The pancreas is a vital gland that is in the abdomen, near the stomach, liver and intestines. The pancreas has two general jobs. One part of the pancreas makes insulin, which helps control your blood sugar levels. When the pancreas cannot adequately control blood sugar levels complications, such as diabetes mellitus, develop. The second part of the pancreas makes the enzymes that help you digest food properly so that nutrients can be absorbed by your body.
When the pancreas becomes inflamed, it is called pancreatitis. There can be severe consequences, including life threatening ones, both short term and long term, when pancreatitis develops.
There are two main types of pancreatitis, though there is often overlap between the two forms.
- In acute pancreatitis, it is possible for the pancreas to heal completely.
- In chronic pancreatitis there is long lasting or permanent damage, though your pet still has the potential to feel good and have a good quality of life.
Causes of pancreatitis can include:
- Genetics – Some breeds are much more likely to develop pancreatitis than others, including miniature Schnauzers, English Cocker spaniels, Cavalier King Charles spaniels, collies and Boxers. Siamese cats are more likely to develop pancreatitis than other cat breeds. However, any breed can develop pancreatitis.
- Diet – Either eating something too fatty or even eating something that isn’t particularly unhealthy but is too different from your pet’s normal diet can lead to pancreatitis.
- Trauma, such as being hit by a car, can cause pancreatitis.
- Medications – Some drugs, such as organophosphates (in older generation garden products), azathioprine, potassium bromide, l-asparaginase, cisplatin and thiazide diuretics, have been linked to pancreatitis. Unfortunately, it’s not possible to predict which animals will develop pancreatitis on these medications. There is a long standing debate as to whether steroids cause pancreatitis. More recent studies indicate that steroids are unlikely to be a major cause of pancreatitis in people or animals. In some types of pancreatitis steroids are a treatment.
- Infections – Bacterial abscesses in the pancreas are much, much less common in cats and dogs than in people. Other infections such as fungal disease, toxoplasmosis, flukes, Babesia, viruses and so on have been documented as causes of pancreatitis but these causes are often very specific to certain parts of the world.
- Certain hormonal diseases, such as hypothyroidism, have been linked with pancreatitis but the link isn’t always well understood.
- Cancer of the pancreas can cause pancreatitis.
Unfortunately, in quite a large number of cases, it is not known what caused a case of pancreatitis.
Cats have slightly different anatomy than dogs and commonly have pancreatitis associated with liver/gall bladder infections and/or inflammatory bowel disease (this is sometimes referred to as “triaditis”).
Signs & Symptoms
Not surprisingly, pancreatitis can look very different in different animals. Dogs will commonly have a painful abdomen and may stand in a “prayer position”, stretching their bodies out to decrease pressure on their abdomen. Vomiting and diarrhea are also very common in dogs. Loss of appetite or pain after eating can occur. You may notice that a dog with pancreatitis has jaundice (a yellow tint to the gums, whites of the eyes and/or skin).
Cats can have all of the above signs but are often much more subtle than dogs. Cats with pancreatitis will often not have obvious signs like vomiting or an obviously painful abdomen but, instead, may simply stop eating and start hiding more. Jaundice can also occur in cats.
Pancreatitis can be surprisingly difficult to diagnose, even with all the testing that is available but frequently requires the following:
- Basic bloodwork is essential because it allows your veterinarian to have information about many organ systems in your pet but it is common for changes to be too nonspecific for pancreatitis specifically to be diagnosed.
- A more specific test, called a PLI (pancreatic lipase immunoreactivity) can be a useful blood test but, like all tests, often is just a piece of the puzzle – your veterinarian needs to interpret this test in conjunction with other test results.
- Radiographs (X-rays) can be helpful to look for other causes of vomiting or abdominal pain (for example, checking to see if your pet has eaten an object that requires removal) but are rarely diagnostic for pancreatitis specifically.
- Abdominal ultrasound can be useful in detecting some cases of pancreatitis but not all. If the pancreas is very swollen, that can often be seen, and pancreatitis can be diagnosed. If the pancreas is not very swollen, ultrasound is much less helpful.
- In some cases, the only way to confidently diagnose pancreatitis is by collecting surgical biopsies for the laboratory to look at.
In short, your veterinarian may need to run different tests to determine whether your pet’s illness is due to pancreatitis or another disease that can cause similar clinical signs but may require different treatment.
Treatment & Aftercare
There are different ways to treat pancreatitis, and your veterinarian will discuss treatment options appropriate for your pet. The main goals of treatment are to keep your pet hydrated, treat any identifiable causes and address your pet’s nausea, vomiting and pain. As with most diseases, we have learned, over time, more about the best ways to treat pancreatitis. Therefore, recommendations have evolved over time and those made by veterinarians today may be different from recommendations you have heard in the past. As always, if you have questions about a recommendation, do not be afraid to ask for clarification or to seek the advice of a board certified veterinary internal medicine specialist.
To prevent pancreatitis from occurring again in the future, your veterinarian may make recommendations for some lifelong changes, including permanent diet changes and suggestions for supplements or medications to be continued indefinitely.
Some cases of pancreatitis will heal completely. In some cases, damage accumulates over time, particularly if your pet has had multiple episodes of pancreatitis (some of which you may not have been aware of!) or particularly severe pancreatitis has developed. In exceptionally severe cases, long term disease such as irreversible kidney disease, diabetes mellitus or pancreatic insufficiency may develop and may require lifelong treatment. Even with excellent treatment, severe cases of pancreatitis can result in death. Your veterinarian’s goals are to help you and your pet do well during a flare up of pancreatitis and also to help prevent or minimize future occurrences.
Fact Sheet Author:
Courtney North VMD, Diplomate ACVIM (SAIM)