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Pancreatitis

The pancreas is a vital organ that lies on the right side of the abdomen adjacent to the stomach. It produces digestive enzymes and insulin to help regulate blood sugar. Inflammation within the pancreas is referred to as pancreatitis. Normally the pancreatic digestive enzymes are produced in an inactive form within the pancreas for travel through the pancreatic duct to the small intestine when food is present. The enzymes are activated within the small intestine to aide with digestion. Inflammation within the pancreas is referred to as pancreatitis, and this can occur when the enzymes are activated prematurely within the pancreas.

Pancreatitis can lead to inflammation of the abdominal cavity (peritonitis), liver (hepatitis), gall bladder, and intestines. This can result in variable clinical signs for pancreatitis, and the severity will depend on the extent of organ involvement. The most common clinical signs include nausea, vomiting, fever, lethargy, abdominal pain, diarrhea and decreased appetite. If the attack is severe, acute shock or death may occur.

In the cat, pancreatitis appears to occur spontaneously, without any identified trigger or inciting cause. In the dog, pancreatitis can be triggered in some cases by a fatty meal or eating other items outside the normal diet. In many cases the trigger cannot always be identified.

Laboratory tests can reveal an elevated white blood cell count, indicating infection and/or inflammation. Other changes can occur depending on the organs affected and the duration of the disease process. There is a specific test that can measure the elevation of pancreatic enzymes within the blood, which can be the most helpful in diagnosing pancreatitis. However, the pancreatic levels can be normal in some patients depending on the severity and the time of diagnosis is being made during the disease process.

Radiographs may show changes associated with inflammation in the area of the pancreas. An abdominal ultrasound study may be more helpful by showing inflammation in the pancreas or surrounding area. Some patients may elude detection, and treatment is based on clinical signs and history at time of presentation.

The successful management of pancreatitis will depend on early diagnosis and prompt medical therapy. In dogs, the pancreas is rested for a 24 hour period of time by withholding food and water, so further digestive enzymes will not have to be secreted. Food is slowly re-introduced using a low fat diet while monitoring for further vomiting and an appetite being present. Cats will not undergo a period with food being withheld, so as to avoid secondary complications to the liver. Intravenous fluids will be given to maintain normal fluid and electrolyte balance, and analgesics will be given to control the intense pain. Anti-emetics and gastrointestinal protectants are given to control the nausea and vomiting. Antibiotics will be administered if infection is suspected. Additional treatments depend on other lab findings and presentation.

The prognosis depends on the severity of the disease when diagnosed and the response to initial therapy. Most of the mild forms of acute pancreatitis have a good prognosis with aggressive treatment. Those that are severely sick will have a guarded prognosis.