There are some chances you know little about the pancreas.

It’s not the most well-known organ.

But it’s vital!

No mammal, including humans, can live without it. But, surprisingly, pancreatitis – i.e. an inflammation of the pancreas – is a common condition in dogs. It may cause diabetes and can induce severe digestive problems.

What is the pancreas

The pancreas is a large gland located just below the stomach and very close to the proximal part of the small intestine, the duodenum.

  The pancreas is a remarkable organ in the way it has 2 roles: endocrine and exocrine.

• The exocrine gland: accounts for 95% of the pancreas volume. It releases in the small intestine digestive enzymes: amylase, lipase and trypsinogen. Amylase and lipase help digest complex carbohydrates and lipids respectively. Trypsinogen is an inactive form of trypsin which is involved in the breakdown of large proteins into smaller peptides.
• The endocrine gland accounts for the remaining 5%. It releases in the blood 2 very important hormones which control glycaemia. Insulin lowers blood glucose and facilitates the use of glucose by the body cells. Glucagon has a symmetrical role: it induces the release of the glycogen stored in the liver and increases blood glucose concentration.

When does pancreatitis occur

Pancreatitis occurs when trypsinogen is activated – i.e. transformed into trypsin – too early, when it is still in the pancreas and not yet arrived in the intestines.

Instead of breaking down food proteins, trypsin attacks the pancreas itself thus destroying cells and inducing inflammation ^[1].

The causes of pancreatitis have not been fully elucidated yet. But, scientists have identified some risk factors such as obesity, Cushing disease, and hypothyroidism. Some breeds seem to be more exposed to pancreatitis: Schnauzers, cavalier King Charles spaniels, Cocker spaniels, Shelties, Poodles, Yorkshire terriers, Dachshunds, and sled dogs.

As pancreatitis is one of the main causes of diabetes in dogs, it should be no surprise to often (30%) find it in diabetic dogs.

Of course, aging dogs are more exposed.

What a pancreatitis looks like in my dog

An acute phase of pancreatitis typically occurs when a dog ate food with high fat content which was not intended to him. He could have found it in the garbage or eaten the leftovers of his masters’ meals. He could also have ingested toxic chemical substances.

Pancreatitis may be an adverse event of some drugs ^[2].

As a result, the dog becomes lethargic, he vomits and/or has diarrhea. He doesn’t let you touch his belly.

It’s time to visit the vet.

She will look for the following symptoms:

1. Vomiting
2. Diarrhea
3. Abdominal pain
4. Loss of appetite
5. Lethargy
6. Dehydration
7. Fever

Vomiting, diarrhea, loss of appetite and dehydration are linked together and are caused by the inability to digest food.

Abdominal pain is a direct consequence of the inflammation in the pancreas region and fever comes from a secondary infection.

What your vet will do

If the symptoms are severe, the dog will need emergency care with fluids, anti-emetic drugs and painkillers.

The next step is to make the diagnosis, which is not straightforward. Abdominal pain is the most typical symptom of pancreatitis. And your vet will definitely put pancreatitis on her list of the possible diseases.

But all the other symptoms may be found in many other diseases ^[3]. They won’t help much.

This is why she will necessarily perform at least 2 complementary exams:

• One measures serum lipase that comes specifically from the pancreas (cPL = canine Pancreatic Lipase). These tests have a relatively high proportion of false positive (specificity < 81%): they can’t be the sole basis for the diagnosis ^[4].
• The other is an ultrasound examination that will rule out any other disorder such as peritonitis or an obstruction with a foreign object.

For greater certainty, your vet may propose you she performs a biopsy. It consists of taking a sample of pancreas tissue in your dog.  Needle biopsy is a simple and well tolerated procedure. It is reliable ^[5].

Treatment

For the least severe manifestations of the disease, the prognosis is good.

It is important that the animal starts to eat again as soon as possible. For this purpose, anti-emetic drugs may be prescribed.

On the long run, the treatment is dietary. It consists of a diet with very low fat content.

References

1. DVM 360: What pain What a pain in the gut: Canine pancreatitis
2. Merck Vet Manual on pets pancreatitis
3. Animal Patient’s symptom checker
4. Cridge H. et al.: Assays for the Diagnosis of Clinical Pancreatitis in Dogs
5. Cordner A. et al.: cytologic findings and diagnostic yieldin 92 dogs undergoing fine-needleaspiration of the pancreas