Pancreatitis isIt is a common disorder, but is easier to control if caught early. It occurs when dog's pancreas becomes inflamed. The cells become damaged enough to leak digestive into the abdominal cavity, which can result in secondary damage to surrounding organs, such as gall bladder, intestines, or liver. The pancreatitis is a gland located on the right side of the abdomen, it really as no room for it or it's "spills" to go. The pancreas aids in metabolism of sugar (produces hormones such as insulin) and digestion of food (produces enzymes). Pancreas problems can lead to blood sugar levels and issues with surrounding organs. Go to vet for physical examination and blood panel. Pancreas enzyme levels will help with the diagnosis, but full blood work is needed to get an over all view or which organs may be involved.
Dogs that have elevated pancreatic enzyme levels in their blood commonly develop problems in the liver as well. Hepatitis (inflammation of the liver) and Jaundice (yellowing of skin, gums, eys due to bilirubin in the blood) may be secondary to the primary pancratitis. Typically you'll see a rise in the liver enzymes ALT, AST, Bilirubin, ALKP and possibly GGT. More information is below about secondary liver issues.
CauseThe actual cause is unknown, but here are some possible contributors to pancreatitis.
* it is rarely seen in thin, frequently exercised dogs who are fed low fat balanced diets.
SymptomsTwo Forms of sudden onset pancreatitis:
Mild Case (Edematous)- no multisystem failure, complete recovery
More severe, hemorrhagic form- multisystem failure, complications by infection or abscesses
DiagnosisBlood work, exam, abdominal ultrasound are typical first lines. X-rays show little information with organs. Since symptoms can differ, diagnosis must be combined with laboratory tests, examinations, and ultrasounds.
Lab TestThe vet will run a CBC (Complete Blood Count) and blood chemistry analysis. These test are not specific to pancreatitis, but can give a very good insight into what is going on.
Recently IDEXX Reference Laboratories indroducted the Spec cPL (Canine Pancreas Specific Lipase) Test.
Amylase and Lipase are two enzymes closely watched. They can however indicate other diesease. The CBC helps see the entire "picture". Amylase and Lipase can be increase in diseases such as renal and gastrointestinal disease.
Serum amylase and lipase are generally accepted as tests useful in diagnosis pancreatitis as long as values are at certain levels. Your vet can explain this further.
Liver enzymes (ALT, AST, ALP) are often increased due to the toxins being "dumped" from the pancreas. Bilirubin may be up as well.
Serum amylase- begins to rise 6 to 12 hours from the onset, it peaks between 24 and 48 hours. It can often reach levels 4 to 6 times higher than the upper limit of normal. It starts to typicaly normalize within 48-72 hours, provided the successful treatment is used. It will return to normal in a few days.
Serum lipase- elevates around 24 hours after the onset of symptoms. It normalizes within 7 to 14 days. These level takes longer to rise than amylase and will remain elevated longer.
Mild to moderate increases in white blood cell counts genneral occure with pancreatitis
Serum amylase and lipase enzyme levels are often three times normal.
You can learn more on our Blood Work and Lap Reports page
Treatment*** Need to reset the pancreas from it's role in digestion ***
Most dogs will respond to treatment in a few days. Typically food is with held for 24 hours. Water is given in very small amounts several times a day to avoid dehydration. Keep a very close eye out for it! Fluid therapy may be need.
It is thought that once vomiting stops for 24 hours, pancreatic recovery has begun.
They are then started on a bland diet, giving small portions several times a day. The vet may give an antacid or an antibiotic. Probiotics may be given as well to help the pancreas work less. Because bilirubin is excreted through poop, frequent feeding can help pass the excess bilirubin and reduce jaundice.
Diet is VERY important to help with recovery! Make sure to follow your vets instructions closely!
Dietary EnzymesDietary enzymes are heat sensitive and easily destroyed by cooking. Adding a supplement to food may help the dog's system. The theory is if these enzymes are present, the intestines will tell the pancreas not to release any more. This hopoefully will limit the work and damage the pancres has to do. It needs rest.
Probiotics - Friendly bacteriaThese may also be offered by your doctor. Supplements are available. A vet can help you chose the best for your dog. Yogurt is one.
To fully recover, it is recommended the pancreas needs rest for up to two weeks. The recovery diet helps it do just that.
Long Term Diet
Feeding Raw Diet after Pancreatitis recoveryRaw diet tends to make the system work easier. The food is digested well, with little waste. However, you MUST feed lean raw meats. Skin and fat should be removed beforing feeding dogs with a history of pancreatitis. Raw game meats are much healthier for dogs with past pancretitis. Lean protein is the key, it can be found in elk, moose, wild boar, deer, quail, duck. For fiber, pumpkin and sweet potatoe is a good source along with grains such as oatmeal. Raw meat does offer up extra enzymes that help dogs digest their food. Cooking kills these helpful enzymes.
Liver Disease Secondary to PancreatitsBecause the pancreas is located in the retroperitoneal space with no capsule, inflammation can spread easily. The close proximity of the two organs and the bile duct results in some degree of hepatitis (liver inflammation) whenever the pancrease becomes inflammed. Treat the pancreatits and the liver disease will regress. It is considered normal to see elevated liver enzymes after a bout of pancreatitis. The common bile duct that is shared by the liver and the pancreas is often invovled when the pancreas inflames. Often times this leads to some liver damage (which is usually reversible) with pancreatitis. The liver enzymes can also take a few weeks to come down.
When the pancreas inflames, it is common to see the elevated liver enzymes AST, ALT, ALP, GGT, Bilirubin along with the pancrease enzymes Amylase and Lipase.
From only what I can gather while reading up on values, this what the supportive info I can gather:
Once the injury to the duct is repaired (pancreas is no longer inflamed and the duct has no compression and allowed time to repair any inflammation secondary to the pancreas), these values should begin to decrease. You most likely will see a drop in GGT, AKLP and Bilirubin indicating the duct is recovering. This drop will most likely occure after the pancreas values have returned to normal.
Links that helped me:
Grayhound - Duffy’s Bout with Pancreatitis: Causes and Treatment of Canine Pancreatitis
Those pesky elevated liver enzymes
Liver Health for Pets - Denamarin, Denosyl, and Marin
NZYMES.COM: Official Site! Natural Supplements for Pets and People www.nzymes.com Biliary Obstruction
Complete Blood Count (CBC) / Blood ChemistryAbnormalities detected by standard CBC and blood chemistry analysis are not specific to canine pancreatitis and can be highly variable. A leukocytosis with a left shift is common. Toxic change may be associated with acute pancreatic necrosis. A relative polycythemia or anemia can be seen. Azotemia is a common finding and can be either pre-renal due to dehydration or due to secondary acute renal failure. Liver enzyme activities (ALT, AST, ALP) are often increased, probably due to hepatic ischemia or hepatic damage caused by toxic products from the pancreas. Additional findings include hyperbilirubinemia due to hepatocellular damage or cholestasis, hyperglycemia caused by hyperglucagonemia, stress, or damage to pancreatic islet cells, hypocalcemia associated with hypoalbuminemia or calcium deposition, hypercholesterolemia, hypertriglyceridemia, and hyperlipidemia.1,3,5
Diagnosing Pancreatitis in Dogs and Cats by Laboratory Methods
Laura D. West, DVM and Frederic S. Almy, DVM, MS, Diplomate ACVP
Class of 2007 (West) and Department of Pathology (Almy), College of Veterinary Medicine, University of Georgia, Athens, GA 30602-7388
**** Many of us are not vets or even close to an expert on these topics. Many articles have come from hours spent online reading and talking with others while trying to figure out what is best. If you have any questions, or information to add, feel free to contact me at firstname.lastname@example.org
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