Pancreatitis refers to inflammation of the pancreas and is a relatively frequent occurrence in dogs. The pancreas is an organ located in the abdomen that sits next to the stomach and small intestine. The pancreas is responsible for secreting enzymes to help dogs digest their food and break down sugar for use as energy. Sometimes the pancreas becomes inflamed, leading to the clinical syndrome of pancreatitis.
Classically, dogs with pancreatitis vomit and have significant belly pain. They usually stop eating and often run a fever and act lethargic. Some dogs will attempt to relieve their abdominal pain by adopting an unusual posture, known as the prayer position, in which their hindquarters are raised in the air with their head and chest on the ground and their front legs extended in front of them. This position is not unique to pancreatitis but does indicate significant pain in the abdomen. Occasionally, other signs such as difficulty breathing due to fluid around the lungs, jaundice or diarrhea are present.
The most common scenario in which a dog develops pancreatitis is after eating a relatively high-fat meal, such as barbecue meat or a holiday ham. The clinical symptoms typically begin within the next 12 to 24 hours.
Other causes include certain drugs, trauma and, rarely, cancer. On occasion, pancreatitis is induced as a secondary problem from other diseases. For example, a dog that has eaten a tennis ball that has gotten stuck in its intestines may develop pancreatitis in addition to the bowel obstruction; however, the tennis ball is the primary problem.
Any breed of dog can develop pancreatitis. However, the Miniature Schnauzer and Yorkshire Terrier are known to have an increased risk of this condition.
There is no one test that can diagnose the cause of pancreatitis. Most of the time, accurate diagnosis requires consideration of the symptoms, breed, recent meals and evaluation of laboratory tests such as the following:
- CBC: A complete blood count often shows evidence of inflammation but is not specific for the pancreas
- Amylase and/or lipase: Elevations of these are not specific for the pancreas, but increases in these values provide another piece of the puzzle to help confirm the diagnosis
- Liver enzymes (SAP, ALT, GGT): Often somewhat increased due to the proximity of the pancreas to the liver and gall bladder. On occasion, swelling in the pancreas prevents the normal flow of bile from the gall bladder, which may lead to the development of jaundice or icterus, in which the skin and whites of the eyes turn yellow and the liver enzymes increase dramatically.
- Canine Pancreatic Lipase Inhibitor (cPLI): Increases in cPLI do indicate inflammation in the pancreas, but inflammation may occur secondary to other processes. A positive test means pancreatitis is present, but more testing is needed to rule out primary causes.
- X-rays: The pancreas does not show up well on X-rays, but often there is a general decrease in contrast in the area of the pancreas due to swelling and the accumulation of small amounts of fluid around the pancreas. X-rays are often important to help rule out other contributing factors (such as the tennis ball in the scenario above).
- Ultrasound: Often, ultrasound can provide excellent images of the pancreas to help confirm if it is the source of the clinical signs. It is also useful for evaluating other nearby organs and cases in which cancer is suspected.
Treatment of Pancreatitis
Treatment of pancreatitis varies based on the severity of the clinical signs. Some or all of the below treatments may be indicated:
- Pain Control: Pancreatitis is known to be painful. Treating pain results in a dog that is feeling better and able to eat.
- Anti-vomiting Medication: Usually given by injection, these medicines help dogs reduce fluid loss through vomiting and enable them to begin eating again.
- Fluid Therapy: This may be given under the skin (subcutaneously) in minor cases or often through an intravenous catheter (an IV). Fluids help replenish hydration lost through vomiting and also help dilute the digestive enzymes that are released when the pancreas becomes inflamed.
- Antibiotics: Few pancreatitis cases have a bacterial component, but for those that do or for which it is suspected, antibiotics often play a role in treatment.
- Hospitalization: Many cases of pancreatitis require hospitalization, but some minor cases may be treated on an outpatient basis.
- Surgery: Some rare cases of severe pancreatitis or pancreatic cancer may require surgical intervention to have a chance at recovery.
- Dietary Therapy: In the initial stages of pancreatitis, often dogs are not allowed to eat for 12 to 24 hours or more. Once they have recovered, many dogs will be switched to a low-fat or very low-fat diet for the rest of their lives to prevent the recurrence of pancreatitis.
Cases of pancreatitis may be mild or severe. They may also be acute, meaning they come on suddenly and resolve completely with treatment. Other cases are chronic, meaning they always have some low level of inflammation in the pancreas even after symptoms recede.
Some cases require easy outpatient therapy, while other cases require intensive hospitalization for many days. Most cases of pancreatitis will resolve with treatment, but there are some cases that develop severe complications or have such severe pancreatitis that dogs do not recover. Once a patient has recovered from pancreatitis, they likely remain at increased risk of developing it again in the future.
Suzanne Brown, DVM, is a graduate of Texas A&M College of Veterinary Medicine who lives in Belton, Texas. Dr. Brown practices at Belton Small Animal Clinic and Central Texas Mobile Veterinary Ultrasound.