Pancreatitis is a common, but potentially life-threatening, condition that can occur in both dogs and cats. It happens when the pancreas, an unassuming but notoriously sensitive organ that nestles between the stomach and small intestine, becomes inflamed and begins to swell. When this happens, it causes not only excruciating pain, but also a number of serious problems in the body.
The pancreas has three very important functions:
- It manufactures the hormone insulin, which helps the body process and regulate glucose (sugar).
- It produces bicarbonate to neutralize excess stomach acid.
- It produces the digestive enzymes amylase, lipase, and protease, and secretes them into the small intestine to assist with digestion and the absorption of nutrients from food.
Normally, the pancreas produces these enzymes in a sort of hibernating state, similar to a time-release capsule. The enzymes are only activated once they reach the small intestine, where they begin the digestive process.
However, when the pancreas becomes inflamed, these enzymes activate too soon, causing the pancreas to actually begin digesting itself. The resulting inflammation can cause the enzymes to spill over into the abdominal cavity, resulting in permanent damage to the intestines, liver, gallbladder, and bile ducts.
Dogs and cats with more severe forms of pancreatitis can develop sepsis (body-wide infection), irregular heartbeat, breathing problems, diabetes, or a life-threatening condition known as DIC (disseminated intravascular coagulation) which causes massive hemorrhaging in the body. Severe pancreatitis can be fatal, even with veterinary treatment.
Over the last several years, pancreatitis has become more recognized as a major problem in veterinary medicine. One study found that up to 67% of cats who were autopsied after they had died of other causes were found to have pancreatic lesions – evidence of previous bouts of pancreatitis that their owners were never aware of.
What Causes Pancreatitis?
Most cases of pancreatitis happen spontaneously, and the exact cause is never identified. However, there are several things that are thought to trigger inflammation in the pancreas:
- Certain drugs, such as Potassium Bromide or Phenobarbital (prescribed for seizures), Prednisone (a steroid), and Lasix (a diuretic used for heart patients).
- Cancer of the pancreas or nearby organs.
- Gastrointestinal foreign bodies (inedible items such as plastic, fabric, metal, etc. that are swallowed by the pet).
- Bacterial or viral infections.
- A diet that is too high in fat.
However, by far the most common risk factor (especially for dogs) is dietary indiscretion, better known as “garbage gut.” This can result from a dog getting into the garbage and eating a large amount of discarded human food, but the truth is, it more frequently results from a human feeding the dog a single meal that is very high in fat.
At our veterinary clinic, we could almost always guarantee several cases of pancreatitis two days out of every year, like clockwork: the day after Thanksgiving, and the day after Christmas. Since turkey, gravy, ham, pork roast, beef, and many desserts are all high in fat, we knew we would see at least a few poor dogs with pancreatitis on those days. This gave a whole new meaning to the day we called “Black Friday” – and it had nothing to do with shopping!
Symptoms of Pancreatitis
Pancreatitis can sometimes be notoriously hard to catch, as clinical signs depend on the amount of enzymes that were prematurely activated, as well as the severity of the attack.
However, if your dog or cat is experiencing an episode of pancreatitis, they may exhibit one or more of the following symptoms:
- Diarrhea (sometimes appearing “greasy” and yellow in color)
- Abdominal pain (may be severe)
- Loss of appetite
- Dehydration (dry gums)
In addition, dogs may exhibit a “praying position”, where they lower their heads and front legs to the floor while leaving their rear ends up in the air in an attempt to alleviate the pain. They may also walk in a slow, hunched position due to severe pain in their abdomen.
Cats, on the other hand, may have what feels like a noticeable mass or swelling in their abdomen.
If you notice any of the above symptoms in your dog or cat, call your veterinarian as quickly as possible. If an attack of pancreatitis is severe enough, it can cause a dog or cat to collapse, go into shock, and even die.
Dogs Predisposed to Pancreatitis
It’s thought that certain dog breeds have a genetic predisposition for pancreatitis. These include Miniature Schnauzers, Cocker Spaniels, Labrador Retrievers, German Shepherds, Shetland Sheepdogs, and Yorkshire Terriers.
However, any dog or cat can develop pancreatitis, especially if they are obese.
Pancreatitis can be tricky to diagnose. However, veterinarians may use any of the following tools to assist in their diagnosis:
- Blood work, including a complete blood count (CBC) and chemistry panel. Pets with pancreatitis often have an elevated white blood cell count and elevated levels of pancreatic enzymes.
- X-rays (a severely inflamed pancreas may look “hazy” on x-ray).
- Ultrasound (to determine if the pancreas appears swollen).
Unfortunately, many of these tests provide supporting evidence for pancreatitis, but they can’t definitively diagnose the condition. The quickest, most accurate and reliable test is the pancreatic lipase immunoreactivity (PLI) test. The use of this blood test, along with the pet’s clinical signs and medical history, is currently the best way to diagnose pancreatitis.
The goals of treatment for pancreatitis are to provide pain relief, keep the patient properly hydrated, control vomiting, provide nutritional support, and prevent complications. This can require a stay in the hospital for several days.
During treatment, the dog or cat receives intravenous (IV) fluids. It used to be that food and water was withheld completely for dogs and cats with pancreatitis in order to try to prevent the pancreas from secreting more digestive enzymes that could continue to harm the body, but that plan of treatment is now outdated and no longer recommended. The new recommendation is “If the GI tract is still working, use it.” This usually involves administering anti-vomiting medication to help dogs and cats keep food down. Cats especially cannot go for long periods without food, because when they are not able to eat, their bodies are at risk for developing a serious liver disease called hepatic lipidosis. If anti-vomiting medication doesn’t work, a feeding tube can be inserted through the nose and into the stomach to enable the patient to receive sufficient nutrition, which will help the body stabilize and recover more quickly.
Since pancreatitis is so painful, medications to control pain and reduce inflammation are also given. Other medications, including antibiotics (to help prevent bacterial infection of the abdominal organs), anti-nausea medications (if the pet is vomiting), and anti-diarrheals are also administered.
Once the pet is stable, they may be sent home with a bland, easily-digestible diet to prevent further pancreatic flare-ups.
Most patients with mild pancreatitis who are treated promptly are able to recover without long-term damage. However, if the episode is severe (or if there are multiple episodes), a condition called “exocrine pancreatic insufficiency” (EPI) may develop. This affects the body’s ability to properly digest food, but fortunately it can be treated with a daily enzyme replacement powder.
However, other more serious conditions may also occur, including the onset of diabetes and the formation of painful adhesions (scar tissue) around the pet’s abdominal organs.
Pancreatitis – Tricky and Unpredictable
Pancreatitis can be notoriously difficult to diagnose (especially the mild forms) and unpredictable to treat. Successful treatment and management of pancreatitis depends on diagnosing it early and treating it promptly and aggressively.
If the case is mild, most pets recover well, and a low-fat diet may be all that’s needed to prevent another recurrence. However, in some pets, sometimes severe recurrences may happen, despite the best efforts of the pet parent.
To avoid pancreatitis in your pet, vigilance is the best approach. Limit access to the garbage at all times, and avoid giving your pet human food with a high fat content (especially “splurge” meals, like the ones during the holidays, that your pet may not be used to eating). For most pets, a diet low in fat is a good way to prevent pancreatitis. If you have any questions about your dog’s or cat’s current diet plan, talk it over with your veterinarian.
Understanding what may trigger episodes of pancreatitis, how to avoid those triggers, and how to recognize when your dog or cat may be experiencing an episode of pancreatitis is the best protection for your pets.
Has your dog or cat ever been diagnosed with pancreatitis? Please share your story with us in the comments below!