Pancreatitis is inflammation involving the pancreas and surrounding structures. Both dogs and cats can be affected, but typically show very different signs. The inciting cause is usually not known. Highly fatty meals are theorized to play a part, similar to people. Any breed and either sex can be affected, but miniature and small breed dogs seem to be at a higher risk. Most commonly middle-aged to older animals are affected.
Dogs with pancreatitis typically show acute/sudden onset vomiting, abdominal pain, lethargy, anorexia and possibly diarrhea. Owners are usually very aware that the pet is sick and present the pet to a veterinarian relatively early. Cats, on the other hand, usually do not show obvious signs and have a more chronic/protracted disease course. Lethargy and anorexia are often all that cats display. Owners may not even realize that the cat is sick and may not seek the attention of a veterinarian, until complicating secondary conditions develop (i.e., hepatic lipidosis/fatty liver disease).
Diagnosis is based on characteristic clinical signs, possibly an increased lipase and/or amylase on a routine chemistry screen, characteristic x-ray changes, ultrasound and/or specialty blood tests (TLI and PLI). The diagnosis is typically more straightforward in dogs. In cats, it is often a diagnosis made after exclusion of other possible causes. Diagnosis of secondary complicating diseases, as mentioned above, is very important in cats, as well. The presence of secondary disease often makes the prognosis poorer.
Once vomiting is controlled, starting enteral nourishment (food) is of benefit as soon as possible. Feeding tube placement is often necessary if the pet is not willing/interested in eating on their own. Anti-nausea/vomiting medications, GI protectants, and pain medications are used in both species. IV fluids and other supportive and symptomatic therapies are instituted, as needed.
Prognosis varies greatly between patients based on severity of pancreatic injury, duration and the presence of concurrent or secondary disease. Dogs that suffer from a particularly hard bout can go on to develop a systemic inflammatory response syndrome, where multiple organs/systems sustain injury and can proceed to failure. The prognosis in this situation is very poor. Less severe bouts that are caught and treated early have a relatively good prognosis.
Unfortunately, it is difficult to predict who will develop a more severe bout. Cats overall seem to have a less favorable prognosis than dogs, particularly because many go unnoticed for long periods and develop secondary liver disease from not eating. It can take weeks to months to get these cats eating again for themselves. The key for a better prognosis in either species is early detection and treatment.
Recurrence of pancreatitis is not uncommon. Some dogs have many episodes over their lives and owners learn how to recognize one very early and prevent a full-blown event. Cats may not completely recover between episodes and develop a chronic, insidious, low-grade pancreatitis. Over time, this can cause significant weight loss and may predispose to the development of diabetes mellitus and/or loss of secretion of digestive enzymes by the pancreas (exocrine pancreatic insufficiency/EPI).
Long-term management of recurrent/relapsing cases often involves a high fiber diet with low fat content. Owners must restrict the pet to this diet alone and discontinue treats and/or people food. Diabetes mellitus is treated as usual, if it develops. Enzyme supplements on food are necessary if EPI results. The prognosis is reported to be good if the diet is strictly adhered to.