Pancreatitis

Dr. Tammy Majeski, DVM

Pancreatitis, or inflammation of the pancreas (from the Latin “-itis” = inflammation and “pancreas” from Greek/New Latin), is a common condition seen in dogs and cats. It is a painful disease and requires medical treatment. There are many reasons why a dog or cat could develop pancreatitis, but one of the most common results from having “overindulged,” particularly in a fatty meal. With Thanksgiving upon us, it seems apropos to write about this disease.

 

Where is the pancreas, and what does it do?

The pancreas is an organ in the abdomen that sits adjacent to the stomach, small intestine, and with close connection to the liver and gall bladder. When food is swallowed, it goes to the stomach for initial breakdown. The pancreas is stimulated when ingesta are then moved from the stomach to the small intestine; it secretes enzymes to help to break food material down into smaller nutrients that the body can absorb and use. The pancreas also secretes hormones (insulin and glucagon) to help regulate overall glucose (sugar) levels in the bloodstream as well as in the cells of the body. If the pancreas gets inflamed or diseased, these functions can be altered, leading to major illness.

Pancreatitis in Dogs

As mentioned above, a very common cause for dogs developing pancreatitis is having overindulged in a fatty meal, or with a history of having gotten into the garbage or compost. Because of the pancreas’ intimacy with the GI tract and the liver, pancreatitis can also occur secondary to problems with the intestines (such as an obstruction) and/or liver (such as an infection), or due to some cancers. Chronic syndromes such as IBD (Inflammatory Bowel Disease) or hepatitis can also lead to pancreatic issues. Some breeds are predisposed, and some medications are also known to be associated with pancreatitis. Unregulated diabetes can also cause problems. Similarly, with the GI tract and liver being closely intertwined in function with the pancreas, pancreatitis can lead to liver or GI disease (ie, one may cause the other, and vice versa).

Common signs seen in dogs with pancreatits include vomiting, inappetance or decreased appetite, lethargy, fever, a painful abdomen, and sometimes diarrhea or soft stool. These signs are not specific (ie, other diseases can cause these signs too) and sometimes not all signs are present. A dog may present with a posturing or arched back due to pain in his/her abdomen. A more stoic dog may try to hide discomfort.

Diagnosis and Treatment in Dogs

A diagnosis of pancreatitis in dogs is often made with the help of a physical exam with a veterinarian, blood tests and imaging (such as ultrasound or x-ray). Sometimes, other differentials need to be ruled out in order to help aid in getting to the diagnosis. Depending on the severity of the disease, dogs may need to be hospitalized to be stabilized with IV and injectable treatments. Treatments usually consist of fluid therapy, pain medicine, GI protectants, anti-inflammatories, as well as antibiotics, liver protectants, and other medications if indicated. The goal of treatment is to rest the pancreas to bring the inflammation down, reduce fever and vomiting, reduce and/or eliminate pain, and this usually means no food or oral medication for a time. The duration of in-hospital treatment depends on how severe a dog’s condition is (it can range from a day or two to even up to a week or more).

Once a dog is feeling a little better and is able to eat, then treatments can be given at home on an outpatient basis. Rechecks often include repeating labwork, a physical exam, and possibly imaging. Once a dog recovers from a bout of pancreatitis, he or she may be more prone to developing it again. Often, a diet change to a low-fat meal is initiated. Some dogs with history of severe pancreatitis, those with a chronic disease process, or an at-risk breed may need longer-term GI protectants and management as well. These dogs need closer supervision as any meal or ingestion of something odd may cause another bout.

Pancreatitis in Cats

Pancreatitis in cats can be a little more complicated versus our canine friends. They seem to develop pancreatitis more readily, even with no history of eating anything out of the ordinary. Their signs can be more subtle and vague, which makes it difficult to detect any problem. A cat with pancreatitis may be just not eating as well. Or, they have been vomiting a little bit, or they seem more reclusive than usual. Often, liver, GI disease, and pancreatic disease are even more closely intertwined in cats compared to dogs, and all three of these organ systems may become inflamed (this syndrome is called triaditis).

Diagnosis and Treatment in Cats

Diagnosis of pancreatitis in cats can be difficult, as simple blood testing values may not correlate as closely with cats as with dogs. Special lab testing and- an abdominal ultrasound are often indicated; sometimes excluding other differentials aids in the diagnosis while waiting on other results too (eg, xrays, or radiographs, to rule out an obstruction or the presence of a soft tissue mass, etc.)

Treatment for cats can be sometimes more problematic because, unlike dogs, we can’t really rest their pancreas by having them not eat. A cat’s metabolism is very different from a dog’s, and they are prone to developing liver failure if they do not eat (by going into what is known as “fatty liver syndrome,” or hepatic lipidosis). While many dogs will do well with fluid therapy for a while before additional nutritional support is indicated, we do not have that luxury with our feline friends. This means we have to get them eating on their own even sooner than with a dog. While the goal of treatment is the same as for a dog (ie, bring down pancreatic and other inflammation, get their pain under control, and reduce GI signs, reduce stress levels, and treat underlying infection if present), nutritional support for a cat needs to be considered much sooner. Sometimes a cat may need to have a feeding tube placed (many cats do very well with a feeding tube, and can often have one in place at home for a while if needed).

Once a cat is feeling better, follow-up may include rechecking labwork, repeating imaging, or other diagnostics as indicated. A diet change may be indicated, and if your kitty is one who likes to rummage through the trash or compost, or swallow any foreign material, he or she may need additional monitoring or prevention techniques at home to prevent recurrence. Most of the time, however, cats seem to develop pancreatitis for other (often vague or even unknown) reasons. Cats with more chronic conditions may need supportive treatments over their lifetime. Monitoring a cat’s appetite at every meal and watching for vomiting are important in detecting a potential problem. Checking for weight loss at home can also be helpful (especially for the shy kitty who likes to eat in private or for the multi-cat home where it can be challenging to know if all cats are eating equally). Simply hop on your scale with and without your kitty to get a general weight, and record your cat’s weight weekly.

So, at this time of gratitude and thanks, instead of letting your pooch or kitty finish the rest of your plate, I recommend only 1 small bite of turkey (no skin, no fat, no bones, and only if they have no food allergy/sensitivity). But even better than that, instead of rewarding your critters with “people food” (and please remember some people foods are toxic), show your thanks and love by going for a nice easy walk, a laser light play, or by giving as many smooches and laptime as you can!