By Dr. Jean Hofve, Veterinarian Advisor
The pancreas is an endocrine (hormone-producing) gland located below the stomach and attached to the small intestine. It manufactures two main products: the hormone insulin, which is involved in glucose (sugar) metabolism; and digestive enzymes that the intestines need to break down food so it can be absorbed into the bloodstream.
Inflammation of the pancreas, called pancreatitis, occurs in both dogs and cats, but is more common in overweight, middle-aged dogs.
Pancreatitis can range from mild to severe. It is always painful, and may become life threatening. Pets with mild pancreatitis may be treated at home while those with severe disease will require hospitalization and intensive care. Pancreatitis can reoccur or become chronic, and destruction of normal cells may eventually lead to diabetes.
When the pancreas is inflamed, its digestive enzymes can leak out from cells instead of being channeled into protective ducts. When not confined to the ducts and intestines, these enzymes will digest any tissue they contact. Within the pancreas itself, cell breakdown creates even more inflammation; and in the abdomen, loose enzymes cause generalized inflammation and pain and may even damage other organs—especially the pancreas’s next-door neighbor, the liver. Ultimately the inflammation may spread throughout the body and cause bleeding disorders or multiple-organ failure. Early detection and treatment are the keys to preventing a disastrous outcome.
Fatty foods, obesity, toxins, certain drugs, or trauma can trigger pancreatitis. Pancreatitis may indicate other underlying problems, such as kidney or cardiovascular disease, or bacterial infection. Animals who have hypothyroidism, Cushing’s disease, or diabetes are predisposed to pancreatitis. Miniature Schnauzers are more prone to developing pancreatitis than other breeds.
Pancreatitis may develop within hours after a "dietary indiscretion," or it may take a day or two for symptoms to occur. This is often due to pets getting into the garbage, or eating large amount of fatty leftovers, such as turkey skin, from the Thanksgiving dinner feast.
In dogs, signs of the disease may include depression, loss of appetite, vomiting, or diarrhea. They may have a distended and/or painful abdomen; this in turn can cause restlessness, panting, or resistance to lying down. Mild pancreatitis is harder to detect, since the dog may appear a bit lethargic, or have a reduced appetite. If the pancreatitis is mild and chronic, he may just become generally grumpy or snappy, likely due to pain.
Cats with pancreatitis may not show obvious symptoms, but typically become lethargic and have a decreased appetite. They may develop a fever, and may or may not vomit. Mild pancreatitis causes such non-specific symptoms that it’s hard to pin down; and general supportive treatment can resolve it without the cause ever being known. It’s likely that most cases are never fully diagnosed. Because cats are so good at hiding pain and illness, the classic signs of systemic disease—lethargy and decreased appetite—should always be evaluated by your veterinarian.
Diagnostic tests for pancreatitis include blood tests, urinalysis, radiographs (x-rays), and ultrasound. Specific blood tests can provide solid indications of pancreatitis in dogs, but are much less accurate in cats (but they do help rule out other possible cases of illness). For most cases, ultrasound is the most accurate diagnostic tool.
Prevention, as always, is the best course. Feeding a properly balanced, high quality diet, along with regular exercise, is fundamental. Exercise improves digestion and helps keep your companion’s weight under control. (Please see our article Weight Management for Dogs and Cats — including tips for exercising cats — if your companion is overweight).
Fluid therapy and pain management are the mainstays of pancreatitis treatment. Additional therapies will vary, depending on the severity and duration of the illness. Anti-nausea and anti-vomiting medications are commonly used; but antibiotics are rarely needed. In severe cases, hospitalization and 24/7 monitoring will almost certainly be required.
Early diagnosis and intervention are crucial, so if your pet is displaying any of these signs, have your veterinarian do a thorough examination.
Mild chronic pancreatitis in dogs and cats can potentially be managed at home — after a visit to your companion’s veterinarian for a proper diagnosis, of course!
It used to be recommended to withhold solid food; but this is no longer the case. In fact, such fasting may be detrimental to these patients (except to control vomiting). Careful feeding is the best option.
Animals prone to or recovering from pancreatitis should ideally be fed small, frequent meals. Food should be at room temperature or slightly warmed for increased palatability and better digestion. You can warm up natural canned food by mixing in a little hot water. Microwaving is not recommended due to uneven heating and risk of burns. Dry food is less digestible than canned.
For dogs, an ultra-low fat diet is needed during recovery. Cats are ordinarily very tolerant of fat, but may still need a relatively low fat diet until the condition is resolved.
If the animal is not eating on its own, it may be necessary to place a feeding tube through the nose or esophagus so that food, medications, and supplements can be given directly into the stomach.
Digestive enzymes are extremely important for animals with pancreatitis, as are probiotics. When the pancreas is inflamed, its ability to produce digestive enzymes — and get them to the right place — is compromised. They must therefore be supplemented for proper digestion.
Antioxidants support a healthy inflammation response, and also support the healing process. Essential Fatty Acids may be useful in the later stages of healing, but because animals with pancreatitis may be hyper-sensitive to any fat, be sure to okay it with your veterinarian.
The liver can damaged by pancreatitis when digestive enzymes seep into it. Additionally, the sensitive liver is like a canary in a coal mine; it is highly reactive to many drugs and disease conditions, and to the toxins released due to inflammation. Liver-supporting herbs that support a healthy inflammation response such as milk thistle, ginger, and turmeric may be useful for supporting animals dealing with pancreatitis.
Alternative therapies such as acupuncture and homeopathy may also be helpful for the pain and nausea associated with the disease.
Vaccinations should be minimized or avoided for any animal with a history of pancreatitis. Future diet changes, especially to lower-fat diets, should be made very gradually and carefully to avoid a recurrence.
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