Pets + Pancreatitis

Your canine companion had a field day in the rubbish bin and now they’re literally sick as a dog – throwing up, nursing an aching tummy, and feeling very sorry for themselves. Probably just indigestion from their naughty overindulgence, you think. But what if it’s more than that? Your furry friend could be suffering from pancreatitis – and that’s no joke. In fact, it could be deadly.

We spoke to Dr Travis Gray, BVSc, of the Cape Animal Medical Clinic to find out more about this surprisingly common condition.

BY JENNI DAVIES

PANCREAS 101

First, a pop biology lesson. Cells are the body’s building blocks and, in order to function, they need energy in the form of glucose. When animals eat, digestive enzymes are activated in the small intestine to break food down to get glucose. The hormone insulin is released to allow glucose to be used or stored; when stored energy is needed, the hormone glucagon signals it to be released. What does all that have to do with the pancreas? This tiny-butmighty organ produces several of those crucial enzymes, along with insulin and glucagon. Essentially: no pancreas, no life. Unfortunately, for reasons we don’t fully understand, sometimes things go wrong and the pancreas becomes inflamed. This is pancreatitis and it is serious.

WHAT IS PANCREATITIS?

This is a complex condition but, in a nutshell, the pancreatic digestive enzymes are activated prematurely within the pancreas, instead of in the small intestine. They then start digesting the pancreas itself and can leak into the abdomen, damaging organs, particularly the liver and kidneys.

Two types of pancreatitis affect dogs and cats: acute (sudden onset) and chronic (ongoing), ranging from mild to severe. Dr Gray says, “We see acute pancreatitis in dogs fairly often – on average, every one to two weeks. However, because it’s difficult to diagnose definitively (requiring biopsy), that’s probably an underestimate. We see chronic pancreatitis less often but, since the clinical signs can be so subtle, it’s just overlooked by owners and vets. Pancreatitis in cats is less commonly seen; probably about a case every one to two months. But, again, this is likely because it’s difficult to spot and diagnose. Often, a patient is treated for something else and we see a positive response.” In short: these cases are probably the tip of the iceberg.

In acute canine cases, the most common signs are abdominal pain (your dog may pace, moan, whimper, arch their back, stretch in the ‘downward dog’ position or onto their belly, lick at their abdomen, and snap if you touch), and repeated vomiting, leading to dehydration. Nausea (shown with excess salivation and lip licking) and diarrhoea could be present. They won’t want to eat, they’ll seem flat and lethargic, and might have a fever. They can develop shock, systemic inflammation, and haemorrhagic gastroenteritis (severe bloody diarrhoea). This is not the time for home remedies – this is a serious veterinary emergency. As many as 40% of dogs with untreated severe acute pancreatitis don’t make it.

In chronic or subacute (mild) cases, there may be no symptoms at all, or your pet may just seem not themselves. Dr Gray says, “Theoretically, pancreatitis becomes chronic when there is irreversible damage to the cellular architecture of the pancreas, and you start to see the loss of some of the pancreatic functions.

” Make no mistake, if pancreatitis isn’t obvious, that doesn’t mean it isn’t smouldering beneath the surface, waiting to flare up, nor does itmean it isn’t serious.
As long as it’s leftuntreated, it is causingdamage. “

WHAT CAUSES PANCREATITIS?

“The most common cause is high amounts of fat in the blood,” says Dr Gray. “This can be due to dietary misjudgement with consumption of a high fat meal, but some dogs just tend to have fatty blood and can develop pancreatitis if the owners aren’t careful with what they’re feeding. Some medications, especially anti-seizure medications, have been linked with pancreatitis as well. In cats, pancreatitis is often linked with a larger disease complex involving inflammatory bowel disease and inflammation of the bile ducts in the liver.”

Statistically, obese pets are at greater risk, particularly those regularly fed the wrong food, but, even if animals eat a picture-perfect diet, suddenly wolfing down lots of rich or fatty food can trigger it, which is why vets see more cases around the festive season. Middle-aged and senior animals, particularly females, are more likely to develop it, as are certain breeds, including Cavalier King Charles spaniels, miniature schnauzers, poodles, and Siamese cats. Pancreatitis can also be brought on by physical trauma (e.g. car accident) and ingesting certain toxins, especially chocolate, organophosphates, and lilies. But, really, any dog or cat can get pancreatitis and, in most cases, there’s simply no known reason why some develop it and others do not.

HOW IS PANCREATITIS DIAGNOSED?

As Dr Gray explains, this condition is tricky to spot and diagnose. In suspected cases, vets usually run several tests to confirm suspicion and rule out other causes. A full blood count looks for signs of infection and inflammation and, because pancreatitis affects the liver too, liver enzymes may be checked. Testing for raised pancreas-specific lipase can be done but some animals with pancreatitis have normal levels (false positives). X-rays help rule out other causes, like intestinal blockages. Ultrasound finds around two-thirds of acute cases (not chronic) and can look for other problems, like liver inflammation, gallstones, or pancreatic abscess. Biopsy is the most accurate but it’s rarely done because it’s invasive and animals with acute pancreatitis are generally poor surgery candidates.

Diagnosis is usually made by combining test results with the clinical picture (symptoms, history, and risk factors). Because pancreatitis is time-sensitive, even if there’s no definitive diagnosis, vets often start treating for it anyway.

CAN PANCREATITIS BE TREATED?

Pancreatitis can’t be cured – treatment is supportive and symptomatic, and focuses on reducing possible triggers. “Acute pancreatitis can have a good prognosis with prompt and aggressive treatment,” says Dr Gray. “Unfortunately, necrotic pancreatitis, where parts of the pancreas are actually starting to die off and leak into the abdomen, has a very poor prognosis. Regarding chronic pancreatitis, each vet will have their own experience, but in cases which I’ve seen, this doesn’t generally have a good prognosis from a quality of life perspective. Some patients can do well, but a lot of them battle with frequent relapses and issues with diabetes that usually result in them having to be put to sleep.”

Pets with acute cases are usually admitted to hospital, receive pain and anti-nausea medication, and may be put on a drip for intravenous fluids. Antibiotics aren’t helpful for pancreatitis. Early enteral nutrition (tube feeding) reportedly shortens hospitalisation so, once they’re stable, your pet may be syringe- or tube-fed. Mild cases can sometimes be treated as outpatients. Depending on severity, your dog could be hospitalised for a few days or a couple of weeks, and recovery can take one to two weeks afterwards. However, there is a chance of relapse or of it turning into a chronic case.

Dogs with chronic pancreatitis and those recovering from acute cases cannot go back to their old ways. They need good-quality, easily digestible, low-fat, high-fibre diets, such as prescription low-fat kibbles. Plain cooked skinless chicken breast and veggies like butternut, pumpkin, and squash are good additions if needed. Maintaining a healthy weight is imperative, as is ensuring they get enough exercise and have minimal stress. Probiotic supplements can support
digestion, and milk thistle (Silybum marianum), which has been found to have a protective effect on the liver and pancreas, may also help (under veterinary supervision). In some cases, pain medication is also prescribed. Cats, having a different metabolism, need some dietary fat, although food should still be high-fibre, good quality and easily digestible, and their weight must be controlled.

Although pancreatitis can’t always be prevented, you can reduce the risk of it starting or reoccurring with diet, exercise, and weight management, and by keeping potential toxins out of reach. Saying no to those sweet little faces when they’re asking for extras is tough, but, considering the possible consequences, saying no to treats now could mean saying yes to the rest of their lives.

“Diagnosis is usually made by combining test results with the clinical picture (symptoms, history, and risk factors). Because pancreatitis is timesensitive, even if there’s no definitive diagnosis, vets often start treating for it anyway.”