Wednesday, February 02, 2011
Pancreatitis
is inflammation of the pancreas, the organ responsible for secreting enzymes
important for breaking down all types of food, and secreting insulin. Generally the presentation for this
issue is when a dog has eaten something more rich or fatty than he is used to
eating. This results in vomiting,
diarrhea or nausea and “not doing right.”
Cats can also get pancreatitis, with similar symptoms, or more commonly
just sullenness and hiding, being more subdued.
The
lab work in a “super chemistry” routinely checks amylase and lipase values,
which are a quick screen for pancreatitis through blood analysis. These are not always very sensitive or
specific, so they can sometimes be normal even if pancreatitis is the culprit
for the digestive woes. But it is
good practice to at least screen them.
It is astounding how many times these values are left out of bloodwork
requests, in lieu of a plain “chemistry.”
There are more sophisticated techniques such as “PLI” and “TLI” which
can get very pricey, but start with the amylase and lipase values. If they are elevated, then that is a
good indicator that the pancreas is inflamed. Ultrasounds do not show much of the pancreas, unless it is extremely
inflamed. Endoscopy will not
examine the pancreas at all. So
for all the high tech testing that can be done, it is surprising how often the
pancreas is overlooked as a cause of vomiting or diarrhea in pets.
Treatment
generally consists of fasting and fluid therapy—either intravenously if serious
or by subcutaneous administration, which is under the skin. This helps hydration and helps the body
to get rid of the excess enzymes the irritated pancreas is creating. Often antibiotics are used, although
there is controversy about whether or not this is a result of a bacterial
infection. There are excellent
acupuncture points for bringing amylase values down instantaneously, which also
help digestion, immune function, and well being in general. Traditional Chinese herbal
formulas also help tremendously for pancreatitis and digestive woes of all
sorts. They are well-tolerated
even despite vomiting.