Pancreatitis, or inflammation of the pancreas, can be described as acute or chronic. Acute pancreatitis results in sudden clinical symptoms without any permanent changes to the pancreas. With chronic pancreatitis, persistent inflammation causes irreversible changes to the pancreas and possibly permanent damage to pancreatic function.
The pancreas is located on the right side of the abdomen adjacent to the stomach and duodenum. The pancreas serves two main functions: exocrine functions and endocrine functions. Its exocrine function consists of secreting digestive enzymes to help break down food; its endocrine function includes secretion of insulin to help regulate blood sugar. The exocrine function of the pancreas is the concern during acute pancreatitis. Normally, pancreatic enzymes are produced in an inactive state, travelling from the pancreas through the pancreatic duct to the duodenum. In the duodenum, the enzymes are activated and they begin to digest food. With cases of pancreatitis, the digestive enzymes are activated prematurely in the pancreas, which results in digestion of the pancreas itself. The digestive enzymes can also leak into the abdomen, where they can cause damage to other organs, including the liver and kidneys. If pancreatitis enters a chronic stage, irreversible changes can affect pancreatic endocrine function, resulting in diabetes mellitus.
The symptoms of pancreatitis can vary in severity, depending on the extent of damage. The most common symptoms are anorexia, vomiting, diarrhea, fever, and abdominal pain. Diagnosing pancreatitis in cats can be more difficult than in dogs. Vomiting occurs in up to 90% of dogs with pancreatitis but in only 35% of cats. Abdominal pain occurs in up to 60% of dogs but in only 25% of cats. The symptoms of pancreatitis also overlap with other abdominal diseases, including acute gastroenteritis, gastrointestinal obstruction, and inflammatory bowel disease. Miniature schnauzers are predisposed to pancreatitis, as they commonly have altered fat metabolism.
Oftentimes a diagnosis of pancreatitis involves utilizing more than one diagnostic modality. A combination of physical examination findings, abdominal imaging (including radiographs and/or ultrasound), and a variety of blood tests may be needed for a diagnosis. Physical examination findings may include abdominal pain or fever. Blood tests may show an elevated white blood cell count or elevations of pancreatic enzymes. Abdominal imaging may show evidence of pancreatic inflammation. Some animals may not show abnormalities on these tests, and a presumptive diagnosis is made based on clinical symptoms and medical history.
The cause of acute pancreatitis is usually unknown. Some risk factors include high fat diets, obesity, diabetes mellitus, prior gastrointestinal diseases, and certain medications (including diuretics, chemotherapeutics, and anti-seizure medications).
Treatment of pancreatitis depends on the severity of symptoms. Many affected animals will be treated with analgesics to help control pain and with intravenous fluids to help maintain normal hydration. Additionally, anti-emetic and antacid medications may be administered to help control vomiting. Sometimes antibiotics are used when possible secondary bacterial infections are suspected. Usually, food is restricted temporarily and then slowly re-introduced once vomiting has been controlled.
The prognosis for pancreatitis depends of its severity. In mild forms of acute pancreatitis, with aggressive treatment, the prognosis is usually good. Most animals recover without any permanent pancreatic damage. However, in cases of severe or repeated pancreatitis, the prognosis can be guarded, even with aggressive therapy.
Prevention of pancreatitis may include weight reduction if an animal is obese or providing a fat-restricted diet, as well as avoiding certain medications. However, as many cases of pancreatitis have an unknown cause, preventative measures are not always effective at avoiding pancreatitis.
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