Pancreatitis in Dogs

What is pancreatitis?

The pancreas is a vital organ on the right side of the abdomen adjacent to the stomach. The pancreas produces enzymes to assist in food digestion and hormones such as insulin, which regulates blood sugar or glucose metabolism. The digestive enzymes are secreted into the small intestine, and the hormones enter the bloodstream.

When the pancreas becomes inflamed, the condition is called pancreatitis. Pancreatitis commonly occurs in dogs. There is no age, sex, or breed predisposition. Pancreatitis may be acute or chronic.

Acute pancreatitis may either take a mild, edematous (swelling) form or a more severe, hemorrhagic (bleeding from within or around the pancreas) form. The associated inflammation allows digestive enzymes from the pancreas to spill into the abdominal cavity resulting in secondary damage to the liver, bile ducts, gall bladder, and intestines. A few dogs who recover from an acute episode of pancreatitis may continue to have recurrent bouts of the disease, which is then called chronic or relapsing pancreatitis.

What causes pancreatitis?

Normally, pancreatic enzymes are produced in an inactive state and travel through the pancreatic duct to the duodenum, part of the small intestine. Once they reach the small intestine, they are activated to begin digestion. With pancreatitis, these enzymes are activated prematurely in the pancreas instead of later in the small intestine. 

Think of this as a time-release capsule that suddenly bursts before it reaches its intended target; in this case, the pancreatic enzymes start to digest before they should. This results in the digestion of the pancreas itself. The clinical signs of pancreatitis are often variable, and the intensity of the disease will depend on the amount of enzymes that are prematurely activated.

The exact cause of pancreatitis is unknown, although it may be triggered in some cases by a fatty meal or corticosteroid administration. However, in many cases, it appears to occur spontaneously.

What are the clinical signs of pancreatitis?

The most common clinical signs include nausea, vomiting, fever, lethargy, abdominal pain, diarrhea, and decreased appetite. During an attack, dogs may take a 'praying position', with their rear end up in the air and their front legs and head lowered onto the floor. If the attack is severe, acute shock, severe depression, and even death may occur.

How is pancreatitis diagnosed?

Pancreatitis is usually diagnosed with laboratory testing. Tests may reveal elevations in white blood cells and/or pancreatic enzymes. In recent years, newer pancreatic tests have become available to diagnose pancreatitis more accurately. The SPEC-CPL test, which stands for Specific Canine Pancreatic Lipase test, can be run in the clinic quickly, providing a positive or negative result. See the handout “Pancreatitis in Dogs - Pancreas-Specific Lipase” for further details on this test.

"Some dogs with pancreatitis, especially chronic pancreatitis, 
will escape detection with many of these tests."

Ultrasound studies often diagnose pancreatic inflammation or local peritonitis caused by this condition. Unfortunately, some dogs with pancreatitis, especially chronic pancreatitis, will escape detection with many of these tests. Consequently, the diagnosis of pancreatitis may be tentative or presumptive in some cases and based solely on clinical signs and medical history. 

How is pancreatitis treated?

Successful pancreatitis management depends on early diagnosis and prompt medical therapy. With mild pancreatitis, the treatment is supportive; it involves treating pain and nausea and feeding small amounts of a low-fat, easy-to-digest diet.

In severe cases, additional analgesics will be given to control the intense pain, along with the supportive care mentioned. Intravenous fluids may also be required to restore and maintain a normal fluid and electrolyte balance. Additional diagnostics and treatments may be needed depending on your dog’s condition.

Most dogs with severe pancreatitis are hospitalized for two to four days while intravenous fluids and medications are administered, and food is gradually re-introduced. With severe hemorrhagic pancreatitis, or in cases where the dog shows signs of systemic shock, intensive care will be necessary, with aggressive doses of intravenous fluids and medications to counteract shock.

Your veterinarian may also recommend a new treatment for pancreatitis: Fuzapladib sodium (Panoquell-CA1), an antibody therapy designed to reduce the clinical signs of pancreatitis by reducing inflammation inside the pancreas.

What is the prognosis of pancreatitis?

The prognosis depends on the severity of the disease and the response to initial therapy. Dogs that present with shock and depression have a very guarded prognosis. Most mild forms of pancreatitis have a good prognosis with aggressive treatment. Dogs not treated may progress to the hemorrhagic form and suffer severe consequences, including sudden death.

Will there be any long-term problems?

Most dogs recover without any long-term consequences. However, with severe or repeated episodes of pancreatitis, one or more of the following problems may develop:

• If a significant number of cells that produce digestive enzymes are destroyed, a lack of proper food digestion may follow. This is known as exocrine pancreatic insufficiency (EPI) and can be treated with daily administration of an enzyme replacement powder.
• If a significant number of cells that produce insulin are destroyed, diabetes mellitus can result.
• In rare cases, painful adhesions between the abdominal organs may occur due to pancreatitis.

Dogs with chronic pancreatitis are more likely to develop the above secondary conditions. Management of these conditions is a significant factor in treatment success.