The pancreas is a vital organ in the abdominal cavity near the stomach and liver that produces enzymes which aid in the digestion of food. The gland also secretes insulin, a hormone that helps to regulate the blood sugar levels. When the pancreas becomes diseased it will often release its digestive enzymes into itself rather than into the intestine where they normally go, this is called pancreatitis.
There are two main forms of acute or sudden onset pancreatitis: 1) the mild, edematous form and 2) the more severe, hemorrhagic form. A few dogs that recover from an acute episode of pancreatitis may continue to have recurrent bouts of the acute disease, known as chronic, relapsing pancreatitis. The associated inflammation allows digestive enzymes to spill into the abdominal cavity resulting in secondary damage to the liver, bile ducts, gall bladder, and intestines. The cause of pancreatitis is not known; however, there may be several contributory factors. It is often associated with eating a rich, fatty meal. In some cases, it may be associated with the administration of corticosteroids; however, some dogs with pancreatitis do not have exposure to either. Under normal conditions, digestive enzymes produced by the pancreas are activated when they reach the small intestines. In pancreatitis, these enzymes are activated prematurely in the pancreas instead of in the small intestines. This results in digestion of the pancreas itself. The clinical signs of pancreatitis are often variable, and the intensity of the disease will depend on the quantity of enzymes that are prematurely activated.
The diagnosis of pancreatitis is based on three criteria: clinical signs, laboratory tests, and radiographs (x-rays) and/or ultrasound examination. The disease is typically manifested by nausea, vomiting, fever, abdominal pain, and diarrhea. If the attack is severe, acute shock, depression, and death may occur. Laboratory tests usually reveal an elevated white blood cell count; however, an elevated white blood cell count may also be caused by many other things besides pancreatitis. The elevation of pancreatic enzymes in the blood is probably the most helpful criteria in detecting pancreatic disease, but some dogs with pancreatitis will have normal enzyme levels. Radiographs and ultrasound studies may show an area of inflammation in the location of the pancreas. Unfortunately, many dogs with pancreatitis will elude detection with any of these tests. Consequently, the diagnosis of pancreatitis may be tentative in some cases.
The successful management of pancreatitis will depend on early diagnosis and prompt medical therapy. The mild form of the disease is best treated by resting the pancreas from its role in digestion. The only way to "turn off" the pancreas is to withhold all oral fluids and food. This approach is accompanied by intravenous fluids to maintain normal fluid and electrolyte balance. The presence of shock necessitates the immediate and intense use of intravenous fluids and shock medications. Analgesics are often administered due to the intense pain pancreatitis often causes.