Pancreatitis: Acute & Chronic Causes, Symptoms & Treatment
Pancreatitis is a serious condition. It's painful, and it can lead to other issues like hepatitis (liver issues) and multiple organ failure. While most cases of acute pancreatitis are treatable, the condition can be life-threatening.
But before we delve into the finer details of pancreatitis, let’s start by talking about the organ itself.
What Is a Pancreas?
A pancreas is an abdominal organ that plays a role in digestion. Digestion is the process of converting food into energy. The pancreas produces enzymes that help break down protein, fat and carbohydrates from your pet’s food and convert them into nutrients his body can absorb and use for energy, growth and cell repair.
Enzymes produced by the pancreas:
- Proteases such as trypsin and chymotrypsin help to digest proteins
- Amylase helps to digest carbohydrates
- Lipase helps to digest fat
The pancreas also produces the hormone, insulin.
Digested carbohydrates turn into glucose, also called blood sugar, which travels through the bloodstream to various parts of the body. Glucose needs insulin to move from the bloodstream into the cells where it is either used for energy or stored for later.
So, now that we know more about the pancreas, we can explore the causes, symptoms, diagnosis and treatment options of pancreatitis.
What Is Pancreatitis?
Pancreatitis is inflammation of the pancreas. Inflammation can range from mild to severe. In some cases it can be fatal.
The pancreas produces digestive enzymes in an inactive state until they’re activated by the duodenum in the small intestine. This is what triggers digestion.
In severe cases of pancreatitis, the enzymes are activated too early, which triggers them to digest the pancreas itself, causing inflammation—aka pancreatitis.
There are two types of pancreatitis:
Acute pancreatitis is a condition where the pancreas becomes inflamed (swollen) over a short period of time.
Chronic pancreatitis results in persistent inflammation of the pancreas, which can lead to permanent damage.
Pets who recover from an acute episode of pancreatitis may experience future episodes. When that happens, it becomes a chronic condition.
If too many of the insulin-producing cells are damaged, diabetes can set in. When that happens, you’ll need to monitor your pet’s blood sugar and you may have to give insulin injections at intervals set out by your vet.
In rare cases, scar tissue can form, fusing the surface of the pancreas, liver and gallbladder together. Surgery is the only way to correct this painful condition.
If there is damage to too many of the cells that produce digestive enzymes, it may result in an inability to properly digest food. This is called exocrine pancreatic insufficiency (EPI) and can be managed with a daily enzyme supplement.
What Causes Pancreatitis?
It is uncertain what causes pancreatitis but there are several possible risk factors:
Overly processed, high-fat foods do not contain digestive enzymes. The pancreas is then forced to work overtime to produce all of the necessary enzymes. This kind of pancreatic stress is one possible cause of acute or chronic pancreatitis. It’s more common among dogs than cats.
Again, though no one is entirely sure why, certain medications are known to cause pancreatitis in pets:
- Anticonvulsants: potassium bromide and phenobarbital
- Corticosteroids: prednisone, prednisolone, dexamethasone, triamcinolone and methylprednisolone
- Diuretics: lasix and torsemide
Some canine and feline breeds may have a genetic predisposition to pancreatitis.
Susceptible dog breeds may include:
- Miniature Schnauzers
- Cocker Spaniels
- Cavalier King Charles Spaniels
- Yorkshire Terriers
Susceptible cat breeds may include:
When cats develop pancreatitis, the small intestine and liver may be inflamed at the same time. It can happen because the organs are so close together. It’s called triaditis and it’s relatively common.
In one study, researchers found bacteria in 35% of cats with pancreatitis.
This may be because, unlike dogs who have a pancreatic duct and bile duct leading separately into the duodenum, cats’ pancreatic duct and bile duct join together to form one duct. This single duct leads into the cat’s duodenum, which contains 100 times more bacteria than a dog’s duodenum.
Cats may experience reflux of the duodenum’s bacteria-filled contents, which can move backwards through the ducts that lead to the pancreas and the liver. This can cause triaditis.
Symptoms of Pancreatitis
In both dogs and cats, symptoms of mild pancreatitis may include anorexia, lethargy or diarrhea.
Possible signs of severe pancreatitis in dogs:
- Abdominal pain (shivering, whimpering and belly tenderness may be signs of abdominal pain)
- Dehydration (excessive thirst)
Possible signs of severe pancreatitis in cats:
- Dehydration (excessive thirst)
- Abdominal pain (difficult to identify)
- Shortness of breath
- Uncoordinated, clumsy walking
Ancestors of the modern house cat evolved to hide their pain so they wouldn’t be targeted by predators who saw pain as weakness. Cats today still have this behaviour ingrained in them, which can make it difficult to detect if they’re hurt internally.
Dogs may not hide their pain as well as cats. So if you find your pup with an arched back, head down and rear end up, he may be showing you signs of pancreatic pain.
How Is Pancreatitis Diagnosed?
Pancreatitis is not a condition you can manage at home. If you suspect your pet has pancreatitis, take him to the vet immediately.
Your veterinarian will perform a series of tests to determine the diagnosis, such as:
- History and signalment: vet will ask about your pet’s history and observe his condition
- Complete Blood Count: Known as a CBC, vets will take blood samples to see if red blood cells, white blood cells and platelets are within a healthy range. They’ll also check for possible infection, anemia and leukemia.
- Chemistry profile: vet may test the blood for any chemicals and enzymes that can help determine organ health, blood sugar and electrolyte quantities.
- Pancreas-specific lipase (PLI) test: since the typical amylase/lipase tests are not consistent or sensitive enough to definitively diagnose pancreatitis, vets will run a PLI to determine lipid levels.
- Radiograph: similar to an x-ray, this imaging technique is sometimes used in tandem with other tests to help confirm a diagnosis.
- Ultrasound: this imaging technique uses sound waves to provide a picture of the pancreas. The reliability of the test depends on the quality of the machine and the technician’s skills.
- Surgery: in rare cases, vets may resort to exploratory surgery and collect samples for further testing.
How Is Pancreatitis Treated?
Pancreatic treatment depends on the severity of the condition and the stage of intervention. In some cases, your vet may want to keep your pet at the clinic for a few days to administer IV fluids and monitor the condition. In other cases, you may be sent home with out-patient treatment instructions.
Different vets may have different recommendations for treatment. Some may want your pet to fast for at least 24 hours so the pancreas can rest. In these cases, you may be advised to slowly reintroduce a low-fat diet.
As long as vomiting subsides, your vet may instruct you to feed small portions of a highly digestible, low-fat pet food.
Staying hydrated is crucial.
Pain management will likely be necessary as well. Pain meds may include: fentanyl, morphine and hydromorphone for both cats and dogs. Side effects may include vomiting and constipation.
The best way to prevent your pet from developing pancreatitis is to feed a high-quality diet free of fatty, over-processed ingredients. PureForm recommends feeding raw diets whenever possible.