and thickened walls.
Gastric distension may be visible and barium passage may be delayed indicating abnormal peristalsis.
Radiography is useful to rule out differentials.
'''Abdominal Ultrasound''' is highly specific with a sensitivity of 70% in dogs and 30% in cats but is operator-dependant. Findings include
pancreatic enlargement, peritoneal effusion, hypoechogenic pancreas (pancreatic necrosis) and hyperechogenic surrounding tissue.
==Exploratory Laparotomy/Necropsy Findings==
The pancreas will be oedematous and soft with fibrinous attachments to surrounding organs, there may be free fluid within the peritoneal cavity and pancreas liquefaction if severe enough.
Pseudocysts may be present, as well as omental and pancreatic [[Haemorrhage|haemorrhages]] and areas of fat necrosis.
A biopsy should be taken to provide evidence of inflammation.
== Acute Pancreatitis in Cats<br> ==
== Acute Pancreatitis in Cats<br> ==
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==Literature Search==
[[File:CABI logo.jpg|left|90px]]
Use these links to find recent scientific publications via CAB Abstracts (log in required unless accessing from a subscribing organisation).
<br><br><br>
[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]
[http://www.cabi.org/cabdirect/FullTextPDF/2006/20063041204.pdf ''' Pancreatitis in cats.''' Graves, T. K.; Ontario Veterinary Medical Association, Milton, Canada, Ahead of the curve: OVMA Conference Proceedings, 26-28 January, 2006, 2006, pp 158-163 - '''Full Text Article''']
== References<br> ==
== References<br> ==
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
Blood, D.C. and Studdert, V. P. (1999) '''Saunders Comprehensive Veterinary Dictionary''' (2nd Edition), ''Elsevier Science''
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''
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''