Pancreatitis

Laurie Anne Walden, DVM

Pancreatitis, or inflammation of the pancreas, is common in dogs and cats. Although some cases are relatively mild, pancreatitis is painful and can cause severe disease and even death. Pancreatitis can be triggered by eating a high-fat meal or table scraps, so be very cautious about sharing holiday food with your pets.
 
Pancreatitis is categorized as acute (a short course of disease that can be reversed) or chronic (long-term disease caused by permanent damage to pancreatic cells). These categories can overlap. Animals with repeated episodes of acute pancreatitis can develop chronic pancreatitis, and animals with chronic pancreatitis can have flares of acute disease. In cats, the chronic form is more common than the acute form.[1]
 
The pancreas, which is located near the stomach and small intestine, produces digestive enzymes and insulin. Because of the anatomic location and functions of the pancreas, pancreatic disease doesn’t always happen in isolation. Diseases of the liver, bile duct, and small intestine affect the pancreas and vice versa. In cats, simultaneous inflammation of the liver, small intestine, and pancreas is called triaditis.[2] Chronic pancreatitis is associated with diabetes mellitus and deficiency of digestive enzymes.
 
Causes
The cause of pancreatitis in dogs and cats is often not found. However, some risk factors make pancreatitis more likely:

• Genetics: dog breeds including miniature schnauzers, terriers, Cavalier King Charles spaniels, boxers, and cocker spaniels
• High level of fat in circulating blood
• Dietary factors like eating table scraps or trash
• Being overweight
• Toxins, certain drugs, and possibly environmental factors, especially when combined with genetic risk
• Trauma
• Certain infections
• Immune system disorders[1-3]

 
Symptoms
The symptoms of pancreatitis vary according to disease severity and are not specific; many disorders can cause the same symptoms. Symptoms are usually more severe with acute pancreatitis than with chronic pancreatitis. Other disorders that accompany pancreatitis also contribute to the symptoms.
 
These are some of the symptoms of acute pancreatitis:

• Loss of appetite
• Vomiting
• Weakness
• Abdominal pain
• Diarrhea
• Severe disease: shock, organ failure, death

 
The symptoms of chronic pancreatitis are often vague and can be mistaken for other disorders. Animals with chronic pancreatitis might have these symptoms:

• Intermittent loss of appetite

• Occasional weakness
• Weight loss
• Vomiting
• Diabetes: increased thirst, increased urine volume, weight loss
• Digestive enzyme deficiency: weight loss, increased appetite[4]

 
Diagnosis
Diagnosing pancreatitis can be tricky, especially in animals with vague symptoms or multiple organ systems affected. Baseline bloodwork and urinalysis don’t necessarily give a diagnosis but help assess the patient’s overall health and reveal associated disorders. A diagnosis of pancreatitis is typically made with a combination of blood tests for pancreas-specific factors (like serum amylase, serum lipase, canine and feline pancreas-specific lipase, pancreatic lipase immunoreactivity, and trypsin-like immunoreactivity) and ultrasonography of the abdomen.[4]
 
Treatment
Animals with acute pancreatitis usually need to stay in the hospital for at least a few days. Treatment can include intravenous fluids, pain management, antiemetics to control vomiting, tube feeding, possibly antibiotics, treatment of the underlying cause (if known), and treatment of associated disorders. Patients are monitored closely for complications like organ failure and blood clotting disorders. Animals with recurrent acute pancreatitis, chronic pancreatitis, or triaditis might need long-term diet modification.[2,5]
 
Prognosis
The prognosis depends on disease severity. Patients with mild disease tend to recover well, but the prognosis is guarded for animals with severe pancreatitis.
 
References
1. Watson P. Pancreatitis in dogs and cats: definitions and pathophysiology. J Small Anim Pract. 2015;56(1):3-12. doi:10.1111/jsap.12293
2. Simpson KW. Pancreatitis and triaditis in cats: causes and treatment. J Small Anim Pract. 2015;56(1):40-49. doi:10.1111/jsap.12313
3. Lem KY, Fosgate GT, Norby B, Steiner JM. Associations between dietary factors and pancreatitis in dogs. J Am Vet Med Assoc. 2008;233(9):1425-1431. doi:10.2460/javma.233.9.1425
4. Xenoulis PG. Diagnosis of pancreatitis in dogs and cats. J Small Anim Pract. 2015;56(1):13-26. doi:10.1111/jsap.12274
5. Steiner JM. Pancreatitis in dogs and cats. Merck Veterinary Manual. Updated October 2020. Accessed December 22, 2020. https://www.merckvetmanual.com/digestive-system/the-exocrine-pancreas/pancreatitis-in-dogs-and-cats
 
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