Treatment of exocrine pancreatic insufficiency in dogs. Pancreas in a dog: failure and inflammation

Our smaller friends suffer from the same inflammatory processes in the body as humans. One of them is pancreatitis. What kind of disease is this, by what symptoms can it be recognized and, most importantly, what treatment for pancreatitis in dogs will give a positive result?

Definition of disease

Pancreatitis is an inflammation of the pancreas, causing the gland to stop working normally. After dysfunction occurs, digestive problems occur.

However, the danger lies not only in the inflammatory process, but also in the fact that the release of digestive enzymes into the lumen of the duodenum stops, and digestion of food becomes difficult. As a result, undigested food remains move through the intestines, nutrients are not absorbed.

But the gland itself, under the influence of produced, but secreted enzymes, begins to self-digest and break down.

But the most dangerous thing in pancreatitis is the development of diabetes mellitus, as well as damage to other internal organs due to the released toxins due to the destruction of the pancreas. However, this is a lengthy process, as an attentive owner notices symptoms of pancreatitis in their dog. Why does this disease develop?

Causes of pancreatitis

You should understand why a dog needs a pancreas. This is an endocrine gland that "produces" and secretes enzymes that help break down and better break down raw meat.

Initially, a dog is a predator that has been eating raw game for many millennia, so the process of digesting just such (thermally unprocessed) meat has been improved. Now domesticated dogs eat dry food, canned food and pates, so the amount of enzymes produced is not fully “used”. And as mentioned above, these enzymes destroy the pancreas itself, irritate, leading to its inflammation.

Here are the main reasons for the development of pancreatitis:

Wrong diet or its abrupt change (a sharp transition from one type to another).
Genetic predisposition. Some breeds are prone to pancreatic inflammation. These are boxers, toy terriers, spaniels, miniature poodles, miniature schnauzers, border collies, and Yorkshire terriers.
Uncontrolled use of drugs. Self-medication is dangerous, since many drugs adversely affect the digestive organs. Therefore, you should not prescribe treatment for your pet yourself. Only a veterinarian should decide what medicine your pet needs.
Infectious diseases. Especially if the causative agent of the disease affects the digestive organs.

Types of pancreatitis

Inflammation is classified according to its course - acute or chronic.

There are also primary and secondary pancreatitis. Primary is when inflammation is the underlying disease. Secondary develops as a consequence of another disease, and pancreatitis is already a symptom. Most often, secondary develops against the background of an infectious disease or inflammatory process in the gastrointestinal tract.

Symptoms

The most noticeable sign of pancreatitis in a dog is food refusal and depression. Less often, the animal exhibits excessive arousal.
When you feel the abdomen (but the pet must be placed on its back) to the left of the navel, the four-legged family member will experience severe pain.
Vomiting is observed, especially after eating. Therefore, even if the dog wants to eat, it simply cannot eat anything because of the immediate vomiting that occurs. You need to pay special attention to this symptom and immediately contact a veterinarian, because vomiting is a sign of another serious illness -.
Painful abdomen, bloating, the peritoneum is very tense (hard tummy).
Diarrhea or, conversely, constipation. In one case, the feces are like ointment, in the other it is too dense with an excess of starch.
A dog's inflamed pancreas can no longer produce insulin, causing his blood sugar to rise. If you do not take into account the symptoms of pancreatitis, an inexperienced doctor may decide that your pet has diabetes.

Complications

In advanced cases, the dog may develop necrosis of the pancreas, which can lead to peritonitis. Without surgical intervention, the animal may die.

Sometimes sepsis (blood poisoning) does occur. In some cases, there is constriction of the bile ducts.

With chronic pancreatitis, a dog may develop diabetes mellitus.

Dog treatment

Treatment of pancreatitis in a dog begins after confirmation of the diagnosis with mandatory clarification of the cause. Otherwise, it is impossible to eliminate the disease: it will constantly return and worsen, thereby “killing” the pancreas.

Therapy is carried out on an outpatient basis (at the owner’s home). It is extremely rare that surgical intervention or hospital treatment of a sick animal is required.

The first day you will have to keep your pet on a starvation diet. Only clean water at room temperature in very small quantities, but often (once an hour). Otherwise, there is a high risk of stretching the stomach, thereby triggering activation of the pancreas.
If the dog is dehydrated, the veterinarian administers saline solutions intravenously or subcutaneously. To restore water-salt balance.
In acute cases, antiemetics, as well as painkillers and anti-inflammatory drugs are prescribed.
Sometimes antibiotics are prescribed (to prevent bacteria from aggravating the disease) and probiotics to restore intestinal microflora.

Feeding a dog with pancreatitis

The diet must change. It should be rich in vitamins and microelements and be easily digestible. If your pet eats dry food, then give preference to those that are intended specifically for feeding dogs with a diseased pancreas or gastrointestinal tract. You will have to feed often, but in very small portions (the so-called fractional meals).

It is preferable to give low-fat yogurt or cottage cheese (without any additives, flavorings or dyes), and white meat (boiled). A few days after the start of treatment, if there is relief, you can add a little boiled rice or oatmeal.

Prevention

The best prevention is proper and healthy nutrition. No prohibited foods (fried, smoked, salted, spicy, etc.).
Don’t forget about infectious diseases - be sure to vaccinate your pets.
Visit your veterinarian to examine your beloved dog and rule out inflammatory processes in the digestive tract.
No self-medication. Some medications can speed up the process of destruction of the pancreas.
If your pet has a genetic predisposition to pancreatitis, then you need to visit a veterinarian for preventive examinations.

More than 90% are idiopathic. In the pancreas, digestive enzymes are activated, leading to its partial digestion, which leads to its inflammation. In cats, the most common forms of pancreatitis are chronic non-suppurative (lymphocytic or eosinophilic) and purulent (neutrophilic) pancreatitis. Septicemic pancreatitis and exocrine pancreatic insufficiency (EPI) are less common. Primary exocrine pancreatic insufficiency is not typical for cats; secondary exocrine insufficiency is more common in chronic or epizoodic pancreatitis. With EPI, a lack of digestive enzymes leads to impaired digestion and absorption: the cat loses weight, has oily fur, increased stool volume, fatty feces with a foul odor, or diarrhea. The occurrence of acute pancreatitis does not depend on the age or breed of the cat.
Symptoms include anorexia, depression and lethargy, vomiting and diarrhea, and abdominal pain may occur. In some cases, shortness of breath is observed due to the accumulation of fluid in the pleural cavity (due to pleural or pulmonary inflammation under the influence of inflammatory mediators circulating in the blood). Chronic pancreatitis occurs in middle-aged and older cats, the symptoms are usually non-specific: intermittent anorexia or variable appetite, vomiting or diarrhea may occur, weight loss and possible abdominal pain.

Establishing diagnosis:

Pancreatitis is very difficult to diagnose. Clinical and biochemical blood tests show nonspecific changes. In a clinical blood test, neutrophilia, neutropenia, monocytosis, mild aplastic anemia can be detected. A biochemical blood test can reveal hyperglobulinemia, bilirubinemia and increased levels of liver enzymes, hypercholesterolemia, hyperglycemia (with the development of concomitant diabetes mellitus). Determination of lipase and amylase in the blood rarely helps in the diagnosis of pancreatitis in cats, although in some cases an increase in the level of lipase is noted. In the chronic course of the disease, the level of cobalamin and folate in the blood often decreases. Ultrasound examinations may reveal enlargement of the pancreas, abnormal shape or heterogeneity, enlargement of the mesenteric lymph nodes, and the presence of ascites. To make a diagnosis, immunoreactive trypsin is determined. Immunoreactive trypsin may be increased in pancreatitis and decreased in exocrine pancreatic insufficiency. The level of immunoreactive pancreatic lipase, which increases with pancreatitis, is also determined. Treatment for acute pancreatitis includes fluid resuscitation and systemic pain medications. Also used are H2 histamine receptor blockers (ranitidine), antiemetics (metoclopramide), antibiotics, drugs that support liver function and the blood clotting system, as well as tube feeding.

Treatment for chronic panreatitis:

Pancreatic enzymes are replenished by adding them to food (Pancreatin, Creon). In non-purulent forms of pancreatitis, corticosteroids are used to reduce inflammation (prednisolone for a long time with a gradual reduction in dose).

Supportive care:

easy-to-digest low-fat diet. Feeding in small portions at short intervals.

There is a decrease in Cobalamin levels due to a lack of intrinsic pancreatic factor and malabsorption. In this regard, Cobalamin must be administered additionally.

Vitamin K1 is often administered, since if fat absorption is impaired, the absorption of fat-soluble vitamins is impaired, which can lead to impaired hemostasis.

Vitamin E is prescribed due to its antioxidant properties.

antacids reduce pain that occurs after eating (ranitidine, famotidine)

The prognosis depends on the severity of the lesion. Acute pancreatitis is difficult to treat, and it is impossible to determine whether the case of inflammation of the pancreas was a one-time event that will not recur or whether it can lead to a chronic disease characterized by alternating periods of complication and weakening. With EPI, the prognosis is good as long as the cat receives pancreatic enzymes exogenously.

Factors causing pancreatitis

Recently, many doctors have come to the conclusion that acute and chronic pancreatitis are a phase of one disease. Pancreatitis is a fairly common disease in small domestic animals, but the issues of diagnosis and treatment

remain complex. Diagnosis of pancreatitis is one of the most difficult both in humane gastroenterology and in veterinary medicine, which is associated with the nonspecificity of the manifestations of clinical symptoms of the disease and laboratory research methods. In veterinary medicine, diseases of the pancreas are divided into non-inflammatory (diabetes mellitus, acinar atrophy leading to exocrine pancreatic insufficiency), inflammatory (acute edematous pancreatitis, acute hemorrhagic pancreatitis, etc.), pancreatic tumors (insulinomas, adenocarcinomas) and fibrosis with pancreatic atrophy.

The factor that causes pancreatic damage in both dogs and cats often remains unknown. Provoking factors include heavy feeding of fatty foods, obesity and hyperlipidemia (in miniature schnauzers), infections (toxoplasmosis and infectious peritonitis virus in cats, parvovirus in dogs), obstruction of the pancreatic duct, ischemic and traumatic lesions of the pancreas caused by both surgery and and the injury itself, as well as a number of medications that can cause functional impairment.

Genetic predisposition. Miniature schnauzers, Yorkshire terriers, cocker spaniels, and poodles are predisposed to this disease. In German Shepherds, pancreatic acinar atrophy is hereditary and is transmitted in an autosomal recessive manner.

The pathogenesis (mechanism of development) of the disease includes autoimmune destruction of pancreatic tissue and atrophy of the acini. The affected areas of the gland decrease in size and cease to function.

Exocrine pancreatic insufficiency in dogs can develop at any age, but is more common in dogs under 4 years of age. German Shepherds and Rough Collies are predisposed to this disease. According to statistics, 70% of dogs with exocrine pancreatic insufficiency are German shepherds, and 20% are rough collies.

In cats The cause of the disease is usually pancreatitis, no genetic inheritance has been identified.

Breed predisposition

Miniature Schnauzers, Miniature Poodles, Cocker Spaniels
Siamese cats

Average age and age range

Acute pancreatitis is most common in middle-aged and older dogs (over 7 years of age), with an average age of 6.5 years. The average age of acute pancreatitis in cats is 7.3 years.

Sex predisposition

Bitches (dogs)

Risk factors (contributing to the development of pancreatitis)

Breed
Obesity
Intercurrent diseases in dogs such as diabetes mellitus, hyperadrenocorticism, chronic kidney failure, neoplasia
Recent medication use
See also reasons

Pathophysiology

The body has many protective mechanisms that prevent the gland from self-digesting the digestive enzymes that it secretes.
Under certain circumstances, these natural mechanisms fail and self-digestion occurs as enzymes become activated within the acinar cells.
Local and systemic tissues are damaged by the activity of released glandular enzymes and free radicals.

Causes
The initial causes of pancreatitis in both dogs and cats remain unknown. The following etiological factors need to be considered:

Nutritional – hyperlipoproteinemia
Ischemia and injury of the pancreas (pancreas)
Duodenal reflux
Medicines and toxins (see Contraindications)
Pancreatic duct obstruction
Chronic kidney disease
Hypercalcemia
Infectious agents (Toxoplasma and feline peritonitis virus).

Course of the disease.Pancreatitis is conventionally divided into acute and chronic. Acute pancreatitis is inflammation that develops suddenly without any prior symptoms. Chronic pancreatitis is a long-term inflammatory disease, which is often accompanied by irreversible morphological changes in the structure of the organ. Acute pancreatitis can have a mild (edematous) form or a severe form, often ending in death - in the form of hemorrhagic pancreatic necrosis. Normally, the pancreas has a number of protective mechanisms that prevent the activation of digestive enzymes in the gland itself and its self-digestion. As a result of premature activation of enzymes (trypsin, and then chymotrypsin, lipase, etc.), edema and necrosis, damage to the walls of blood vessels occur. Clinical symptoms are quite diverse. Typically, dogs experience damage to the gastrointestinal tract (vomiting, diarrhea), pain in the epigastric region, weakness, and refusal to feed. The disease very often develops some time after feeding. Severe forms of the disease are manifested by severe pain, which can quickly lead to the development of collapse and shock. This condition is characterized by a praying posture (the front legs are extended forward, the chest is on the floor, and the back of the animal is raised). In cats, symptoms are often non-specific - they can be lethargy, depression and refusal to feed.

Affected Systems

Gastrointestinal – changes in motility (ileus) due to regional chemical peritonitis, local or generalized peritonitis due to increased permeability; hepatic damage due to shock, pancreatic enzymes, inflammatory cell infiltrates and cholestasis.
Urinary – hypovolemia from loss of gastrointestinal secretions, which can cause prerenal azotemia.
Respiratory—pulmonary edema, pleural effusion, or pulmonary embolism in some animals.
Cardiovascular – Cardiac arrhythmia due to the release of myocardial depressant factor in some animals.
Blood/lymphatic/immune – disseminated intravascular coagulation in some animals.

Clinical signs typically manifested in this disease.

Clinical signs in dogs are more due to gastrointestinal disorders.

Clinical signs in cats are more vague, nonspecific, and nonlocalized.

Lethargy/depression is common in cats and dogs
Anorexia (in both species)
Vomiting is more common in dogs due to acute inflammation, less common in cats
Dogs may exhibit abdominal pain by showing abnormal postures.
Diarrhea is more common in dogs than in cats

Usually dehydration
In some animals, fluid is felt in distended intestinal loops
Massive damage is felt upon palpation
Fever is more common in dogs, and fever and hypothermia have been noted in cats.
Jaundice is more common in cats than in dogs.

Less common systemic abnormalities include respiratory distress, coagulation disorders, cardiac arrhythmias

. Let's list them point by point:

Arrhythmia
heart murmur
Muffled heart sounds
Prolongation of capillary refill time
Tachycardia
Weakness of the pulse
abnormal stretch
Anorexia
Ascites
Bloody feces
Reduced amount of feces
Diarrhea
Hematemesis
Melena
Vomiting, regurgitation
Ataxia, discoordination
Dysmetria, hypermetria, hypometria
Fever, pyrexia
Generalized weakness, paresis, paralysis
Inability to stand
Hypothermia
Jaundice
Abdominal masses
Obesity
Pale mucous membranes
Petechiae and ecchymosis
Polydipsia
Tetraparesis
Trembling, tremor, fasciculation
Lack of weight, fatness
Weight loss
Coma, stupor
Stupidity, depression, lethargy
Head tilt
Seizures and fainting, convulsions, collapse
Anisocoria
Nystagmus
Colic, abdominal pain
Pain from external pressure on the abdomen
Abnormal pulmonary and pleural sounds
Muffling pulmonary and pleural sounds
Dyspnea
Nose bleed
Tachypnea
Cold skin, ears, limbs
Glucosuria
Hematuria
Hemoglobinuria or myoglobinuria
Ketonuria
Polyuria
Proteinuria

Differential diagnosis

Differentiate acute pancreatitis from other abdominal pain
Perform complete blood count, biochemical, and urinalysis to rule out metabolic disease.
Perform abdominal radiography to exclude organ perforation; generalized loss of detail indicates pleural effusion; check for organomegaly, masses, radiopaque stones, obstructive disease, and radiopaque foreign bodies.
Perform abdominal ultrasonography to rule out the presence of masses or organomegaly.
Perform paracentesis and fluid analysis if the patient has an effusion.
Special studies are required, including gastrointestinal contrast radiography, excretory urography, and cytological examination.

Blood and urine tests

Hemoconcentration, leukocytosis with a left shift, toxic neutrophils in many dogs
In cats it is more variable and may have neutrophilia (30%) and non-regenerative anemia (26%)
Prerenal azotemia, reflecting dehydration.
The activity of liver enzymes (ALT and AST) is often high, as a consequence of liver ischemia and exposure to pancreatic toxins.
Hyperbilirubinemia, more common in cats, is caused by hepatocellular injury and intra- or extrahepatic obstruction.
Hyperglycemia in dogs and cats with necrotizing pancreatitis caused by hyperglucagonemia. Moderate hypoglycemia in some dogs. Cats with purulent pancreatitis may be hypoglycemic.
Hypercholesterolemia and hypertriglyceridemia often.
Serum amylase and lipase activities are high in some dogs, but are not a specific sign. Serum amylase and lipase activities are high in some animals with liver disease, kidney disease, or neoplasia in the absence of pancreatitis. Administration of dexamethasone may increase serum lipase concentrations in dogs. Lipase may be high or normal in cats. Amylase is usually normal or decreased in cats. In general, lipase activity is a more reliable marker in the diagnosis of pancreatitis. A normal serum lipase level does not exclude disease.
The urine test results are normal.

Laboratory tests The diagnosis can be indirectly confirmed by an increase in the activity of pancreatic amylase and lipase in the blood, but their normal content does not exclude inflammation of the pancreas. Conversely, an increase in these indicators in the absence of clinical symptoms of the disease does not indicate pancreatitis in the animal. An increase in transaminases (ALT, AST), leukocytosis, an increase in bilirubin, and glucose are often observed. Abroad, trypsin-like immunoreactivity in blood serum is measured in animals. On ultrasound, even an edematous pancreas is often not visualized. An indirect sign is the presence of gas (flatulence) in the gastrointestinal tract during radiography and ultrasound of the abdominal organs.

The trypsin immunoreactivity test (TIRT) is specific to the pancreas and high serum concentrations have been observed in some dogs and cats with pancreatitis.
TIRT tends to increase faster and returns to normal faster than amylase and lipase in dogs.
Reduced glomerular filtration may cause an increase in serum TIRT.
Normal TIRT values do not exclude pancreatitis.

ELISA for trypsinogen-activating peptide (TAP)

Acute pancreatitis stimulates intrapancreatic trypsinogen activation by tPA release into the blood serum. TPA is then excreted from the body in urine.
The recent development of an ELISA test for tPA has made this study possible but is not yet commercially available.

This analysis is intended to be produced for specific and rapid assistance in the diagnosis of acute pancreatitis.

Diagnostics

Contrary to popular belief, amylase and lipase activity in the blood are not decisive factors for the diagnosis of pancreatitis. The fact is that, unlike in humans, in acute pancreatitis in dogs and cats the level of these enzymes can be normal, while in other diseases of the gastrointestinal tract, for example, intestinal foreign body or enteritis, their level can be high.

A sensitive test for pancreatitis recently developed at Texas A&M University, called Pancreatic Lipase Immunoreactivity (PLI), is not yet available in Ukraine.

Considering the above, to diagnose pancreatitis, the doctor must analyze the animal’s symptoms, clinical and biochemical blood test data, and the results of ultrasound and/or abdominal x-ray. Since uncomplicated pancreatitis is treated therapeutically, and its symptoms are similar to those of intestinal obstruction, the main diagnostic task that the doctor solves is to exclude pathology that requires emergency surgical intervention.

Also, to diagnose pancreatic insufficiency, the doctor uses as much data as possible about the animal, taking into account its breed, age, symptoms, data on the presence of the disease in the parents, and fecal analysis for feed digestibility.

Visual diagnostic methods
X-ray of the abdominal cavity

Increased opacity of soft tissues in the right cranial abdominal compartment. Loss of visceral detail (ground glass) due to pleural effusion.
The presence of static gas in the proximal duodenum.
Widening of the angle between the pylorus and the proximal part of the duodenum.
Delayed transit of contrast from the stomach and proximal small intestine.

X-ray of the chest cavity

Pulmonary edema
Pleural effusion
Changes suggestive of pulmonary embolism

Ultrasonography

Heterogeneous dense and cystic masses indicate pancreatic abscesses.
Loss of normal echogenicity of the pancreas in many patients.

Other diagnostic tests

An ultrasound-guided biopsy can confirm the diagnosis.
Laparotomy and pancreatic biopsy may be required to identify or confirm pancreatitis.

Histopathological studies

Edematous pancreatitis - moderate edema
Necrotizing pancreatitis - grayish-yellow areas of pancreatic necrosis accompanied by varying degrees of hemorrhage.
Chronic pancreatitis - the pancreas is small in size, dense, gray in color, and may contain extensive adhesions to surrounding organs.
Microscopic changes include edema, parenchymal necrosis, and neutrophil cell infiltrate in animals with acute lesions. Chronic lesions are characterized by fibrosis of the pancreas around the ducts, hyperplasia of the ductal epithelium, and a mononuclear cell infiltrate.

Prevention

Weight reduction for obesity
Avoiding a high fat diet
Avoid taking medications that can cause pancreatitis.

Possible complications

Pulmonary edema
Heart rhythm disturbances
Peritonitis
Hepatic lipidosis in cats
Lack of response to maintenance therapy.
Diabetes
Exocrine pancreatic insufficiency

Expected course and forecast

Good prognosis for animals with edematous pancreatitis. These patients usually respond well to treatment. Relapse or treatment failure occurs most often in animals that are given oral nutrition prematurely.
Poor or guarded prognosis in animals with necrotizing pancreatitis and life-threatening complications.

Owner education (familiarization with the complexity of the disease and prognosis)

Discuss the need for prolonged hospitalization.
Discuss the possibility of complications such as relapse, diabetes mellitus, exocrine insufficiency.

Surgical aspects

Surgery may be necessary to remove acute pancreatic abscess or necrotic tissue in patients with necrotizing pancreatitis.
Extrahepatic obstruction caused by pancreatitis requires surgical correction.

Medicines and liquids.

Diet. In mild cases, a fasting diet for at least a day and painkillers and antispasmodics are indicated to reduce pancreatic secretion. In severe cases, hospitalization of the animal with intensive infusion therapy is necessary to prevent the development of such severe conditions as pulmonary edema, peritonitis, and disseminated intravascular coagulation syndrome. Analgesics (butorphanol), parenteral or enteral nutrition through a tube, plasma, and protease inhibitors (contrical) are also used in therapy. antacids and antiemetics, antisecretory drugs (Sandostatin), antioxidant drugs (Mexidol, Essentiale), antibiotic therapy, lytic mixtures, dopamine.

Aggressive intravenous therapy is the key to successful treatment. Balanced electrolyte solutions such as Ringer's lactate are the first choice in treatment. The amount of rehydration required for the initial adjustment must be accurately calculated and administered over the first 4-6 hours.
Colloids (dextrans and hetarstach) may be necessary to maintain pancreatic microcirculation.
After making up the deficiency, additional fluids are given to provide support for the patient's needs and ongoing losses. Potassium chloride is needed because of the normal loss of potassium through vomiting.

Corticosteroids are only indicated for patients in shock.
Central antiemetics for patients with intractable vomiting are chlorpromazine (every 8 hours) and prochlorperazine (every 8 hours).
Antibiotics are needed if the patient has clinical or laboratory evidence of sepsis - penicillin G (every 6 hours), ampicillin sodium (every 8 hours) and possibly aminoglycosides.
Analgesics may become necessary to relieve abdominal pain: butorphanol (every 8 hours s.c.) is an effective remedy for dogs and cats.

Contraindications

Avoid using anticholinergic drugs such as atropine. These drugs have variable effects on pancreatic secretion and can cause generalized suppression of GI motility, leading to ileus.
Avoid the use of azathioprine, chlorothiazide, estrogen, furosemide, tetracycline, and sulfamethazole.

Warning

Use corticosteroids only in patients who are adequately hydrated due to corticosteroids' promotion of vasodilation. Corticosteroids may complicate pancreatitis.
Use phenothiazine antiemetics only in well hydrated patients, as these drugs have an antihypertensive effect.
Use dextrans cautiously in patients with hemorrhagic pancreatitis, as they may contribute to bleeding.

conclusions

Assessing the patient's hydration is especially important in the first 24 hours of treatment. Evaluation of the results, complete blood count, total plasma protein, residual urea nitrogen, body weight, diuresis - 2 times a day.
Assess rehydration therapy after 24 hours, adjust the intensity of fluid administration and its composition accordingly. Repeat serum chemistry panel to assess electrolytes and acid-base balance.
Repeat the plasma enzyme concentration test (eg, lipase or TIRT) after 48 hours to assess the status of the inflammatory process.
Closely monitor for systemic complications. Perform appropriate diagnostic tests as needed (see complications).
Gradually introduce oral nutrition as clinical signs resolve.

Likar - VOLODIMIR GENADIYOVYCH SUVOROV

Pathologies in the pancreas in dogs have become more frequent in recent years. It is difficult to identify them in the initial stage. The most common anomaly is considered to be pancreatitis in dogs. The complexity is explained by the fact that the pancreas provides the digestive system with the necessary hormones and enzymes. Violations can be detected only if characteristic symptoms are present. It is impossible to visually establish pathology based on symptoms. Using modern techniques and laboratory tests, it is possible to determine the nature of the pathology, severity and possible treatment mechanisms.

Any dysfunction of the pancreas is fraught with serious complications. The sooner the owner notices any deterioration in the dog’s well-being, the faster the disease will be identified, and the easier and more effective the treatment.

Types of inflammatory processes in the pancreas of dogs

Animals also need to eat right

The pancreas is considered extremely important for the digestive system. It is endowed with two important functions - endocrine and exocrine. The first is responsible for the synthesis of insulin for the absorption of glucose. The second is for the production of enzymes that promote the absorption of proteins, fats, carbohydrates.

Pancreatitis leads to a violation of carbohydrate metabolism, on which water, salt, protein and fat metabolism depends. Other vital systems also suffer from this pathology. The dog’s body does not receive nutrients by about 60%. Against this background, the dog begins to develop exhaustion.

Endocrine insufficiency

Pancreas (pancreas) of the dog is difficult to traditional methods of examination due to the complex anatomical location in the body of a quadruped. One can learn about its working capacity and condition only by the disturbed functions of the organs that are interconnected with it.

Exocrine insufficiency is manifested in a deficiency of enzymes, the inability of the stomach to digest food, and maintain normal intestinal pH. Under such conditions, in addition to digestive disorders, there is an increased reproduction of microbes, provoking the development of dysbacteriosis and the deterioration of all digestive processes. Exhaustion increases even when the dog eats heavily.

Symptoms

Problems with a dog's pancreas associated with exocrine insufficiency can be identified by the following signs:

nausea;
polyuria;
glucosuria;
diarrhea – rumbling and foul-smelling;
polydipsia;
pancreatogenic stool - sour odor, voluminous foamy masses with remnants of undigested food.

Diagnostics

It is rarely possible to make an accurate diagnosis of a dog during its lifetime. If during the initial examination the veterinarian manages to consider the described symptoms, he has every reason to suspect pancreaopathy in the animal. To make a final medical conclusion, the four-legged animal is prescribed several functional tests.

Sectional view of pancreatitis

Pancreatic atrophy

The atrophied pancreas resembles a parchment sheet - thin and transparent, retaining the ducts. The German Shepherd suffers from this disease more often than other breeds. The etiopathogenesis of the disease is unknown. Dogs are born with a healthy organ, atrophy begins to appear in the first few months of life, but can develop in middle life.

The reasons for the development of pancreatic atrophy have not yet been established and have not been thoroughly studied.

Symptoms

Typical symptoms of this pathology:

extreme feeling of hunger, to the point of eating one’s own feces;
progressive exhaustion, despite increased nutrition;
frequent bowel movements;
increased amount of feces;
the consistency of stool is foamy, clay-yellow in color with a sour odor;
rumbling or splashing sounds are made from the peritoneum.

Upon palpation, the large intestine is felt full of feces. The fur of a sick animal is tousled, does not adhere well, and the skin is dry and scaly.

Attacks of exacerbation of pathologies in the dog's pancreas are accompanied by severe pain. You can ease your physical well-being with a subcutaneous injection of No-Shpy. The injection is replaced with a tablet if the dog is able to swallow it.

Treatment

Symptoms of pancreatic disease in a dog associated with organ atrophy, if they can be identified in time, are treated. The diet of a sick animal should consist of lean meat and foods that do not contain carbohydrates or fats. Specially selected replacement therapy is recommended. The dog is prescribed enzyme-based drugs - "Panzinorm" or "Pancreatin" with painkillers - and an antibiotic. If treatment does not give the desired result, euthanasia is recommended for the animal.

View of a dog feeling unwell

Insulinoma

Infrequently, this pathology is also diagnosed. Insulinoma in dogs is a hormonally active neoplasm. Develops in the form of islets of Langerhans and consists of beta cells. Produces insulin in excess amounts, and this is fraught with chronic hypoglycemia and accelerated glucose synthesis.

Symptoms

The disease is accompanied by:

ataxia;
epileptic convulsions;
muscle tremors;
insulin shock (hypoglycemic coma) in the last stages of its course.

Treatment

A dog with this pathology undergoes a partial pancreatectomy - surgical intervention. Before this, the dog must be on a therapeutic diet. The surgery is performed under general anesthesia.

The pancreas is very important for a dog’s life. She is entrusted with the main functions of the dog’s life and cannot be joked with. Any inflammation of the pancreas in dogs must be treated competently and in a timely manner, so you need to be attentive to even the most minor deterioration in the animal’s well-being.

Dropper for dehydration

Pancreatitis

The etiology of this disease has not yet been established and has not been fully studied. Acute pancreatitis in dogs is organ necrosis, which can be caused by enzymatic autolysis and impregnation of the same pathogenic muscle cells.

Symptoms

Signs of pancreatitis in dogs appear suddenly and develop rapidly (from several hours to several days). In mild forms the concern is:

vomit;
nausea;
ascites;
increasing pain;
apathy;
jaundice;
heat;
anemia;
foul (smelly) diarrhea.

Visual examination of the animal by a veterinarian

Symptoms of pancreatitis in a dog with severe form:

severe, unbearable pain that can cause a state of shock or collapse;
drooling with bradycardia;
the dog takes a supplicating pose: stretches its forelimbs forward, places its torso (stomach) on the floor or ground, slightly raises its hindquarters.

Palpation reveals acute pain in the peritoneum, especially on its walls. Laboratory analysis of urine and blood shows high levels of amylase, and immediately - almost in the first minutes of the development of the disease.

Necrotizing pancreatitis is considered the last stage - the death of pancreatic cells occurs. Total pancreatic necrosis leads to the death of the animal.

The disease can result in a complete recovery of the dog or acquire another recurrent form of progression - chronic pancreatitis, which is no less dangerous. In severe and advanced forms: in the presence of peritonitis, a state of shock or collapse, the disease is fraught with death in the first day and even hours of the development of the disease.

It must be remembered that pancreatitis in a puppy is more difficult to tolerate and the consequences will be more severe. Therefore, children are at risk.

Drug treatment of pancreatitis

Diagnostics

A competent diagnosis is only half the path an animal will have to go through to recovery. The problem with laboratory tests in quadrupeds is different than in humans. In humans with pancreatitis, the amount of lipase and amylase immediately increases. In a quadruped with the same diagnosis, amylase and lipase levels may be within normal limits.

To establish an accurate medical conclusion, the dog is additionally assigned:

ultrasound examination of the peritoneum;
X-ray;
biopsy from the internal walls;
laboratory analysis of urine.

In addition to these studies, the dog is subjected to a visual examination by a veterinarian. Then, only the sick animal is prescribed drugs, the scheme and duration of administration are determined.

Feeding a sick animal

Treatment

On the first day of the discovery of the disease, the dog is put on a starvation diet. It is permissible to give the dog only water, in small quantities.
You can treat a sick dog with antibiotics only in cases where it is advised by a veterinarian.
To avoid dehydration, the animal is placed on an intravenous drip with saline.
In the acute course of pancreatitis, painkillers, antiemetic and antibacterial drugs, as well as anti-inflammatory drugs are prescribed.

Treatment for pancreatitis in dogs at home should be ordered by a veterinarian after an accurate diagnosis has been made. The treatment regimen and drugs should be prescribed by a specialist after passing all tests and diagnostics. You need to understand that this disease is very dangerous and experimenting with the health of the dog is unacceptable.

Complications and consequences

The symptoms and treatment of pancreatitis in dogs must be determined in time. This disease is very insidious and fraught with consequences:

In advanced stages, pancreatitis can turn into pancreatic necrosis, then into peritonitis. And here you can not do without surgical intervention. Otherwise, the dog will die.
Sometimes veterinarians can state complications such as blood poisoning, sepsis.
Very rarely, but there are cases of constriction of bile ducts.
Another complication of chronic pancreatitis is the development of diabetes mellitus.

Regular medical examinations as a prevention of the development of pancreatitis

It is dangerous to let all inflammation of a dog’s pancreas take its course. It is easier to prevent than to treat later - every owner of a four-legged must know this. You need to be attentive to your pet, look closely at his well-being more often, and conduct preventive medical examinations. At the slightest deterioration, it is necessary to urgently show it to the veterinarian.

The digestive system of animals and humans is a complex complex, each element of which is extremely important for the normal, full life of your pet. If any organ gets sick, you can forget about all this. Inflammation of the pancreas in dogs, better known as pancreatitis, is very dangerous.

The weight of the pancreas is only 70 grams. Despite its tiny size, the organ is extremely important for digestion. It secretes three types of enzymes that are necessary to digest food. It is known that the food consumed by a dog contains water, mineral salts, macro- and microelements, proteins, fats and carbohydrates. Enzymes secreted by the pancreas are necessary specifically for the breakdown of proteins, fats and carbohydrates. But the importance of the organ lies not only in this. In total, scientists identify two most important functions:

exocrine.
Endocrine.

What does each of them mean? The exocrine role is that the organ secretes enzymes necessary for the proper digestion of food into the dog's intestinal cavity. Endocrine function means that Insulin is synthesized in the pancreas. A hormone without which the human or animal body physically cannot absorb glucose. With its deficiency or excess it occurs. A deadly disease that claims many thousands of lives every year. And yes, diabetes is a common complication of pancreatitis in animals and humans.

Remember! With pancreatitis, a violation of carbohydrate metabolism almost always occurs, on which fat, protein, water-salt metabolism depends, and other body functions also suffer. The animal's body lacks nutrients by 60%, and exhaustion develops.

What is pancreatitis and what does it mean?

– inflammation of the pancreas. It is accompanied, as we have already said, by a serious disruption of all functions of the organ, many of which are vital. Why can the endocrine gland, securely hidden in the abdominal cavity, become inflamed? After all, in the way of bacteria and other traditional inflammatory factors there is a reliable barrier in the form of lymph nodes and other defenses of the body?

Under normal conditions, the enzymes involved in the process of digestion are in an inactive state in the cells. Damage to the pancreas occurs when these substances are activated in the organ itself before they are released into the duodenum. The consequences of this are catastrophic: the body simply begins to digest itself. This further leads to abscesses, bleeding and complete necrosis of the pancreas.

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Predisposing factors of pathology

There are many reasons why pancreatitis develops. Interestingly, in many cases, the lifestyle of a sick pet, its eating habits and dietary characteristics are of key importance. It is known that many dogs like to eat something spicy, sweet, they like fatter food, they love fried meat ... That's just d For animals, such treats are poison, their regular consumption just leads to inflammation. In addition, dogs often get sick, whose owners like to treat their pet for real and fictitious diseases on their own.

Pancreatitis is divided into acute and chronic. Interestingly, it is the “chronicle” of the disease that is found everywhere, and acute types are very rare. However, it is the pathologies in the acute form that are “in sight”, since their manifestations are difficult not to notice. The pain reaction is such that the dog simply rolls on the ground and howls from unbearable pain. Without immediate surgical intervention, the animal may be doomed.

Chronic pancreatitis, as we have already said, is much more common. As a rule, they are diagnosed in dogs aged six years and older. Although recently the trend towards “rejuvenation” of the disease is very clear. Interestingly, females get sick more often. The clinical picture, the severity of the development of the pathology completely depends on how severely the internal structures of the pancreas are affected. The larger the affected area, the more severe the pathology.

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Diagnosis of pancreatitis in dogs

The diagnosis is made based on both visual signs and numerous diagnostic studies. You should not rely on external symptoms of the disease alone. At first, the pain may be minor, short-lived and infrequent. They arise spontaneously, the dog can yelp a couple of times from unpleasant sensations, and then continue to play as if nothing had happened. It is not surprising that owners do not notice anything suspicious for a long time. So in the first months and even years of the development of the disease, pain quickly arises, but passes just as quickly. But later the disease begins to progress: the pain becomes more severe, attacks occur more often.

When do seizures most often occur? Immediately after eating, usually. During this period, abundant secretion and release of digestive enzymes occurs, which, coupled with the sad state of the pancreas, causes an acute pain attack in the pet. So get into the habit of carefully observing your dog during feeding and after it: if he begins to behave inappropriately, immediately talk to a veterinarian, or immediately bring your pet for an examination. The sooner you start treating pancreatitis, the greater the likelihood of a complete recovery.

It is mandatory to take blood tests to check the level of enzymes in her serum, determine the leukocyte formula, etc. X-rays of the abdominal cavity, pancreas, and duodenography (visual check of the condition of the duodenum) are also used. Only on the basis of all the information received, the doctor can diagnose pancreatitis. After this, treatment is prescribed. In especially difficult and implicit cases, a biopsy of the pancreas is strongly recommended: during the procedure, a piece of organ tissue is taken. It is used for microscopic analysis, cytological studies, and (which is especially valuable) as a material for seeding on nutrient media. In general, this is the only way to accurately know the type of pathogen responsible for the development of the inflammatory process.

Therapeutic measures

To begin with, a sick pet is put on a strict diet, and the more pronounced the pain syndrome is, the stricter the diet will be. In some cases, complete hunger is indicated, but for no more than a day and a half. During this time, the sick dog is provided with food without any restrictions. For the first two weeks, it is recommended to treat pancreatitis in a veterinary clinic (especially in complex cases). Then, as the pain subsides, the diet expands, vegetable soups and liquid cereals are allowed (but in small quantities), lean meats are allowed: turkey, chicken, rabbit. Broths made from these types of meat are also shown, which include vegetables (not potatoes!) that have been pureed through a sieve. During the period of exacerbation, all vegetables are completely removed from the diet of a sick pet.