Pancreatitis In Dogs And Cats

The pancreas is an essential organ for all warm blooded creatures. It is located in the abdomen near the liver and stomach, and has several responsibilities, the two primary ones being regulation of the sugar (glucose) level in the blood and providing enzymes for the digestion of food. An upset with either of these functions will result in significant metabolic changes, such as diabetes for the former and chronic diarrhea with the latter. 

This organ has two distinct components, the endocrine pancreas and the exocrine pancreas, and each provides a different function: 

• The endocrine pancreas produces various hormones. Two of the main hormones produced by the endocrine pancreas are glucagon and insulin. These hormones regulate blood glucose (sugar) levels. The most common disorder of the endocrine pancreas is diabetes mellitus, caused by a decreased level of insulin production, which results in elevated blood sugar levels.

• The exocrine pancreas produces enzymes which are delivered to the intestinal tract to aid in the digestion of fats, proteins, and carbohydrates. In rare cases there may be a deficiency in output of these enzymes. In this situation, the digestive process is negatively affected, resulting in chronic diarrhea and severe weight loss. If these enzymes become activated prematurely, they can seep into the pancreas and surrounding tissue, causing damage and inflammation. This results in a disease known as pancreatitis.

The pancreas is fragile and can be affected adversely by a fatty diet in dogs, and spontaneous bouts of inflammation in the cat. Studies have shown that nearly 50% of dogs of any age have a degree of inflammation of this organ, and nearly 66% of cats at post mortem were diagnosed with either acute or chronic forms of the disease, and 45% of apparently healthy cats had evidence of pancreatitis when thoroughly checked.

Diagnosis: 

Determining that pancreatitis is present can be difficult. Generally, a spec cPL is the most reliable test for diagnosis in the dog and a serum cPLI for the cat. However, these specific tests are not part of the routine blood tests that veterinarians do using their “in house” instrumentation. Consequently, pancreatitis is often missed as a cause for the dog’s or cat’s problem. Currently, there are two main commercial laboratories used by veterinarians: IDEXX and Antech. IDEXX does not include a test for pancreatitis in their main panels and the spec cPL or serum PLI are only included as “add-ons” at extra expense. Antech includes a test similar to the spec cPL/fPL in some of their major panels, so veterinarians using Antech may have a better chance of determining if pancreatitis is involved. 

An abdominal ultrasound can diagnose pancreatitis if certain parameters are met and noted. Radiographs (X-rays) are not considered to be a good diagnostic tool for this disease. Routine blood tests may give a “hint” but usually changes in blood tests without the above mentioned specific tests, will not definitively diagnose pancreatitis. There is a SNAP test for pancreatitis for in hospital use, but it should only be used as a screening test as it has proven to be unreliable in some cases. 

Dogs

Risk factors:

• Hypertriglyceridemia: Schnauzers are 4X as likely to develop pancreatitis if this condition is present
• Obesity 
• More common in smaller breeds – Yorkshire terriers, miniature poodles, schnauzers and other terrier breeds.
• Trauma
• Previous Gastrointestinal disease
• Endocrine disease, especially Diabetes Mellitus 
• Hypercalcemia

Symptoms can be variable and may be difficult to associate with pancreatitis. Mild forms of the disease may only have a diminished appetite as the presenting symptom, whereas more severe cases usually show symptoms of vomiting and/or diarrhea, extreme lethargy, discomfort and a significantly diminished appetite. These dogs are usually nauseous, which may or may not lead to vomiting. Nausea can be indicated by licking of the lips and salivation, as well as discomfort with the dog moving from place to place and seeking abnormal locations. The abdomen is often tense on palpation and resistance to even slight touching of the abdomen is seen. 

High fat diets can induce or worsen the severity of pancreatitis in dogs. A large ingestion of fat at one time can also lead to pancreatitis, but the greater majority of cases are idiopathic with no known cause. Some chemotherapy medications (L-asparaginase) can create inflammation of the pancreas, and the anti-seizure medications, potassium bromide and phenobarbital, both increase the potential for pancreatitis. 

Since pancreatitis is so common in all ages of dogs, it is important to consider it in any dog that is a so called “picky eater.” In the elderly dog, it should be considered anytime there is a decrease in appetite, even when there are underlying diseases such as kidney, liver or vague gastrointestinal problems. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9151489/

Cats

Veterinarians have generally been taught that pancreatitis is rare in cats so it is not considered in many differential diagnoses. As stated above, it is much more common than was originally thought. In over 95% of cases of pancreatitis in cats, there is no known cause. However, pancreatitis can be associated with other diseases, such as chronic intestinal disease, liver and gallbladder disease and Diabetes Mellitus. Chronic pancreatitis should be considered in cats that are not responding well to treatment for other chronic diseases. 

Cats can suffer from two forms of pancreatitis: acute and chronic, and to make matters worse, both can coexist at the same time. Clinical signs can be similar for either form, but tend to come on more rapidly and are more severe in cats with acute pancreatitis. The most common clinical signs are vague, including lethargy and a reduced appetite. About 50% of cats will have vomiting or weight loss, and some cats will develop diarrhea as well. Abdominal pain, while a very common finding in human and canine pancreatitis, is only reported in about 10-30% of cats with pancreatitis, but this may be related to cats’ stoic nature. Some cats with chronic pancreatitis may show very mild or almost unnoticeable signs, while cats with severe, acute pancreatitis can become suddenly and critically ill. Nausea is universally present and this may account for the diminished appetite often associated with either acute or chronic pancreatitis. 

https://www.vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center/health-information/feline-health-topics/feline-pancreatitis

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7995362/