Pancreatitis in Dogs

pancreatitis in dogsThe pancreas is a thin, elongated organ that is shaped a bit like a pounded piece of chicken tenderloin. The pancreas lies along the initial portion of the small intestine called the duodenum. As the bile duct leaves the gall bladder, it traverses the pancreas before it enters the duodenum. The pancreas is probably best known for producing insulin, the hormone deficient in patients with diabetes. The pancreas also produces digestive enzymes essential for breakdown of food into its nutrient component parts.

-itis = inflammation
When a body part is inflamed, the suffix “-itis” modifies the root word to indicate the disease process of inflammation. Tennis elbow is really inflammation of the elbow bone and in doctor speak is epicondylitis. Inflammation of the appendix is appendicitis. Inflammation of the pancreas is pancreatitis. Pancreatitis is the most common condition of the dog and cat pancreas.

Causes of pancreatitis in dogs
The exact trigger for pancreatic inflammation in dogs is elusive. High fat meals, such as one obtained illicitly from the kitchen trash can are often blamed. Miniature Schnauzers are a dog breed with an increased risk of pancreatitis. Some diseases, like diabetes, hyperadrenocorticism and hypothyroidism increase a dog’s risk for pancreatitis. Blunt force trauma, like an automobile accident or a fall from a height can injure the pancreas and set off the inflammatory cascade. Whatever the cause of the inflammation, it promotes release of the digestive enzymes from the pancreatic cells. The enzyme release worsens the inflammation and also the clinical signs.

Clinical signs of pancreatitis
Pancreatitis can be either an acute fulminant illness or a more insidious, chronic problem. The list of clinical signs attributed to pancreatitis is quite long: vomiting, anorexia, weakness, dehydration, abdominal pain and fever. Dogs may assume a “praying” position with their elbows on the floor and their rump held high. Veterinarians interpret this as a response of the dog to abdominal pain. Since the major signs of pancreatitis are nonspecific, vomiting and anorexia, a battery of blood tests, x-rays, and an abdominal ultrasound may be necessary to establish a diagnosis of pancreatitis.

Treatment of pancreatitis
There is no specific treatment for pancreatitis like there are antibiotics for bacterial infection. Veterinarians treat dehydration with fluids, control vomiting with anti-nausea medications, and manage pain with pain medications. We also rest the gastrointestinal tract of patients with pancreatitis by withholding food and water until the vomiting ceases, followed by a low fat, bland diet. Dogs may take several days to recover from a serious case of pancreatitis.

To help prevent pancreatitis, restrict your dog’s intake of human foods, especially fatty ones. There will be less dieting for him in the new year and hopefully no pancreatitis to spoil his fun.

How Many Ways Can the Thyroid Malfunction?

The thyroid gland sits in the neck of dogs and cats, just below the voice box, and controls metabolic functions. Most of the time, a routine physical examination cannot detect the organ if it is normal. Last week, my patient list ran the gamut of thyroid dysfunction. Here is a sampling:

A Tail of Two Thyroids

Some days, strange coincidences happen in the waiting room. Today it was two dogs, both with thyroid cancer. Although measuring 15 centimeters in length, Beckey’s thyroid tumor had been surgically removed. The biopsy showed her tumor trying to escape into the lymph vessels and she was waiting her turn for chemotherapy, administered to halt the spread. Her treatment involves intravenous administration of two different chemotherapy agents and Beckey so far has sailed through the treatment with flying colors.

As Beckey was leaving the waiting room, Henry entered. A CT scan showed his thyroid tumor had already spread to the lymph nodes in his neck, precluding surgical removal. He was in for a check-up following completion of four radiation therapy treatments. Careful measurement of his tumor with calipers showed no increase in tumor size. The radiation treatment arrested tumor growth but had given him a sore esophagus. I had warned the owners about this type of side effect before we started treatment and told them to expect it to start resolving about two weeks after he completed his treatment. Henry did not disappoint us. Through telephone triage, we had already rearranged his medications to make his throat less painful. Henry spends summer in the country but in the fall he will come back to The AMC for measurement of the tumor and a chest x-ray.

Old Patient, New Problem

Otra’s family was worried. This cute kitty had completed chemotherapy for intestinal lymphoma about a year ago, but suddenly her weight plummeted. I could see from the look on their faces they were sure the cancer was back. Auscultation of Otra’s heart discovered a very elevated heart rate, prompting a test of her thyroid levels. Overactive thyroid glands ramp up the cat’s metabolism and they lose weight despite eating well, have a high heart rate, and are very peppy. An abdominal ultrasound showed no evidence the lymphoma had recurred and blood tests showed the thyroid was overactive. I sent thyroid-suppressing medications home with the relieved family and planned to reassess the thyroid hormone levels in two weeks.

Porterhouse to Pork Chop

Every time I saw Mango to follow up on a skin tumor that had been completely removed via surgery, she had gained another pound. This 60-pound Portuguese Water Dog should have weighed 50 pounds. The owners took her swimming, fed her diet food from feeding toys, and still she gained two more pounds. During an evaluation for a urinary tract infection, we noted her thyroid hormone levels were borderline low. When we retested the levels three months later, we confirmed diagnosis of hypothyroidism. Low thyroid function, the opposite of Otra’s problem, can cause weight gain. Since she started treatment with thyroid supplementation, Mango has lost nearly 6 pounds and gone from a 20-ounce porterhouse to a 4-ounce pork chop over the past few months!

There you have it, thyroid malfunction runs the gamut of disease: overactive, underactive, and two different tumors, all in one tiny organ.