Treatment of exocrine pancreatic insufficiency in dogs. Pancreas in a dog: insufficiency 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 of pancreatitis in dogs will give a positive result?

Disease Definition

Pancreatitis is an inflammation of the pancreas that causes the pancreas to stop working properly. After dysfunction occurs, digestive problems occur.

However, the danger lies not only in the inflammatory process, but also in the fact that they stop secreting digestive enzymes into the lumen of the duodenum, digestion of food is 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

It should be understood why a pancreas is needed in a dog. 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 causes of pancreatitis:

Wrong diet or its abrupt change (a sharp transition from one type to another).
genetic predisposition. Some breeds are prone to inflammation of the pancreas. These are boxers, toy terriers, spaniels, miniature poodle, miniature schnauzer, border collie, Yorkshire terrier.
Uncontrolled use of drugs. Self-medication is dangerous, since many drugs adversely affect the digestive organs. Therefore, you should not independently prescribe treatment for your pet. Only a veterinarian should decide which medication 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 the 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, the secondary develops against the background of an infectious disease or an inflammatory process in the gastrointestinal tract.

Symptoms

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

Complications

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

Sometimes there is sepsis (blood poisoning). In some cases, there is a constriction of passages for bile.

With chronic pancreatitis, a dog can develop diabetes mellitus.

dog treatment

Treatment of pancreatitis in a dog begins after confirmation of the diagnosis with the obligatory 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). Very rarely, surgical intervention or treatment in a hospital of a sick animal is required.

The first day will have to withstand the pet on a starvation diet. Only pure water at room temperature in very small quantities, but often (once an hour). Otherwise, there is a great risk of stretching the stomach, thereby provoking the activation of the pancreas.
If the dog is dehydrated, then the veterinarian injects saline solutions intravenously or subcutaneously. To restore the water-salt balance.
In acute cases, antiemetics, as well as painkillers and anti-inflammatory drugs, are prescribed.
Sometimes antibiotics are prescribed (so that bacteria do not aggravate the course of the disease) and probiotics to restore the intestinal microflora.

Dog food for pancreatitis

The diet needs to change. It should be rich in vitamins and minerals, be easily digestible. If your pet eats dry food, then give preference to those that are designed 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 nutrition).

Of the products, it is preferable to give low-fat yogurt or cottage cheese (without any additives, flavors and dyes), 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 a proper and healthy diet. No prohibited foods (fried, smoked, salty, spicy, etc.).
Do not forget about infectious diseases - be sure to vaccinate your pets.
Visit a veterinarian to examine your beloved dog and rule out inflammation in the digestive tract.
No self medication. Some medicines can speed up the process of destruction of the pancreas.
If the pet has a genetic predisposition to pancreatitis, then you need to visit a veterinarian for preventive examinations.

Over 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 nonpurulent (lymphocytic or eosinophilic) and purulent (neutrophilic) pancreatitis. Septicemic pancreatitis and exocrine pancreatic insufficiency (EPI) are less common. Primary exocrine pancreatic insufficiency is uncharacteristic for cats, secondary is more often observed in chronic or epizootic pancreatitis. With EPI, a lack of digestive enzymes leads to impaired digestion and absorption: the cat loses weight, she has an oily coat, an increase in stool volume, fatty faeces with a bad smell, or diarrhea is present. The occurrence of acute pancreatitis does not depend on the age or breed of the cat.
Symptoms are: anorexia, depression and lethargy, vomiting and diarrhea, abdominal pain may occur. In some cases, there is shortness of breath associated with 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, and symptoms are usually non-specific: intermittent anorexia or altered 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. A clinical blood test may reveal neutrophilia, neutropenia, monocytosis, mild aplastic anemia. 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 is often reduced. Ultrasound examinations may reveal enlargement of the pancreas, malformation 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 elevated in pancreatitis and lowered in exocrine pancreatic insufficiency. The level of immunoreactive pancreatic lipase is also determined, which increases with pancreatitis. Treatment for acute pancreatitis includes fluid therapy and systemic pain medications. Also used are blockers of H2 - histamine receptors (ranitidine), antiemetics (metoclopramide), antibiotics, drugs that support liver function and the blood coagulation system, as well as tube feeding.

Treatment for chronic panreatitis:

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

Supportive care:

an easily digestible, low-fat diet. Feeding in small portions at short intervals.

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

often vitamin K1 is administered, since in violation of the absorption of fats, 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 single case that will not recur, or it can lead to a chronic disease characterized by alternating periods of aggravation and weakening. The prognosis for PEI 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 phases of the same disease. Pancreatitis is a fairly common disease in small pets, but the issues of diagnosis and treatment

remain complex. Diagnosis of pancreatitis is one of the most difficult in both human gastroenterology and veterinary medicine, due to the non-specific manifestations of the clinical symptoms of the disease and laboratory research methods. In veterinary medicine, pancreatic diseases 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 atrophy of the pancreas.

The factor that causes damage to the pancreas in both dogs and cats is often unknown. As provoking factors, they suggest abundant feeding with fatty foods, obesity and hyperlipidemia (in miniature schnauzers), infections (toxoplasmosis and infectious peritonitis virus in cats, parvovirosis 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, Poodles are predisposed to this disease. In German Shepherds, pancreatic acinar atrophy is inherited and is transmitted in an autosomal recessive manner.

The pathogenesis (development mechanism) 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 younger than 4 years of age. German Shepherds and Rough Collies are predisposed to this condition. According to statistics, 70% of dogs with exocrine pancreatic insufficiency are German Shepherds, and 20% are Wire 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 old) with a median age of 6.5 years. The mean age of acute pancreatitis in cats is 7.3 years.

Sexual 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 drug use
See also reasons

Pathophysiology

The body has many defense mechanisms to prevent the gland from being self-digested by the digestive enzymes it secretes.
Under certain circumstances, these natural mechanisms fail, and self-digestion processes appear when enzymes begin to be activated inside the acinar cells.
Local and systemic tissues are damaged by the activity of released gland enzymes and free radicals.

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

Nutritional - hyperlipoproteinemia
Ischemia and injury of the pancreas (pancreas)
Duodenal reflux
Medications and toxins (see Contraindications)
Obstruction of the pancreatic ducts
chronic kidney disease
Hypercalcemia
Infectious agents (toxoplasma and feline peritonitis virus).

Course of the disease.Pancreatitis is conditionally divided into acute and chronic. Acute pancreatitis is an inflammation that develops suddenly without showing any signs before. 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 be mild (edematous) or severe, often fatal, 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 further chymotrypsin, lipase, etc.), edema and necrosis occur, damage to the walls of blood vessels. Clinical symptoms are quite diverse. Usually, dogs have lesions of the gastrointestinal tract (vomiting, diarrhea), pain in the epigastric region, weakness, 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 very characteristic of the supplication posture (the front legs are extended forward, the chest lies on the floor, and the back of the animal is raised). In cats, symptoms are often non-specific and may include lethargy, depression, and food refusal.

Affected Systems

Gastrointestinal - change in mobility (ileus) due to regional chemical peritonitis, localized 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 release of myocardial depressant factor in some animals.
Blood/lymphatic/immune - disseminated intravascular coagulation in some animals.

Clinical features typically associated with this disease.

Clinical signs in dogs are more related to gastrointestinal disturbances.

Clinical signs in cats are more vague, non-specific, and non-localized.

Lethargy/depression 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 displaying abnormal postures.
Diarrhea is more common in dogs than in cats

Usually dehydration
Some animals feel fluid in the distended bowel loops
Massive lesions are felt on 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, bleeding disorders, cardiac arrhythmias

. Let's list them point by point:

Arrhythmia
heart murmur
Muffled heart sounds
Prolongation of capillary filling time
Tachycardia
Weakness of the pulse
abnormal stretch
Anorexia
Ascites
Bloody feces
Decrease in the 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
Paleness of mucous membranes
Petechiae and ecchymosis
Polydipsia
tetraparesis
Trembling, tremor, fasciculation
Lack of weight, fatness
Weight loss
Coma, stupor
Stupidity, depression, lethargy
head tilt
Convulsions and fainting, convulsions, collapse
Anisocoria
nystagmus
Colic, abdominal pain
Pain from external pressure on the abdomen
Abnormal lung and pleural sounds
Muffled lung 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 a complete blood count, biochemistry, and urinalysis to rule out metabolic disease.
Perform an abdominal x-ray to rule out organ perforation; generalized loss of detail suggests pleural effusion; check for organomegaly, masses, radiopaque stones, obstructive disease, and radiopaque foreign bodies.
Do abdominal ultrasonography to rule out masses or organomegaly.
Perform paracentesis and fluid analysis if the patient has an effusion.
Special studies are needed, including gastrointestinal contrast radiography, excretory urography, cytological examination.

Blood and urine tests

Hemoconcentration, left shift leukocytosis, toxic neutrophils in many dogs
Cats are more variable and may have neutrophilia (30%) and nonregenerative anemia (26%)
Prerenal azotemia reflecting dehydration.
Liver enzyme activity (ALT and AST) is often high as a consequence of hepatic ischemia and exposure to pancreatic toxins.
Hyperbilirubinemia is more common in cats, caused by hepatocellular damage 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 activity is high in some dogs, but non-specific. Serum amylase and lipase activity is 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 rule out disease.
Urinalysis 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 an animal. Often there is an increase in transaminases (ALT, AST), leukocytosis, an increase in bilirubin, glucose. 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 rule out 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 the urine.
The recent development of the TPA ELISA test has made this study possible, but is not yet commercially available.

This assay is intended to be released as a specific and rapid aid in the diagnosis of acute pancreatitis.

Diagnostics

Contrary to popular belief, the activity of amylase and lipase 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, a foreign body of the intestine or enteritis, their level can be high.

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

Given the above, to diagnose pancreatitis, the doctor must analyze the symptoms of the animal, the data of the clinical and biochemical blood tests, the results of ultrasound and / or X-ray of the abdominal cavity. 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 a pathology requiring emergency surgical intervention.

Also, for the diagnosis of pancreatic insufficiency, the doctor uses the maximum data about the animal, taking into account its breed, age, symptoms, data on the presence of the disease in the parents, analysis of feces for the digestibility of food.

Visual diagnostic methods
X-ray of the abdomen

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

chest x-ray

Pulmonary edema
Pleural effusion
Changes suggestive of pulmonary embolism

Ultrasonography

Inhomogeneous dense and cystic masses show pancreatic abscesses.
Loss of normal pancreatic echogenicity 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 - medium edema
Necrotizing pancreatitis - grayish-yellow areas of necrosis of the pancreas accompanied by varying degrees of hemorrhage.
Chronic pancreatitis - the pancreas is small in size, dense, gray in color, may contain extensive adhesions with 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 loss for obesity
Avoiding a high-fat diet
Avoid taking drugs that can cause pancreatitis.

Possible Complications

Pulmonary edema
Heart rhythm disorders
Peritonitis
Hepatic lipidosis in cats
No response to supportive therapy.
Diabetes
Exocrine pancreatic insufficiency

Expected course and forecast

Good prognosis for animals with edematous pancreatitis. These patients generally respond well to treatment. Relapse or treatment failure is most commonly observed in animals that are prematurely administered oral nutrition.
Poor or cautious 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 needed to remove an 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 serious conditions as pulmonary edema, peritonitis, DIC. In therapy, analgesics (butorphanol), parenteral or enteral nutrition through a probe, plasma, and protease inhibitors (kontrykal) are also used. 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 volume of rehydration required for initial adjustment must be accurately calculated and entered 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 usual loss of potassium during 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 the use of 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 starting treatment. Evaluation of the results, complete blood count, total plasma protein, residual urea nitrogen, body weight, diuresis - 2 times a day.
Evaluation of rehydration therapy after 24 hours, correction of the intensity of fluid administration and its composition, respectively. Repeat serum chemistry to assess electrolytes and acid-base balance.
Repeat plasma enzyme assay (eg, lipase or TIRT) after 48 hours to assess inflammatory status.
Careful monitoring of systemic complications. Perform appropriate diagnostic tests as needed (see Complications).
Gradually introduce oral nutrition as clinical signs resolve.

Likar - VOLODYMYR GENADYOVYCH SUVOROV

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

Any dysfunction of the pancreas is fraught with serious complications. The sooner the owner notices any deterioration in the health of the dog, the sooner the disease will be detected, the easier and more effective the treatment.

Varieties of inflammatory processes in the pancreas of dogs

Animals need to eat right too.

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 lacks useful substances 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. You can learn about its performance 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

Pancreatic problems in a dog associated with exocrine insufficiency can be identified by the following signs:

nausea;
polyuria;
glycosuria;
diarrhea - rumbling and offensive;
polydipsia;
pancreatogenic stools - sour smell, voluminous foamy masses with remnants of undigested food.

Diagnostics

It is not often possible to make an accurate diagnosis of a dog during life. If during the initial examination the veterinarian manages to consider the described symptoms, he has every reason to suspect pancreopathy in the animal. To make a final medical conclusion, the four-legged animal is prescribed several functional tests.

Sectional view of pancreatitis

Atrophy of the pancreas

The atrophied pancreas resembles a parchment sheet - thin and transparent, preserving 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 the middle period of life.

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

Symptoms

Typical symptoms of this pathology:

the strongest feeling of hunger, before eating their own feces;
progressive wasting despite increased nutrition;
frequent bowel movements;
increased amount of feces;
the consistency of feces is frothy, clay-yellow in color with a sour smell;
rumbling or splashing sounds are made from the peritoneum.

On palpation, the large intestine is palpable full of feces. The coat of a sick animal is ruffled, does not hold well, the skin is dry, scaly.

Attacks of exacerbation of pathologies in the pancreas of a dog are accompanied by a strong pain syndrome. Physical well-being can be facilitated by 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 atrophy of the organ, if they can be detected in time, are treated. The diet of a sick animal should consist of lean meat and foods that do not contain carbohydrates or fats. A specially selected replacement therapy is recommended. The dog is prescribed drugs based on enzymes - "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. It develops in the form of islets of Langerhans, consists of beta cells. It produces insulin in excess, and this is fraught with chronic hypoglycemia, accelerated glucose synthesis.

Symptoms

The disease is accompanied by:

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

Treatment

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

The pancreas is very important for the life of a dog. The main functions of the life of the dog are assigned to it and you can’t joke with it. Any inflammation of the pancreas in dogs should be treated competently and in a timely manner, so you need to be attentive to even the slightest deterioration in the well-being of the animal.

Dehydration drip

Pancreatitis

The etiology of this disease has not yet been established and is not fully understood. 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, develop rapidly (from several hours to several days). In mild forms, they are concerned about:

vomit;
nausea;
ascites;
growing pain;
apathy;
jaundice;
heat;
anemia;
foul-smelling diarrhea.

Visual inspection 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;
salivation with bradycardia;
the dog assumes a pleading pose: it stretches its forelimbs forward, the torso (belly) is placed on the floor or the ground, and the back part is slightly raised.

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 - pancreatic cells die off. Total pancreatic necrosis leads to the death of the animal.

The disease can end in a complete recovery of the dog or acquire another recurrent form of the course - 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, the consequences will be more severe. Therefore, babies are at risk.

Medical treatment of pancreatitis

Diagnostics

Proper diagnosis is only half the path that an animal will have to go to recovery. The problem with lab tests is different in tetrapods than in humans. In a person with pancreatitis, the amount of lipase and amylase immediately increases. In a quadruped with the same diagnosis, the values of amylase with lipase may be within the normal range.

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

ultrasound examination of the peritoneum;
x-ray;
biopsy from the inner 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 the inflammation of the pancreas of a dog 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 urgent to 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 at least some organ becomes ill, all this can be forgotten. 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 distinguishes three types of enzymes that are necessary for the digestion of food. It is known that the food consumed by the dog contains water, mineral salts, macro- and microelements, proteins, fats and carbohydrates. Enzymes secreted by the pancreas are necessary just for the breakdown of proteins, fats and carbohydrates. But the significance of the body lies not only in this. In total, scientists distinguish two most important functions:

exocrine.
Endocrine.

What does each of them imply? The exocrine role is that the organ secretes the enzymes necessary for the proper digestion of food into the intestinal cavity of the dog. Endocrine function means that insulin is synthesized in the pancreas. A hormone without which the human or animal body cannot physically absorb glucose. With its deficiency or excess 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, there is almost always a violation of carbohydrate metabolism, on which fat, protein, water-salt metabolism depends, and other functions of the body also suffer. The body of the animal is 60% less nutritious, exhaustion develops.

What is pancreatitis, and what is it fraught with

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

Under normal conditions, the enzymes involved in the process of digestion are in the cells in an inactive state. 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 in recent years 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 on the basis of both visual signs and numerous diagnostic tests. You should not rely on external symptoms alone. At first, the pain may be minor, short-lived and infrequent. They arise spontaneously, the dog may squeal a couple of times from discomfort, and then continue to play as if nothing had happened. It is not surprising that the owners do not notice anything suspicious for a long time. So in the first months and even years of the development of the disease, the pain quickly arises, but just as quickly passes. But in the future, the disease begins to progress: the pain at the same time becomes stronger, attacks occur more often.

When do seizures most often occur? Usually immediately after a meal. During this period, abundant secretion and release of digestive enzymes occur, which, coupled with the sad state of the pancreas, causes an acute pain attack in the pet. So get in the habit of watching your dog carefully during and after feedings: if he starts to behave inappropriately, talk to the veterinarian immediately, or bring your pet in for a checkup right away. The sooner you start treating pancreatitis, the more likely it is to make a full recovery.

It is mandatory to take blood tests to check the level of enzymes in her serum, determine the leukocyte count, etc. X-ray of the abdominal cavity, pancreas, duodenography (visual check of the condition of the duodenum) is also used. Only on the basis of all the information received, the doctor can diagnose pancreatitis. After that, 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 activities

A sick pet is first put on a strict diet, and the more pronounced the pain syndrome, the stricter the diet will be. In some cases, complete hunger is shown, but for no more than one and a half days. Drinking for a sick dog at this time is provided without any restrictions. The first two weeks it is recommended to treat pancreatitis in a veterinary clinic (especially in difficult 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. Also shown are the broths on these meats, which include vegetables rubbed through a sieve (not potatoes!). For the period of exacerbation, all vegetables from the diet of a sick pet are removed completely.