Don't let the Spectre of Pancreatitis haunt your holidays!

    Pancreatitis simply means “inflammation of the pancreas”. The disease itself is not simple to diagnose or treat. If the inflammation gets severe enough, pancreatitis can be life threatening. Acute attacks of pancreatitis can come on very quickly with no warning signs. If severe enough, an acute attack may also damage other abdominal organs, putting the pet at risk for systemic disease and multi-organ involvement. If a pet has more than one attack of pancreatitis, it can lead to chronic inflammation that may ultimately destroy pancreatic cells. 

        To understand pancreatitis, it’s important to understand what the pancreas does. The pancreas is a small but mighty vital organ situated next to the stomach. It serves the body in 2 different ways. The pancreas’ endocrine cells produce insulin and glucagon which are hormones that regulate blood sugar. Disorders in these cells can lead to diabetes. While diabetes can put a pet at risk for developing pancreatitis, these are different disease processes.

      The exocrine cells of the pancreas produce all the digestive enzymes we need to process our food. Normally, the pancreas releases these enzymes in an inactive state and they do not become active until they reach the small intestine. In pancreatitis patients, something causes these enzymes to activate prematurely while they are still in the pancreas. The activated enzymes start trying to digest the pancreas, causing severe inflammation. The damage provokes a response from the immune system, which can further aggravate the inflamed pancreas and may also affect other organs in the abdomen, such as the liver, bile ducts, gall bladder and intestines.

       Pancreatitis can occur in both dogs and cats. The signs of pancreatitis include loss of appetite, lethargy, persistent vomiting and diarrhea. Vomiting is considered persistent if the pet vomits several times within a few hours or periodically over a few days. Lethargy can be as subtle as a pet being less active than usual and is often more noticeable in young pets. Vomiting and diarrhea put the pet at risk for dehydration. Dehydration occurs when a pet is losing more fluid through vomiting and diarrhea than they are able to replenish by drinking water. If the pet also has a fever, the likelihood of dehydration increases significantly. In cats, we may also see a large volume of abdominal fluid and a yellowish tinge to their mucous membranes.

     These signs are always accompanied by abdominal pain. Pets will often show abdominal pain as a hunched back posture or the owner may see distension of the abdomen. Dogs sometimes try to alleviate such pain by assuming a prayer position, forequarters down and hindquarters up. Other signs of pain can include trembling and guarding the abdomen against being touched.

       While we rarely diagnose a specific cause for an individual case of pancreatitis, studies have identified several risk factors that seem common to most cases. In dogs, there is usually a history of dietary indiscretion, often involving fatty foods that are not normally part of the dog’s diet. This is why we  see a lot  of pancreatitis around the winter holidays. If you are a guest, ask the pet owner first before giving a pet a “treat”. If you are the hostess, ask your guests not to feed your pet people food as a treat. You may want to keep approved treats on hand and set a limit.

      Other contributing factors include obesity and endocrine diseases like hypothyroidism, diabetes or hyperadrenocorticism (Cushing’s disease). Some pets develop pancreatitis after suffering from a severe blunt trauma like being hit by a car or falling from a great height. Pets can also develop pancreatitis after a major surgery due to insufficient perfusion of the pancreas under anesthesia. Certain medications and toxins can contribute to the development of pancreatitis. If your pet takes medicine daily to manage chronic conditions, talk to your veterinarian about the possibility of pancreatitis for your pet.

    Some studies have shown that small toy breeds and terriers seem to be more predisposed to developing pancreatitis. My experience has shown me that breed plays less of a role than how the pet is cared for and other diseases that may be present.

     If you suspect your pet may have pancreatitis, seek veterinary care immediately. Pancreatitis can be life threatening! When the veterinarian or technician asks about your pet’s medical history, be sure to include all medications taken regularly. The history should also detail recent changes in the pet’s routines or environment. Around the holidays, this can be associated with the stress of guests which disrupt the normal routines and may be sharing fatty foods too freely with the resident pets. 

       After a thorough exam, your veterinarian will likely request blood work to help confirm a diagnosis of pancreatitis. Blood chemistry may show elevations in the pancreatic enzymes amylase and lipase. A CBC will likely show signs of inflammation. Recently, more specific SNAP tests have been developed to test for canine and feline pancreatic lipase. Ultrasound or radiographs may be suggested to confirm the diagnosis.

       The best recommendation for pets with moderate to severe pancreatitis is hospitalization with IV fluid therapy to address dehydration and supportive care to address symptoms like vomiting and pain. Most pets will be hospitalized for at least 48 hours. Food will be withheld for the first 24 hours to rest the pancreas, then will slowly be reintroduced providing the vomiting is under control. Studies have shown that the sooner we get these patients back to eating, the better their prognosis is. Early nutritional support may be provided through a feeding tube placed through their nose or throat directly into the stomach until the pet is willing to eat on its own.  

    A very mild case of pancreatitis may be treated outpatient. The treatment recommendations for dogs include switching to an ultra low fat diet along with medications to control vomiting and pain. Cats have different nutritional requirements so their recommendation is for a moderately fat restricted diet with appropriate medications. Owners will be instructed to monitor for signs of worsening disease.

    Severe cases of pancreatitis have a guarded prognosis, especially if other organs are affected or the pet arrives in shock. Moderate cases have a slightly better prognosis. Mild cases of pancreatitis usually have a good prognosis. All pets who are diagnosed and treated for pancreatitis are at increased risk for developing it again. Owners will be asked to be alert for any signs of another impending attack for the rest of the pet’s life.

Pancreatitis in Dogs vcahospitals.com/know-your-pet/pancreatitis-in-dogs

Pancreatitis and Other Disorders of the Pancreas in Dogs merckvetmanual.com/dog-owners/digestive-disorders-of-dogs/pancreatitis-and-other-disorders-of-the-pancreas-in-dogs

Pancreatitis in Dogs and Cats merckvetmanual.com/digestive-system/the-exocrine-pancreas/pancreatitis-in-dogs-and-cats

Pancreatitis vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center/feline-health-topics/pancreatitis

Feline Pancreatitis vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center/feline-health-topics/feline-pancreatitis