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Pancreatitis in Dogs

What is the pancreas?
The pancreas is a vital organ which lies on the right side of the abdomen. It has 2 main functions:

  1. To produce enzymes which help in food digestion (carbohydrates, proteins and fat)
  2. To produce hormones like insulin and glucagon, which regulates blood sugar level

What is pancreatitis?
Pancreatitis is a condition where the pancreas becomes inflamed. In a healthy animal, digestive enzymes produced by the pancreas are activated when they reach the small intestine. However, with pancreatitis these enzymes are activated prematurely in the pancreas itself, causing a lot of pain! The inflammation associated with pancreatitis can also lead to digestive enzymes spilling into the abdominal cavity. This may result in secondary damage to surrounding organs, such as the liver, bile ducts, gall bladder and intestines.

Pancreatitis can present acutely (sudden onset) or chronically (slow onset). There are 2 main forms of acute pancreatitis: the mild oedematous and the more severe, haemorrhagic form. Chronic pancreatitis are usually cases where there are often no symptoms as it develops slowly over time. Chronic pancreatitis can also be a result of repeated events of acute pancreatitis.

What causes pancreatitis?
There can be several contributing factors. The exact mechanism leading to pancreatitis is unknown. In dogs, pancreatitis is often associated with feeding a rich, fatty meal.

Some other risk factors include:

  • Hypothyroidism
  • Blunt trauma to the pancreas
  • Genetic predisposition: Schnauzers, smaller toy breeds and terriers
  • Intake of certain medications/ chemicals

What clinical signs should I be looking out for?
These can be variable and the intensity of the disease will depend on the quantity of the enzymes that are prematurely activated. Most pancreatitis is very painful!

Some common symptoms are:

  • Nausea and hypersalivation
  • Vomiting
  • Fever
  • Abdominal pain
  • Diarrhoea
  • Hunched back
  • Inappetence/ anorexia

In severe cases, acute shock, depression, and death may occur.

How is pancreatitis diagnosed?
The diagnosis is based on:

  • Clinical signs
  • Full blood test
    • The elevation in pancreatic enzymes is often present in dogs with pancreatitis. However, some dogs with pancreatitis may have normal values of pancreatic enzymes. A full blood test also helps us to rule out other diseases that can also show similar signs as pancreatitis.
  • Laboratory tests (a SNAP cPL)
    • This SNAP test measures pancreas-specific lipase levels and is one of most specific (the ability to identify a patient without a disease) and sensitive (the ability to identify a patient with a disease) tests for pancreatitis. This test gives us the results within 10 minutes.
  • Imaging- usually abdominal ultrasound ± radiographs
    • The ultrasound helps us to visualise changes in the pancreas to determine the presence and severity of the pancreatitis. wAt the same time, it helps us to visualise other organs to rule out other causes that may have contributed to similar clinical signs. Radiographs may not be particularly useful in visualising the changes in the pancreas but may be recommended as a modality to rule out other disease processes that can present with similar clinical signs.

How is pancreatitis treated?
Successful management will depend on early diagnosis and prompt medical therapy.

Some common treatment options are:

    • Administration of intravenous fluids
      • The intravenous fluids are important to keep your furbaby hydrated and maintain electrolyte balance.
    • Anti-vomiting and anti-nausea medication
      • Most animals with pancreatitis will be presented with vomiting. Maropitant is an antiemetic that will help to reduce the discomfort from vomiting and reduce the risk of dehydration. Maropitant also decreases nausea to encourage eating in the early stages of pancreatitis. Maropitant have also been shown to decrease abdominal pain in animals.
    • Gastric acid suppression
      • Gastric acid suppression drugs may be indicated if your dog is showing signs of gastric ulceration (vomiting blood or has darkened digested blood in the faeces) and if your dog has increased risk of developing oesophagitis (inflammation of the oesophagus) from regurgitation and acid reflux.
    • Antibiotics
      • Some dogs with pancreatitis may require treatment with antibiotics if we suspect infection.
    • Pain relief
      • Pancreatitis can cause pain and discomfort. One or a combination of pain relief medications may be used depending on the level of inflammation.
    • Nutrition
      • It is now recommended that dogs with mild pancreatitis should be fasted until they can consume food voluntarily. However, intervention will be required if these animals are still not willing to eat beyond day five. In dogs with severe pancreatitis, interventional feeding should be initiated immediately via a stomach tube, either through the nose or the oesophagus.

What is the prognosis for pancreatitis?
It depends on the extent of the disease initially and how the animal reacts to the treatment.

Mild cases should recover with no long-term effects. However, there are long-term complications that may follow severe or repeated pancreatitis:

  • If a significant number of cells that produce digestive enzymes are destroyed, it will result in a lack of proper food digestion. This is known as exocrine pancreatic insufficiency and can be treated with daily administration of enzyme tablets.
  • If a significant number of cells that produce insulin are destroyed, diabetes can result and insulin therapy may be needed.

My furbaby can now be discharged from hospital. What are some important things to do at home?
Please continue to feed your furbaby Hill’s LOW FAT i/d prescription food at home for the next 2 weeks or as directed by your veterinarian. Once better, we would need to recheck your furbaby’s fat levels in the blood before transitioning back to their usual diet gradually over 7-10 days. Please ensure your furbaby is drinking enough water and getting lots of TLC at home!

Pancreatitis can be a very painful disease. If you think that your furbaby is presenting signs of pancreatitis, please do not hesitate to reach out to your veterinarian. The prognosis of pancreatitis is generally good for milder forms that receive supportive treatment early. If left untreated, pancreatitis can progress to a hemorrhagic form, which can lead to severe consequences such as sudden death.