Sunday, July 22, 2012

Pancreatitis: 'Tis the Season



                                               By Loren W. Noblitt, DVM, MS

     Scrumptious leftover Thanksgiving turkey, Mom's famous Christmas gravy, and other fatty leftovers like turkey and chicken skin, or ham from holiday meals - all have the potential to cause pancreatitis in dogs (and cats, too!). 
Pancreatitis is, by definition, inflammation of the pancreas caused by inappropriate release of pancreatic enzymes that are normally pre-formed and tucked away for use during normal everyday digestion.  These pancreatic enzymes literally digest and eat away at the pancreatic and surrounding tissues - an extremely painful and dangerous process.  In addition to fatty food ingestion - trauma, underlying endocrine diseases like Hypothyroidism, Diabetes Mellitus, and Cushing's Disease, high amounts of triglycerides in the blood, and breed predispositions (Miniature Schnauzers, Shelties, and Yorkshire Terriers, in particular)...all are well-known risk factors for pancreatitis in dogs.
     The pancreas is a very delicate organ [comparatively speaking], nestled up closely between the first part of the small intestine (duodenum), the stomach, and adjacent to the liver in the right upper quadrant of the dog and cat's abdomen.
    Pancreatitis manifests in dogs most commonly by vomiting, abdominal pain (tenseness), restlessness, diarrhea, depression, and unwillingness to eat their normal food.  A fever is commonly present, as well, but is only present in roughly 50% of cases.  A "prayer stance" is often observed in dogs with pancreatitis - this stretching is done presumably because their abdomen is uncomfortable.  Cats are not immune to pancreatitis by any means, and although eating [unaccustomed] fatty meals is definitely a trigger, there is generally less known about causes of pancreatitis in cats, compared to dogs.  Decreased appetite, hiding, and extreme lethargy are the most common signs to look for in cats suspected of having pancreatitis.  The anatomy of the cat's intestinal tract is unique and, as a result, intestinal and liver diseases can often lead to bouts of feline pancreatitis.
     Diagnosing pancreatitis is often a challenge for veterinarians, regardless of species.  There is a relatively simple blood test that can be run in-house, called CPLi (canine pancreatic lipase immunoreactivity).  This test is not as routinely available for cats (FPLi) and has to be sent to an outside laboratory - thankfully, results are available 12-24 hours later.  Unlike humans, the enzymes lipase and amylase are very unreliable in dogs and cats.  Occasionally, lipase and amylase values that are elevated three or four-fold can assist the diagnosis, but seldom are relied upon solely by the veterinarian to make the diagnosis.  X-rays can be helpful in some cases, but the PLi test is really the gold standard for making the diagnosis.
    
     The treatment of pancreatitis varies somewhat between dogs and cats, but there are two cornerstones of therapy, regardless of species:  Pain Control and Intravenous Fluid Therapy.  In fact, there is an old adage in Veterinary medicine that has served many veterinarians through the years: "the pancreas is a prima donna when it comes to pain and perfusion." 
Other important facets to consider are nausea-control and giving the pancreas a rest (not offering food or water for a short time).  Antibiotics are sometimes indicated, but only in advanced cases.  It is important to note that once your pet has had a bout of pancreatitis, he or she will be more likely to have another in the future.  A low fat diet is generally recommended long term to help prevent future episodes.
    
     The prognosis is generally very good if pancreatitis is caught early, but not always.  It can run the gamut from mild, with no or minimal vomiting, all the way to life- threatening-disease-status and can be the cause of rapid death.
    
     So, in summary, safe guard your trash cans and empty them frequently when table scraps are lurking in them, do your very best to discourage "counter-surfing", and DO NOT give-in to your dog when he or she begs you for those tasty leftovers (easier said than done - I KNOW!).  Your pet will thank you in the long run!  For more information or if you feel that your pet may be experiencing an episode of pancreatitis, please contact the Veterinarians at Zionsville Animal Hospital immediately.

 

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