Pancreatitis in Dogs
by Dr. Audrey Harvey, BVSc (Hons)
Pancreatitis in dogs occurs when the pancreas becomes inflamed. This condition can be life threatening, and needs urgent veterinary care.
The pancreas is a small gland that sits between the stomach and upper small intestine, and it has two very important functions.
It's first, and best known, role is in the production of insulin. This hormone is involved in blood sugar regulation. When a dog's pancreas doesn't produce insulin, they become diabetic.
The other substances created by this little gland are the digestive enzymes which help to break down food. A shortage of these enzymes results in malnutrition and weight loss.
Causes of Pancreatitis in Dogs
There is no single cause of pancreatitis; in fact, veterinarians aren't completely sure why it occurs. This makes it difficult to protect dogs from it. However there are some risk factors which make some dogs more likely to suffer from the disease.
1. Breed. There is some evidence that Yorkshire Terriers may be at increased risk of pancreatitis. On the other hand, the same study suggested Labrador Retrievers and Miniature Poodles are less likely to be affected. There is an understanding that a hereditary predisposition to pancreatitis occurs in the Miniature Schnauzer. However, it is a disease of all breeds, and every dog owner should watch out for any symptoms.
2. Diet. Overweight dogs are more likely to develop this disease than their leaner counterparts, so owners need to be watchful of how much their dog is eating. High fat diets are also a big risk factor. Veterinarians often see dogs with pancreatitis during the festive season, when they have been fed too many leftovers from the Christmas ham.
3. Health. Certain medical conditions also predispose to pancreatitis. Such conditions include diabetes, Cushing’s Disease, and hypothyroidism.
4. Medications. It is known that prednisolone use in dogs can lead to pancreatitis. Other drugs that have a similar effect are furosemide and tetracycline antibiotics.
Affected dogs tend to be middle-aged, and the disease also appears to be more common in spayed females. Perhaps this is because these groups of dogs are more likely to be overweight.
Clinical Signs and Diagnosis of Pancreatitis in Dogs
Dogs with pancreatitis show quite a variety of symptoms, some of which are quite vague. The severity can vary from being a bit off their food to fever and severe abdominal pain. Many of the symptoms are similar to those of gastroenteritis or an intestinal obstruction. A close look at what a dog has been eating and whether they have been taking any medications is often helpful in starting to differentiate between these conditions.
90% of dogs with this disease will vomit, and over half will show signs of abdominal pain such as restlessness and panting. They may also have a rapid heart rate, and can dehydrate quite quickly.
Although the symptoms can be very non-specific, veterinarians are usually suspicious of pancreatitis based on clinical signs and the results of some standard blood tests. Most dogs have an increased white blood cell count, they also show anemia (low red cell count) and thrombocytopenia (low platelet numbers).
On blood biochemistry tests, the main indicators of pancreatitis are increases in two enzymes called amylase and lipase
. There may also be changes to liver and kidney function. Again, these don't give a definite diagnosis; to do this, veterinarians need to do a canine pancreatic lipase immunoreactivity test
, which is over 90% accurate.
Other tests that can help with diagnosis are x-rays and ultrasound of the abdomen, but they aren't used on their own. They are useful to support a diagnosis obtained with blood tests, and to make sure there isn't anything else happening inside a dog's tummy.
The most accurate way of diagnosing pancreatitis in dogs is to do a biopsy, and have it analyzed by a pathology laboratory. This is invasive, and most veterinarians don't go this far unless they suspect their patient may have pancreatic cancer.
Treatment of Pancreatitis in Dogs
There is no specific treatment for pancreatitis in dogs. All that veterinarians can do is support the dog as they recover from their illness. This can be done at home, if the dog isn't too unwell, or in hospital for those that are seriously ill.
Mild cases are treated with pain relief and fluids under the skin to rehydrate them. Tramadol is an ideal analgesic for dogs with pancreatitis, but because it is given orally, it isn't useful if a dog is still vomiting. They are given nothing by mouth until the vomiting stops, and then they are offered small amounts of water and a bland diet. It's important that they are regularly checked, because their condition can deteriorate quickly.
Severely ill dogs need much more aggressive treatment. They often need hospitalization for several days until they are well enough to be managed at home. Treatment usually involves the following:
1. Intravenous fluids to replace those lost by vomiting, and to treat dehydration. In extreme cases, fresh frozen plasma can be given.
2. Electrolyte replacement. Electrolytes such as sodium, chloride and particularly potassium are lost when a dog has vomiting and diarrhea. This can make them sicker still, so they are often added to the bag of fluids. Regular blood tests are needed to keep them at a normal level, because too much of some electrolytes is as harmful as too little.
3. If vomiting is ongoing, then drugs such as metoclopramide are helpful to control it. This drug can be given by injection, but as a dog recovers, they can be given it in tablet form.
4. Pepcid and Zantac are given to protect the lining of the stomach, and control gastritis.
5. Broad spectrum antibiotics such as amoxicillin or enrofloxacin are given to dogs with high temperatures or symptoms of shock.
6. Pain relief is critical for these poor dogs. Pancreatitis hurts, and they will benefit greatly from buprenorphine or oxymorphone until they are feeling better.
Many dogs will take 3-5 days to recover enough to start eating again. When they do, a highly digestible bland diet is best for them. Chicken and boiled white rice, or low fat cottage cheese are good choices. There are prescription diets such as Hills I/D which are also very suitable, but may be a little more expensive.
Consequences of Pancreatitis in Dogs
Pancreatitis can be fatal to dogs within days, even with the best treatment. Many dogs recover from pancreatitis and have no further problems. Others can develop a chronic form of the disease which can affect the production of digestive enzymes. The result is exocrine pancreatic insufficiency, and these dogs will need supplements of digestive enzymes for the rest of their lives.
Any dog that has recovered from pancreatitis should be fed a low fat diet, to reduce the risk of it happening again. A balanced commercial food with a fat content between 6% and 10% is a good choice. Home made diets are also fine, provided they have been formulated by a veterinary nutritionist. This will make sure they will meet your dog's nutritional needs for the rest of their life.
Another way in which owners can reduce the risk of their dog getting pancreatitis again is to put them on a diet so they lose their excess weight.
Pancreatitis in dogs is a scary disease. Although you can reduce your dog's chances of getting it, there is no guarantee. It is vital that you understand the risk factors and learn to recognize the symptoms. Early diagnosis and supportive treatment will give your dog the best chance of making a full recovery.
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