Pancreatitis

What is the pancreas?

The pancreas is a small glandular organ which is located next to the stomach and the first part of the small intestine. The pancreas has two roles:

1. Production of digestive enzymes that go into the small intestine and help break down food into smaller components so that the gut can absorb them. These enzymes are packaged into a single unit and only release the enzymes once they are in the intestines. The lining of the gut is protected from digestion by a thick mucus lining, this ensures that the enzymes only work on the food present.

2. It produces the hormone insulin which regulates blood sugar in the body.

What is pancreatitis and what are the symptoms?

Pancreatitis means inflammation of the pancreas and can be caused by a variety of factors, however the cause of it can also be unknown (idiopathic pancreatitis). Any of the causes listed below lead to damage and inflammation of the pancreas:

  • Recent ingestion of a fatty meal

  • Obesity

  • Infection – which can ascend from the small intestine via a duct to the pancreas

  • Pancreatic tumour

Any of the above lead to the enzymes that the pancreas produces being prematurely released into the pancreas itself. This results in digestion of the pancreas, pain and inflammation. All three of which can be very severe.

The symptoms of pancreatitis are very variable and may include one or more of the following:

  • Lethargy

  • Vomiting

  • Anorexia

  • Abdominal pain – may see your pet stretching ‘prayer position’

  • Diarrhoea

  • Dehydration

  • High temperature

  • Weakness

  • Collapse

  • Sudden onset diabetes

How is pancreatitis diagnosed?

Diagnosis is based on history taking, clinical examination and laboratory tests.

  • Haematology – assess for signs of infection and dehydration.

  • Blood Amylase and Lipase are measured – these are two enzymes that the pancreas produces and there levels increase.

  • Canine/Feline specific pancreatic lipase snap test – this is a highly sensitive test that provides information on pancreatic function and can be run in-house.

  • Canine/feline pancreatic trypsin-like immunoreactivity – this is a very sensitive test that determines if the pancreas is not working properly or if there is pancreatic damage present. This test is performed at an external lab.

  • Imaging of the pancreas may be advised, but is not always warranted.

Treatment of pancreatitis

Treatment needs to be instigated immediately and generally quite aggressive as the condition can progress quickly. Treatment includes some or all of the following:

  • Intravenous fluid therapy

  • Intravenous antibiotics

  • Pain relief – modality is dependant on severity of pain

  • Anti-vomiting medications

  • Gastroprotectants

  • Nil by mouth for a short period of time may be recommended to try and reduce the production of enzymes by the pancreas.

Your vet may recommend repeat blood tests to monitor response to treatment.

Prognosis for pancreatitis?

Prognosis for pancreatitis is dependent on the underlying cause, age and severity of the condition at the time of presentation. Mild cases are more likely to respond to treatment, however severe cases with a severe underlying problem carry a very guarded prognosis and are associated with higher fatality rates due to secondary complications including organ failure and septic shock.

Long term treatment of patient that have had or suffer from pancreatitis flare-ups.

Animals that have had pancreatitis in the past are considered at risk of future pancreatitis episodes. They are also at greater risk of developing diabetes. Management of diet, weight, lifestyle and medication can help reduce the risk of further attacks, which need also need prompt veterinary attention if they do occur.