Pancreatitis- What we do and don’t know
Holly Mims, DVM, Dip. ACVIM
I was at a lecture given by Dr. Davis this weekend and one of the attendees inquired about pancreatitis. His dog died acutely from pancreatitis despite aggressive medical care and he was wondering why this happened. Unfortunately, this is not an uncommon scenario and one that the internal medicine doctors face regularly. Pancreatitis is a frustrating disease. I routinely have patients who can be treated as outpatients and those whose disease is so severe that they have to be hospitalized and despite our best efforts succumb to this disease. When this happens we are all left with unanswered questions and a sense of loss. What causes the disease to be mild for one dog and life threatening for others? In some cases, we can identify a trigger and in others we never identify a cause. As such, I thought I would put together some information on what we do know.
What is pancreatitis? Pancreatitis is inflammation of the pancreas. The pancreas is a digestive organ that is important in releasing enzymes that help to break down food. Those same enzymes that break down food can be released locally within the pancreas itself and result in “autodigestion” of the pancreas creating inflammation.
Pancreatitis comes in two varieties: acute and chronic. The acute form means that there is a rapid onset of action and this form is often the most severe. Acute pancreatitis typically requires hospitalization and intensive supportive care. It can also result in tissue death (necrotizing) and this is a life threatening form that often requires surgery to stabilize the patient and to remove the significantly inflamed tissue. Hypovolemia (decreased intravascular fluid volume/dehydration) from vomiting, diarrhea, and anorexia may contribute to the progression of the disease and severity. The chronic form is typically less severe with waxing and waning clinical signs when the inflammation flares up. This form can require hospitalization and supportive care for several days, but often can be managed on an outpatient basis.
We are not sure of all of the underlying triggers for pancreatitis, but experimental evidence suggests that low-protein, high-fat diets can induce pancreatitis. Overweight dogs and cats are considered at greater risk. This could be related to their diet or the fact that increased adipose tissue (fat) is associated with a chronic inflammatory state in the body. Concurrent diseases such as Diabetes mellitus, Hypothyroidism, and Hyperadrenocorticism (Cushing’s disease) are also commonly reported in dogs with pancreatitis. We also know that some breeds such as the Miniature Schnauzer are genetically predisposed to developing pancreatitis.
How can you prevent pancreatitis? Maintaining a healthy weight and feeding a nutritionally balanced diet is a good start. Avoid table scraps, left overs, or higher fat treats. Yearly blood work (fasting) performed by your veterinarian will evaluate cholesterol and triglyceride levels, help screen for concurrent diseases, and can give us clues as to the potential risk of developing pancreatitis. If clinical signs of vomiting, diarrhea, or anorexia are present, seeking medical attention sooner rather than later can also be beneficial to prevent the progressive effects of dehydration.