Exocrine Function

• Produces digestive enzymes (lipase, amylase, proteases)
• Secretes these enzymes into the small intestine to break down food

Endocrine Function

• Produces insulin and glucagon
• Regulates blood glucose levels

• Chronic Pancreatitis: Long-term, ongoing inflammation that can lead to permanent damage
• Acute-on-Chronic: Acute flare-ups in dogs with underlying chronic pancreatitis

• Sudden diet changes: Abrupt transitions to rich or unfamiliar foods
• Dietary indiscretion: Eating garbage, compost, or inappropriate items

• Diabetes mellitus: Increased risk, especially if poorly controlled
• Hypothyroidism: Associated with lipid metabolism abnormalities
• Cushing's disease (hyperadrenocorticism): Altered fat metabolism
• Obesity: Significant risk factor for pancreatitis

• Azathioprine and other immunosuppressants
• Potassium bromide (seizure medication)
• Organophosphate insecticides
• L-asparaginase (chemotherapy drug)

Some breeds have higher incidence:

• Miniature Schnauzers (often have familial hypertriglyceridemia)
• Yorkshire Terriers
• Cocker Spaniels
• Dachshunds
• Poodles
• Cavalier King Charles Spaniels

• Trauma to the abdomen
• Concurrent biliary disease
• Middle-aged to older dogs (though can occur at any age)
• Post-surgical complications

• Abdominal pain: Dogs may show a "praying position" (front legs down, rear elevated)
• Anorexia: Complete refusal to eat
• Lethargy: Marked decrease in activity
• Dehydration: Due to vomiting and reduced water intake
• Diarrhea: May or may not be present; can be bloody
• Fever: Often present in acute cases

Dogs may show abdominal pain through:

• Restlessness and inability to get comfortable
• Whimpering or reluctance to be touched
• Guarding the abdomen
• Hunched posture
• Reluctance to walk or move

In severe pancreatitis, complications may include:

• Shock
• Disseminated intravascular coagulation (DIC)
• Acute respiratory distress syndrome (ARDS)
• Cardiac arrhythmias
• Acute kidney injury
• Multi-organ failure

Chronic cases may present more subtly:

• Intermittent vomiting
• Chronic weight loss
• Poor appetite
• Intermittent abdominal discomfort
• Greasy, pale stools (if exocrine pancreatic insufficiency develops)
• Diabetes mellitus (if endocrine function is compromised)

Diagnosis begins with:

• Complete history, including recent diet and exposure to fatty foods
• Physical examination
• Assessment of pain response
• Evaluation of hydration status

Pancreatic Lipase Immunoreactivity (cPLI/Spec cPL)

• Gold standard blood test for pancreatitis
• Highly sensitive and specific for pancreatic inflammation
• SNAP cPL provides rapid in-house results
• Spec cPL provides quantitative measurement

Amylase and Lipase

• Traditional tests, but less specific than cPLI
• Can be elevated in kidney disease and other conditions
• Not recommended as sole diagnostic tests

Complete Blood Count (CBC)

• May show increased white blood cells (leukocytosis)
• Hemoconcentration from dehydration
• Anemia in severe cases

Serum Chemistry

• Liver enzyme elevations (ALT, ALP)
• Increased bilirubin
• Electrolyte imbalances
• Azotemia (elevated BUN/creatinine)
• Hypoglycemia or hyperglycemia

Abdominal Ultrasound

• Most useful imaging modality
• May show pancreatic enlargement, decreased echogenicity
• Peripancreatic fat inflammation ("hyperechoic mesentery")
• Fluid accumulation around pancreas
• Can help rule out other conditions

Radiographs

• Less specific than ultrasound
• May show loss of abdominal detail
• Displacement of stomach or duodenum
• Rule out foreign bodies or other causes

• Blood gas analysis for acid-base status
• C-reactive protein (inflammatory marker)

Most dogs with moderate to severe pancreatitis require hospitalization for:

• Intravenous fluid therapy
• Pain management
• Anti-nausea medications
• Nutritional support
• Monitoring

• Corrects dehydration and supports organ perfusion
• Crystalloid solutions (lactated Ringer's, 0.9% saline)
• Colloids may be needed in severe cases
• Electrolyte supplementation as needed

Pain control is essential:

• Opioids (buprenorphine, hydromorphone, fentanyl)
• Local anesthetic techniques (epidural, splanchnic nerve blocks)
• Lidocaine CRI in severe cases
• Multimodal approach often needed

Control vomiting and nausea with:

• Maropitant (Cerenia) - first-line choice
• Ondansetron
• Metoclopramide (also promotes gastric motility)

Early Enteral Nutrition

• Current recommendations favor early feeding (within 24-48 hours)
• Withholding food is no longer standard practice
• Small, frequent meals of low-fat, easily digestible food
• Appetite stimulants if needed (mirtazapine, capromorelin)

Feeding Options

• Ultra-low fat prescription diets
• Home-cooked bland diet (boiled chicken breast, white rice)
• Nasoesophageal or nasogastric tube if not eating voluntarily
• Parenteral nutrition in severe cases where enteral feeding isn't possible

• Used if secondary bacterial infection suspected
• Broad-spectrum coverage if sepsis is a concern

• Plasma transfusion in severe cases
• Treatment of concurrent conditions (diabetes, hypothyroidism)
• Enzyme supplementation if exocrine insufficiency develops

• Most dogs recover within 3-5 days with appropriate treatment
• May require ongoing dietary management

• Recovery may take 1-2 weeks
• Higher risk of recurrence
• May develop chronic pancreatitis

• Mortality rate can be 30-50% or higher
• Risk of complications (organ failure, DIC)
• Survivors may have long-term pancreatic damage

• Exocrine pancreatic insufficiency (EPI)
• Diabetes mellitus
• Chronic pain
• Recurrent episodes

• Repeat bloodwork to monitor enzyme levels
• Dietary compliance is essential
• Watch for signs of recurrence

• Avoid table scraps and fatty treats
• Prevent access to garbage and inappropriate foods
• Gradual diet transitions when changing foods
• Weight management in overweight dogs

• For dogs with history of pancreatitis: often less than 8% fat
• Prescription low-fat diets are available from major pet food companies

• Regular exercise appropriate for the dog's condition
• Stress reduction
• Prevent dietary indiscretion with secure garbage, fencing

For dogs with chronic pancreatitis:

• Regular veterinary check-ups
• Periodic blood work monitoring
• Watch for signs of diabetes or EPI
• Early intervention if symptoms recur

Dogs on long-term medications that increase risk:

• Discuss alternatives with your veterinarian
• More frequent monitoring may be needed
• Regular pancreatic enzyme level checks

• Seek veterinary care immediately if symptoms occur
• Don't wait to see if symptoms resolve on their own
• Keep emergency veterinary contact information accessible