Pancreatitis in Dogs: Symptoms, Treatment and Prognosis

Medically reviewed by: Kinga Wojtczak, Doctor of Veterinary Medicine, specialist in canine and feline diseases

The pancreas is one of the most important organs in a dog's body. Unfortunately, it is also very vulnerable to dysfunction. Often as a result of dietary mistakes or other factors, inflammation of the pancreas develops. A species that is particularly prone to this disease is the dog. What is the pancreas, and how does it become inflamed? Is it life-threatening for my four-legged friend? And finally, how is pancreatitis in dogs treated and prevented?

You will find answers to these and other questions about pancreatitis in dogs in this article.

What is the pancreas and why is it so important?

The pancreas (Latin: pancreas) lies along the duodenum and stomach in dogs. This inconspicuous organ plays a very important role in the body. Above all, it has an exocrine function—it is the pancreas that makes digestion of food possible. How does this happen? The pancreas is responsible for secreting digestive juices, that is, enzymes that break down nutrients, as well as substances responsible for neutralizing the acidity of partly digested food.

The digestive juices I mentioned are secreted in the form of inactive proenzymes and stored in vesicles called zymogen granules. Released into the lumen of the pancreatic acini, they travel through the system of pancreatic ducts to the duodenum, where they are activated and take part in digesting the individual components of food.

Most of the enzymes in pancreatic juice are:

• protein-digesting enzymes (proteolytic),
• fat-digesting enzymes (lipolytic),
• carbohydrate-digesting enzymes (amylolytic),
• nucleic acid-digesting enzymes (nucleases).

Put simply, they break complex, long-chain food compounds down into simpler, shorter ones, from which the body draws energy or building material. In addition to producing these substances, the pancreas aids the absorption of vitamin B12, prevents bacteria from multiplying in the first part of the small intestine and also has a beneficial effect on the intestinal mucosa. Besides its digestive function, this organ also has endocrine functions.

The pancreatic islets, known as the islets of Langerhans, which make up about 2% of the organ's mass, produce, among other things:

• insulin,
• glucagon,
• somatostatin,
• pancreatic polypeptide.

These substances are mainly responsible for proper carbohydrate (sugar) metabolism in a dog's body. Disorders of the islets of Langerhans, in turn, can cause diabetes in animals.

Disorders of the exocrine part of the pancreas include:

• pancreatic insufficiency,
• tumors,
• pancreatitis.

This article is about pancreatitis. Read on to learn what this disease is and how it can be recognized.

What is pancreatitis in dogs?

There are two forms of pancreatitis:

1. Acute pancreatitis involves the sudden activation of proenzymes. Despite advances in science, we still do not fully know what causes it. AP (acute pancreatitis) leads to interstitial edema of the organ, autodigestion and damage to the pancreas and the surrounding organs. This is because the active pancreatic enzymes digest everything in their path.
2. Chronic pancreatitis is less common. It involves recurring or persistent inflammation. It is usually triggered by a harmful factor that can lead to destruction of the pancreatic parenchyma and improper functioning of the organ.

It is currently believed that 25% of cases of vomiting and diarrhea of unknown cause in dogs are in fact undiagnosed AP.

Acute pancreatitis in dogs

Not long ago, a small dog was brought to my clinic. On the morning of the visit he had had an episode of diarrhea, and during the night he had vomited several times. He was clearly in a great deal of abdominal pain. Misio, until then well behaved and affectionate with everyone, would not let anyone touch him. Because of the chronic liver failure he suffers from, he ate only a liver support diet, so food poisoning was unlikely…

A blood test showed that he was suffering from acute pancreatitis. Fortunately, with treatment everything returned to normal. Still, I kept wondering what could have caused such a severe reaction. Only a few days later did the owners admit that Misio had been given a small piece of bacon because, as they put it, he used to love it so much, and it was his birthday…

I see cases like this in my practice quite often. You should know that in Misio's case, his owner, who is very sensitive to every change in his behavior, reacted immediately. That is why his story ended so well. In many cases, however, things turn out differently… Acute pancreatitis is a very difficult opponent.

Causes of acute pancreatitis in dogs:

• a high-fat diet,
• obesity,
• lack of exercise,
• impaired blood flow to the pancreas after an accident,
• reflux,
• autoimmune diseases,
• obstruction and swelling of the pancreatic ducts (e.g., in ascariasis, a roundworm infection),
• organophosphate poisoning,
• drugs such as: * azathioprine, * sulfonamides, * L-asparaginase, * high doses of glucocorticoids, * long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs).
• breed, e.g., Miniature Schnauzers.

The truth, however, is that we often do not know how pancreatitis develops. One day a dog is the picture of health, then it has episodes of diarrhea, and a few days later it dies…

Pancreatitis is also classified into two forms:

1. edematous (mild),
2. hemorrhagic (severe).

The hemorrhagic form of pancreatitis often leads to autodigestion of the organ and thus to the animal's death. This is because, as a result of necrosis, the body releases substances that impair the function of the heart, liver, kidneys and lungs.

Symptoms of acute pancreatitis in dogs

Depending on the form of pancreatitis, the symptoms may be mild (edematous form) or very severe (hemorrhagic form). The symptoms are also often varied and nonspecific because of the general metabolic disturbance. What should worry you?

If you notice symptoms in your dog such as:

• sudden loss of appetite,
• vomiting,
• diarrhea,
• acute abdominal pain,
• fever,
• rapid breathing,
• weakness,
• depression,
• a change in the color of the mucous membranes.

See a veterinarian immediately!

Diagnosing pancreatitis in dogs

If the veterinarian suspects pancreatitis in your dog, they will probably recommend:

• a blood test that includes measuring cPL (canine pancreatic lipase),
• an ultrasound or X-ray examination.

In a complete blood count, especially in the early stage of the mild form of the disease or in the chronic form, there may be no changes at all. When the process flares up, the neutrophil count rises, monocytosis develops and so does anemia. In biochemistry tests, attention should be paid to the liver enzymes. In the acute form of pancreatitis, it is these parameters that rise first, which is an indication to measure pancreas-specific lipase (cPL). A positive cPL result indicates pancreatitis…

Blood biochemistry also measures lipase and amylase levels. An increase in them may also indicate inflammation. Note also that dogs with pancreatitis often have lipemic serum even after proper fasting before the test. This means that their blood contains too much fat. In some cases, this can be seen as early as when the blood is drawn.

Treating pancreatitis in dogs

Treatment of acute pancreatitis is based on four stages:

1. Reducing pancreatic activity.
2. Stabilizing the patient's condition.
3. Preventing further progression of the disease.
4. Managing complications.

Reducing pancreatic activity

A fast lasting several days used to be recommended; today prolonging it is not advised. Once vomiting is controlled with medication, feeding is resumed as early as possible—usually within 1–2 days—with small portions of an easily digestible, low-fat food. If the dog does not eat on its own, the veterinarian may feed it through a feeding tube.

Next, we switch the dog to a therapeutic diet with reduced fat and protein content, such as:

• Gastrointestinal Low Fat,
• Dog Intestinal,
• other diets for dogs with pancreatic diseases.

Fluid therapy is also important, preferably given as intravenous (IV) fluids. Depending on the patient's condition, Ringer's solution or NaCl solution with glucose is given.

Vitamin and mineral deficiencies are corrected with parenterally administered products such as:

• Duphalyte,
• Intravit,
• Combivit,
• Catosal.

Stabilizing the dog's condition

To stabilize the patient, anti-shock agents (glucocorticoids) and analgesics are used.

The best options in this case seem to be very potent drugs such as:

• Tramal (tramadol),
• fentanyl,
• buprenorphine.

It is also important to control vomiting because, on the one hand, it may be a consequence of AP, and on the other, it can itself trigger inflammation. Maropitant (Cerenia) works very well here. Antibiotic treatment is also indicated to protect against the body's own bacterial population in the pancreas.

Preventing further progression of the disease and managing complications

In some cases, an intravenous infusion of fresh plasma or fresh frozen plasma may also be necessary. A whole blood transfusion can also be performed. These procedures supply the dog's body with natural inhibitors of pancreatic enzymes.

AP can lead to a number of complications. The most commonly seen are:

• inflammation and necrosis of the peripancreatic fat,
• cholangiohepatitis (more common in cats),
• peritonitis.

In the above cases, in addition to the treatment already mentioned, the following are used:

• symptomatic treatment,
• drainage of fluid from the abdominal cavity,
• peritoneal lavage,
• antibiotic coverage,
• liver medications: * choleretics, * ursodeoxycholic acid (ursodiol),
• dietary supplements: * Vetahepar, * Epato, * Hepatiale forte.

Over the course of the disease, pathological bacterial overgrowth in the small intestine, reduced peristalsis and weakened local immunity may develop. In this case, tylosin (10–20 mg/kg twice a day) or metronidazole (10–15 mg/kg twice a day) is given for 3 weeks.

Prognosis for pancreatitis in dogs

So, as you can see, treating this disease is fraught with difficulties. If your dog goes into shock, the prognosis is poor; in other cases, you have to be prepared for complications. However, if action is taken quickly enough, your dog has a chance of recovery.

Diet for pancreatitis in dogs

Unfortunately, dogs that have had pancreatitis once tend to have relapses. Only proper care by their owners will keep them healthy. The most important thing is to control your dog's diet. First, stop giving your dog fatty foods, such as fatty raw meat and oils (e.g., flaxseed oil, so often used to improve coat quality). In my opinion, dogs that have once had pancreatitis should be fed therapeutic diets such as Gastrointestinal Low Fat and the like for the rest of their lives.

Second, have your dog's pancreas checked from time to time with regular blood tests—only early detection gives your dog a chance of full recovery.

Chronic pancreatitis in dogs

Chronic pancreatitis is diagnosed fairly rarely in dogs. It occurs in an asymptomatic form, as chronic progressive inflammation, or as recurrent inflammation. In dogs, we most often see the recurrent form.

Symptoms of chronic pancreatitis

It causes dogs to have intermittent episodes of diarrhea and vomiting, as well as digestive disturbances. In some cases, abdominal pain is seen. As for the causes of this disease, they are similar to those of acute pancreatitis. The test results may be similar too. Often, however, blood tests are not even done, because no one suspects pancreatitis…

The disease is often diagnosed at necropsy (postmortem examination) or laparotomy. The veterinarian can then see a change in the structure of the organ's parenchyma—calcification or fibrosis.

Treating chronic pancreatitis

Severe cases are treated similarly to acute pancreatitis. In mild cases, fasting is recommended.

Sometimes the veterinarian will also prescribe pancreatic enzymes, such as:

• Amyladol,
• Amylactiv.

In chronic pancreatitis, a low-fat diet is also recommended for the dog.

Summary

As you can see, dear Reader, pancreatitis, both acute and chronic, is a very insidious disease, and its treatment is complex. Unfortunately, when treatment is started too late, it often ends in the dog's death. However, by taking the right steps and having basic knowledge, you can prevent this serious disease in your four-legged friend. I hope my article will help you do just that.

Do you have questions about this disease? Let me know in the comments below the article, and I will reply as soon as I possibly can.

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