Ask the Vet: Pancreatitis – A pain in the gut
By Matthew Kearns, DVM
As Thanksgiving and the winter holidays approach, I thought this would be a good time to discuss a disease that affects both dogs and cats: pancreatitis.
Pancreatitis, or inflammation of the pancreas, is a serious disease with potential fatal consequences. The pancreas is an organ that sits just behind the stomach and has two functions: an exocrine (digestive) function, as well as an endocrine (glandular) function. The exocrine portion of the pancreas produces bicarbonate (to neutralize acid as food leaves the stomach) and digestive enzymes (to breakdown protein, starch, and fat into molecules small enough to be absorbed by the small intestine).
We will focus more on the exocrine portion when describing pancreatitis. During normal digestion the exocrine pancreas is stimulated to secrete its bicarbonate and enzymes through small tubes called pancreatic ducts into the duodenum, or first section of small intestine. In the case of pancreatitis, these same enzymes are overproduced and begin to digest the pancreas itself. This pathology is referred to as autodigestion.
Risk factors include: hypertriglyceridemia (excessive fatty acids in the bloodstream) is the most common cause, obesity, glandular diseases (such as diabetes, Cushing’s Disease, and an underactive thyroid) medications (such as cortisone derivatives, certain antibiotics, and many chemotherapies), certain breeds (Miniature Schnauzers, Yorkshire Terriers, and many other toy breeds), and any trauma to the abdomen (hit by a car or an attack by another animal) can trigger inflammation of the pancreas. We tend to see an increased number of acute pancreatitis cases around the holidays. Usually guests were sneaking the pet extra treats and table scraps.
Symptoms of pancreatitis include lethargy, vomiting, and splinting (this refers to a hunched up appearance due to abdominal pain). Some patients will become jaundice, or yellow because the bile duct, gall bladder and liver are located just next to the pancreas. Mess with one and there can also be complications to the other as well.
Treatment usually consists of intravenous (IV) fluids, IV medications for nausea, pain management, and antibiotics. Severe cases require transfusions of plasma or blood. Surgery to treat pancreatitis is indicated if there are abscesses or dead tissue but usually a last resort because surgery for pancreatitis is so risky. Some cases are so acute and severe that the patient may not improve. These cases are very sad because the patient either passes on their own, or owners are forced to euthanize for humane reasons.
Long term complications of pancreatitis include diabetes and exocrine pancreatic insufficiency (EPI). EPI refers to when the pancreas no longer produces enough enzymes to digest food so commercially made synthetic enzymes have to be added to the food. Diabetes requires daily injections of insulin. Both are expensive and time consuming.
The best way to treat pancreatitis is to prevent it altogether. Therefore, when Fluffy is giving you the sad eyes this holiday season, do not give in. I hope everyone has a safe and happy Thanksgiving.
Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine.
