Pancreatitis In Dogs And Cats
By Ron Hines DVM PhD
Pancreatitis is an inflammation of the pancreas, a gland within the abdomen. The pancreas is composed of two portions. One portion produces enzymes that are secreted into the intestine to aid in digestion while the other portion (the islets) produces insulin, a hormone necessary in the regulation of sugar in the blood and its ability to be utilized by the cells that make up the body. In acute pancreatitis, the signs we see are due to the enzyme-producing portion of the gland being inflamed.
Pancreatitis is a perplexing disease in dogs and cats for two reasons, no two cases are alike and we really do not know what causes the condition. Both the severity and the outcome of pancreatitis is quite variable. Some dogs and cats show only minimal discomfort and an elevation in pancreatic enzymes while in others pancreatitis is a life-threatening disease. When pancreatitis is severe, many organs of the body are affected and the prognosis (chance of recovery) is poor.
Cause:
The cause of pancreatitis in dogs and cats and humans remains unclear. However, there are certain things that we know that are associated with the disease. The first is diet. In both humans and dogs it appears that diets too rich in fat increases the risk of this disease.
We know that certain drugs and chemicals can cause pancreatitis in pets and humans. One group of these drugs are certain insecticides (organophosphates). Others that we suspect may have caused cases of pancreatitis include diuretics (furosemide), hormones (estrogen), certain antibiotics (metronidazole, tetracycline, nitrofurantoin and sulfonamides) long acting antacids (cimetidine, ranitidine), Tylenol (acetaminophen).
In human beings, cases of pancreatitis have occurred after having one’s abdomen hurt in traffic and other accidents.
Excessively high levels of blood calcium have also been known to cause the disease.
Signs:
Dogs and cats with acute pancreatitis often run a fever. Their tummy aches. They often vomit and refuse to eat (anorexia). They are depressed yet restless due to the pain and they are often dehydrated from vomiting, diarrhea and lack of drinking. . Cats may not vomit but just act depressed. In severe cases, the liver may become involved and the pet may become jaundices (ictric) by their third or fourth day of the disease.
Breed And Age Predisposition:
Among dogs, miniature schnauzers are notorious for this condition. It is most common in middle-aged and older pets. Dogs with this condition are often plump and more females develop the disease than males.
Diagnostic Tests:
Pets with pancreatitis have elevated serum lipase and amylase, two enzymes produced by the pancreas that are normally secreted into the intestine but in the disease leak into the blood in excessive amounts. The administration of corticosteroids (cortisone-like drugs) can elevate serum lipase and depress serum amylase – results that might be mistaken for pancreatitis.
Treatment:
The most important treatment for acute (sudden) pancreatitis is the administration of large amounts of intravenous fluid solutions. Most dogs with pancreatitis are dehydrated due to persistent vomiting and many of them have lost additional body fluid due to diarrhea. Dehydration leads to shock and intravenous administration of dilute salt solutions help to cure shock. I can estimate the degree of dehydration by monitoring the plasticity of the skin as well as the concentrations of potassium, sodium and chlorine in the blood.
The blood also often becomes either too acidic or too basic (alkaline) so we usually also give these dogs a buffering agent (intravenous sodium bicarbonate).
Pancreatitis is a painful condition. Often the abdomen (tummy) is as tight as a drum. These pets need pain killers such as butorphanol (Torbugesic 0.1-0.2mg/lb every four hours) meperidine (Demerol), hydrocodone or oxycodone. They are all best given by injection.
Dogs and cats that are vomiting need relief from nausea. I usually administer metoclopramide (Reglan) to calm their stomachs. If the pet is hospitalized I give this medicine by subcutaneous injection. If the patient is at home I dispense pediatric suppositories.
Because dogs with pancreatitis tend to nausea and vomission I withhold any type of oral nutrition (food) until the pet has begun to recover. Once the pet is no longer retching, I can begin by giving it frequent, small amounts of water and gradually add nutrients to the liquid. At this stage I only allow low-fat products such as soups made of rice, cereals and potatoes as well as cooked egg whites which I give in frequent small feedings. If the dog or cat has not improved enough to begin taking oral nutrients in 3-4 days one needs to give nutrients intravenously.
I treat mild pancreatitis with low fat diets. Some recipes for low fat diets are given on this website. They are also available commercially (EN, i/d). After repeated bouts of mild pancreatitis the pancreas may become scarred and unable to produce digestive enzymes. If this occurs I supplement their diets with pancreatic enzymes (Viocase, Pancreozime).
Dogs in severe pancreatic shock often have heart irregularities. They may have difficulty breathing, an inability to produce urine and other major organ failure. Each of these problems needs to be treated in order for the pet to survive. A common complication of severe pancreatitis is life-threatening disseminated intravascular coagulation (DIC) – a condition in which the blood both clumps and leaks from within the circulatory system. I treat this with oxygen, intravenous fluids, a blood-thinning agent called heparin, an osmotic agent (dextran) antibiotics and B-vitamins. As a last resort I give whole blood transfusions or blood plasma. Some veterinarians also give dopamine and selenium. I also give intravenous steroids to pets that are drifting away in shock when I fear I am going to loose them.
Prevention:
Most veterinarians recommend a low fat (5-10%) diet for pets that have experienced pancreatic. Weight reduction in obese pets is probably also wise.
