Pancreatitis in Pets

The pancreas is the organ in the abdomen that is responsible for
producing the enzymes that digest food before its absorption and
for producing the hormone insulin, which regulates blood glucose
concentrations and prevents diabetes mellitus. Pancreatitis is
inflammation of the pancreas and develops when the enzymes
produced and stored within the pancreas become active and start
to digest the pancreas itself.

Many factors can trigger this abnormal self-digestion of the
pancreas. In human beings pancreatitis is most commonly caused
by gallstones and excessive alcohol consumption, factors that
are not important in dogs and cats. Other causes of pancreatitis
include various drugs and toxins, conditions such as shock and
trauma that affect the supply of oxygen to the pancreas, genetic
factors, dietary factors, excessive fat in the bloodstream, and
tumors or parasites in the pancreatic duct system. In many cats
and dogs with pancreatitis no evidence of any of these
predisposing factors can be found, and the cause is unknown. The
clinical signs of pancreatitis are highly variable, probably
reflecting the great variation in digestive enzyme activation
that may be present in any individual dog or cat. Diagnosis of
pancreatitis is usually suspected from the history and clinical
signs (usually depression, poor or no appetite, and vomiting)
and a suggestive pattern of abnormalities on routine blood
testing. Confirmation of the diagnosis (and elimination of other
diseases that cause similar clinical signs) may be difficult and
usually requires special blood testing, radiographic and
ultrasonographic examination of the abdomen, and sometimes
direct examination and biopsy of the pancreas at surgery.

Once a diagnosis has been made, it is important to remember that
pancreatitis is a highly unpredictable disease of widely varying
severity, and it is difficult or impossible to give a prognosis.
If the underlying cause is known and can be corrected (for
example, exposure to a toxin, side effect of a drug, ingestion
of a meal high in fat), supportive care and fluid therapy for a
couple of days are usually followed by complete recovery.
Overweight pets are more likely to have severe pancreatitis and
to have a protracted recovery or even fatal complications. Most
dogs and cats with uncomplicated pancreatitis probably recover
naturally after a single episode and do well as long as high-fat
foods are avoided. Many dogs recover fully after an isolated
episode of severe pancreatitis.

Unfortunately, in some pets life-threatening signs accompanying
severe acute fulminating pancreatitis lead to death in spite of
aggressive supportive measures. In other cases, relatively mild
or moderate chronic or recurrent pancreatitis persists despite
all therapy, and the pet either dies in an acute severe
exacerbation of the disease or undergoes euthanasia because of
failure to recover and the expense of long-term supportive care.

Special care usually includes intravenous fluid therapy and
provision of good nutritional support by tube feeding if
vomiting is not too severe. If vomiting is severe, food may be
withheld for a few days in an attempt to “rest” the pancreas.
Because such starvation may not be tolerated well, long-term
(particularly in cats) intravenous feeding or feeding through a
tube placed in the intestine may be recommended.

Despite much research, there are no “magic” drugs to treat
pancreatitis. We try to remove the cause if it is known. A goal
is to keep your pet comfortable, well nourished, and well
hydrated. It is important to be aggressive with supportive
medical care and to do everything possible to prevent the
pancreas from starting to digest itself. In many patients this
approach is successful, but it is not possible to predict which
animals will do well.

When dogs and cats recover from pancreatitis, no special
treatment is required other than to avoid known risk factors,
particularly fatty foods and obesity. In a few patients
(especially miniature schnauzers) pancreatitis smolders,
sometimes without obvious clinical signs and the pancreas may
gradually be destroyed. If the pancreatic cells producing
digestive enzymes are destroyed, your pet may eventually require
special enzymes to be added to meals in order to digest food and
prevent weight loss and diarrhea. If the pancreatic cells
producing insulin are destroyed, diabetes mellitus may develop
and insulin therapy may be required. Fortunately, these
complications of pancreatitis are uncommon.

The above is general veterinary information. Do not begin
any course of treatment without consulting your regular
veterinarian. All animals should be examined at least once every
12 months.