Why Pancreatitis in Dogs and in Cats Should not be Overlooked
Pancreatitis is one of the main causes of diabetes in dogs. Perhaps is it THE main cause. Studies show that around 30% of dog diabetes come from untreated pancreatitis. It could be actually much more since many think this disease is significantly underestimated because of the challenge of diagnosing it.
Thus, diabetes is often a pancreatitis complication. Pancreatitis in dogs and in cats may start long before the clinical signs appear. It is recommended to screen diabetic pets for pancreatitis because this condition makes the management of diabetes more difficult.
What is pancreatitis
The pancreas is a lobular gland positioned at the beginning of the small intestine and close to the stomach. It is mostly composed of exocrine tissues dedicated to the production and release of digestive enzymes. The enzymes are collected by a duct network that pours into the duodenum (first section of the small intestine) where the enzymes helps food digestion.
The second function of the pancreas is endocrine: it consists of the production and release of homones in the blood stream. Many of them play a role in blood glucose regulation. The hormones are produced by specialized cells brought together to form the islets of Langerhans. The islet of Langherans include:
- alpha (α) cells that produce glucagon
- beta (β) cells that produce amylin and insulin
- delta (δ) cells that produce somatostatin
- PP cells that produce pancreatic polypeptide
- epsilon (ε) cells that produce ghrelin
Amylin, glucagon, insulin and somatostatin are involved in blood glucose regulation. The pancreatic polypeptide regulates food transit and digestion. In humans, ghrelin increases appetite and helps fat storage in the abdomen.
Pancreatitis is defined as an inflammation of the pancreas that may occur in two different forms, acute or chronic. The chronic form leads to permanent changes within the pancreas: atrophy, necrosis and/or fibrosis.
Whatever its form, its severity ranges from mild to very severe and potentially lethal. Pancreatitis is difficult to diagnose. Untreated pancreatitis, even in the absence of symptoms, can lead to diabetes.
What causes pancreatitis
Pancreatitis is characterized by an autodigestion of the pancreas: the digestive pancreatic enzymes are produced in too large quantities and act on the pancreas instead of the food they should digest. Inflammation follows and aggravates the initial lesion.
The triggering factors are still unclear. Several hypotheses have been considered: severe blunt trauma (blunt trauma is opposed to penetrating trauma where an object such as knife can enter the body), surgery, infectious disease as well as the exposition to some drugs. Obese pets and pets fed with high fat diet are more at risk. Although it is controversial, some dog breeds seem to be more exposed: Schnauzer, Terriers, Spaniels…
In fact, most cases of pancreatitis in dogs and cats seem to be idiopathic: they occur spontaneously or from unknown reason.
What are the symptoms of pancreatitis
The symptoms are numerous and not specific to the disease, especially in cats. Although abdominal pain is usually associated with pancreatitis, it does not occur in all cases and even rarely in cats.
Pancreatitis symptoms in dogs: anorexia, vomiting, weakness, abdominal pain, dehydration, and diarrhea
Pancreatitis symptoms in cats: anorexia, lethargy, dehydration, weight loss, hypothermia, vomiting, icterus, fever, and abdominal pain
Clinical symptoms vary in nature. They also vary in severity since they range from mild gastrointestinal disorders to death.
How to diagnose pancreatitis
Diagnosis is difficult. As the clinical signs are very unspecific to the disease, they will not help a lot your vet for the diagnosis. Nevertheless, she will try to get as many information as possible on your pet medical history for orientating her research. Of course, concurrent diabetes will make her suspect pancreatitis. But she will have to perform many exams to ascertain the diagnosis
Complete blood count (CBC) and serum chemistry will help check for any complication
Radiograph of abdomen and chest will help rule out any foreign body in the abdomen, gastrointestinal obstruction or possible thoracic disorder
Ultrasound will then help greatly in ascertaining the diagnosis. It will show pancreas shape and lesions as well as important inflammation.
Spec cPL® Test for dogs and Spec fPL® Test for cats have been recently commercialized. They are the most specific pancreatitis tests on the market. They can be used alternatively or in complement with ultrasound.
Biopsy (removal of a piece of pancreatic tissue for diagnostic) is the golden standard for diagnosing pancreatitis. It has many practical and medical drawbacks though, that will make it very rarely performed in day to day veterinary medicine.
How to treat pancreatitis
There is no drug for healing canine or feline pancreatitis. The treatment is supportive: it is aimed at relieving the symptoms.
Fluid therapy: corrects dehydration and mineral imbalance caused by diarrhea and vomiting. It helps restore pancreas perfusion.
Pain management: mild or moderate pain will be treated orally whereas more severe pain will require a continuous-rate infusion
Pancreas resting: in case of intense vomiting, the pets receive neither food nor fluid by mouth, but are fed and hydrated intravenously.
Diet: dogs and cats often respond well to low fat diets
Antibiotics: are only necessary in case of confirmed infection
Nausea: can prevent the animal from eating and will be treated by antinausea drugs
Plasma: blood transfusion may be necessary in the most severe cases
Of course, the therapeutic approach will take into consideration any other disease that has been revealed during the diagnosis process. The animal will receive appropriate treatment
In many cases, pancreatitis is reversible and the animal gets back to normal. But in the most severe cases, the prognosis is guarded in both dogs and cats.
Learn more about the mechanisms of progression of diabetes in dogs and cats