The Pancreas

The Pancreas is a small organ in the abdomen that is part of the endocrine system.  It produces the hormones insulin and glucagon as well as digestive enzymes that are necessary for the proper digestion of food.  The digestive aspect of the pancreatic function is known as the exocrine pancreas. In a normal pancreas the digestive enzymes are inactive until secreted into the small intestine to aid in the digestion of food.

What is Pancreatitis?

Pancreatitis is an inflammatory condition of the pancreas that occurs frequently in dogs and cats. Pancreatitis can be acute or chronic.

Acute pancreatitis is a sudden inflammatory condition that is completely reversible once the inciting cause is removed. Acute pancreatitis is rare in cats.

 

Chronic Pancreatitis is characterized by irreversible changes such as atrophy or fibrosis of the exocrine pancreas over a long period of time. Chronic pancreatitis can result in scar tissue forming which decreases the ability of the pancreas to function properly.

 

Both forms can be mild to severe. Most mild cases have little or no necrosis or systemic effects and the patient will make a complete recovery. Extensive pancreatic necrosis and multiple organ involvement can be seen in severe cases, which often have a poor prognosis.

 

Causes of Pancreatitis

The exact cause of pancreatitis is unclear but the following are associated with the condition:

♦ High fat / Low protein diet

♦ Trauma

♦ Tumors

♦ Other diseases, such as Cushing's or Diabetes

♦ Some drugs, such as:

♦ Furosemide

♦ Metronidazole

♦ Tetracycline

♦ Nitrofuantoin

♦ Sulfonamides

♦ Cimetidine

♦ Ranitidine

♦ Acetaminophen

♦ Prednisone

♦ Azothiaprine / Immuran

♦ Hormones such as estrogen

♦ Organophosphates

♦ Excessively high blood calcium levels

♦ In cats: Toxoplasmosis, FIP, feline herpes virus, inflammation of the bile ducts or fatty liver disease

♦ Hospitalization

♦ IV fluids

♦ NPO for 12-24 hours only due to the risk of hepatic lipidosis (fatty liver), then give small amounts of a low fat highly digestible diet frequently. If pancreatitis causes a cat not to eat, it may be necessary to use parenteral feeding techniques. (A feeding tube is surgically implanted into the intestine.)

♦ Broad spectrum antibiotics

♦ Antiemetics if vomiting ( vomiting is not as common in cats)

 

 

Complications of Acute Pancreatitis

♦ Diabetes mellitus. The inflammation of the pancreas may cause the endocrine portion of the pancreas to become dysfunctional interfering with the production of insulin. This will likely resolve once the pancreatitis is resolved.

♦ Extra care and observation will need to be given to diabetic patients with pancreatitis because they may show some insulin resistance. Also, necessary dietary adjustments for patients with pancreatitis may also require an adjustment in their insulin dose. Blood glucose levels should be watched carefully while in hospital and post treatment until blood glucose levels are stable and the insulin dosage is properly adjusted.

♦ Chronic pancreatitis may occur after an acute pancreatitis episode due to scarring of the exocrine pancreas.

♦ Exocrine Pancreatic Insufficiency (EPI) - The absence of pancreatic digestive enzymes. Food passes through the digestive tract without being absorbed. Signs include: soft, pale and voluminous stools, weight loss, greasy soiling of the area around the rectum and sometimes the entire hair coat. Treatment includes replacement therapy of pancreatic enzymes in the diet.

  

Long term Management

Weight loss in obese patients is important. When a single attack of acute pancreatitis occurs, avoiding a high fat diet may be all that is necessary to prevent another attack. Table scraps and garbage raids should be avoided. There is no harm in adding pancreatic enzymes to the patient’s diet but they may not help. If the pancreatitis recurs, a low fat diet will be necessary for the rest of the patient’s life.