Pancreatitis
Drugs such as potassium bromide, azathioprine, sulfonamides, and L-asparaginase are suspected causes of pancreatitis in susceptible dogs. Since potassium bromide is becoming more and more popular as a first line anti-seizure medication, it's important to know about pancreatitis so that you can catch and treat it early. The following article provides some basic information on pancreatitis.
| What is pancreatitis? | |
| What causes pancreatitis? | What are the symptoms? |
| How is pancreatitis diagnosed? | How is pancreatitis treated? |
What does the pancreas do?
The pancreas is one of the most important glands in the endocrine and digestive systems. It's located next to the stomach and the large intestine and serves two major functions in the body. One is to produce insulin and alter hormones that regulate carbohydrate metabolism. The other is to secrete inactive digestive enzymes which become active in the intestines and break down proteins, fats and carbohydrates so that they can be absorbed by the body.
In pancreatitis the digestive enzymes are activated prematurely in the pancreas instead of in the small intestines. This results in digestion of the pancreas itself. The inflammation allows digestive enzymes to spill into the abdominal cavity which may result in secondary damage to surrounding organs such as the liver, bile ducts, gall bladder and intestines.
Acute pancreatitis is always associated with sudden onset, however the severity of pancreatitis can be variable depending on the quantity of enzymes that are prematurely activated.
In most cases, the inciting cause of pancreatitis is unknown, however, there may be several contributing factors. Dogs who ingest a rich fatty meal (usually from the garbage can) are very prone to pancreatic inflammation afterwards. Other factors that seem to increase the risk of pancreatitis are obesity and middle age. Whether or not these factors are significant in drug induced pancreatitis is unknown.
The symptoms of pancreatitis are wide ranging and varying in severity. They may include some or all of the following:
Loss of appetite
Depression or lethargy
Nausea and Vomiting
Fever
Diarrhea
Abdominal pain (may be observed by abnormal postures)
If your dog is showing any of these signs, you should consult your veterinarian immediately.
How is pancreatitis diagnosed?
The diagnosis is made based on three criteria: clinical signs, laboratory tests and ultrasound examination. Laboratory tests usually show an elevation in white blood cell count, liver enzyme activities (ALT and ALP) are often high as a consequence of exposure to pancreatic toxins. Pancreatic enzymes lipase and amylase are frequently (but not always) elevated, however these elevations are not conclusive for pancreatitis. Serum levels three to four times the upper end of normal are significant.
Ultra sound will show solid or cystic mass lesions indicating pancreatic abscess. Biopsy may be required to confirm pancreatitis.
The successful management of pancreatitis depends on early diagnosis and prompt medical therapy. A mild case is best treated by resting the pancreas from it's role in digestion by withholding all oral fluids and food. This approach is accompanied by intravenous fluids to maintain normal fluid and electrolyte balance. The role of any medications in the incidence of pancreatitis should be seriously evaluated.
Tilley, LP, The 5 Minute
Veterinary Consult
Honeckman, DVM, DIPL ACVIM, Sept 1 2002 DVM Magazine
Gaskill CL, Cribb AE, pancreatitis associated with potassium
bromide/phenobarbital combination therapy in epileptic dogs, Canadian vet
Jour 2000;41:555-558
