What is it?Pancreatitis is a common condition where the pancreas (an organ in the abdomen that makes digestive juices and helps regulate blood sugar levels) becomes inflamed. It varies in severity from subclinical (very mild symptoms) to severe; and in duration, from sudden onset (acute) to a long-term, grumbling form (chronic).
Why is it important?Mild forms of pancreatitis can go unrecognised for long periods of time which may lead to other diseases of the pancreas, such as diabetes and pancreatic insufficiency. Severe pancreatitis can require lengthy hospitalisation and be so painful that dogs may even require euthanasia.
What’s the risk?
Some breeds are genetically more prone, e.g. Miniature Schnauzers. Increased levels of triglycerides (fat) or calcium in the blood, certain drugs (e.g. seizure medication), trauma, and dietary indiscretions (e.g. stealing a high-fat meal) can be linked to episodes of pancreatitis. Chronic pancreatitis can also be linked to some underlying diseases such as diabetes, hepatitis and IBD.
However, most cases of pancreatitis in dogs are idiopathic, meaning that the reason for the episode is unknown.
What happens to the dog?
Symptoms vary depending on the severity and duration of the inflammation. Some dogs will have mild non-specific symptoms (e.g. intermittent decreased appetite) especially in subclinical chronic pancreatitis. Symptoms of more severe, sudden-onset pancreatitis include;
However, these are not specific to pancreatitis alone.
How do you know what’s going on?
The history and clinical examination of your dog may make your vet suspicious of pancreatitis. As pancreatitis commonly has links to other diseases your vet will look for these at the same time.
Diagnostic imaging (x-ray, ultrasound) is usually recommended to rule out other possible causes of the non-specific symptoms. Imaging of the pancreas is challenging and requires a high level of skill and although changes can indicate disease of the pancreas it does not specifically mean pancreatitis.
Routine blood tests typically show changes associated with the symptoms e.g. vomiting and diarrhoea often causes abnormal salt levels. These blood tests are not specific for pancreatitis but important in forming a treatment plan for the patient and may highlight other diseases. Amylase and lipase (produced by the body to help with digestion) can be increased but are not specific to pancreatitis and can also be normal in dogs with pancreatitis so have little use.
A more specific blood test called pancreatic lipase immunoreactivity (cPLI) is used to assess for pancreatitis. A 15 minute “SNAP” test for cPLI exists which can be used by your vet and rules out pancreatitis if negative. If positive, the blood sample is sent to the laboratory to get a quantitative (numerical) value and confirm the result. This is the most commonly used test for pancreatitis, but sadly it is still not perfect and isn’t usually used on its own to diagnose pancreatitis. That said, in conjunction with other test results and clinical findings, it may be the only confirmation of a suspicious case that is needed.
What can be done?
Immediate treatment of acute cases is aimed at supportive care to ease the patient’s symptoms until the inflammation settles down. This may include:
In most cases, low-fat food is indicated during the treatment of pancreatitis to try and “rest it” as the pancreas plays a major role in digestion. However, not all dogs that have suffered from pancreatitis require a low-fat diet for the rest of their lives; it depends on the underlying cause.
Long-term management looks at addressing any possible underlying cause of the disease to decrease the chance of recurrence. With chronic pancreatitis if underlying risks/disease have been ruled out then a low-fat diet trial is recommended to assess for improvement.
The outcome for dogs with pancreatitis varies depending on the severity and duration of the disease as well as the response to treatment and the underlying cause.