Is Fido begging for that lovely fatty piece of ham with big brown eyes? Don’t let him talk you into it! This month we are focusing on pancreatitis. This is a common illness which, in dogs, is often caused by rich, fatty foods. We see more cases during the holiday season when dogs are fed (or scavenge) yummy celebration food and left-overs.
Cats also suffer from pancreatitis, although for them it isn’t diet-related (that doesn’t mean Felix should have the ham either, as fat can also cause upset tummies).
So what is pancreatitis?
Basically it means “inflammation of the pancreas”. The pancreas sits at the front of the abdomen. It produces powerful enzymes to break down food, especially fat. Too much fat at once overworks the pancreas and it becomes inflamed. Other things like breed (Schnauzers), being overweight, or having another illness like gastroenteritis, Cushing’s disease or kidney failure can make pancreatitis more likely.
If the pancreas becomes inflamed, digestive enzymes are released into surrounding tissue and cause localised peritonitis. This is very painful, and irritates the organs nearby – the stomach, the small intestine and the liver. These organs may themselves stop working properly. The pancreas also produces insulin, a hormone which regulates blood sugar levels. If the insulin-producing cells are affected, Diabetes can develop.
The most common symptoms in dogs are lethargy, not eating, vomiting, diarrhoea, adopting a “downward dog” stance, or stretching out their belly a lot. Cats most often present as just “off their food”, although they can also have vomiting and diarrhoea. Often patients are quite subdued, and they can quickly become dehydrated and even go into shock. Depending on how severe the episode is, your pet may appear just a little off-colour, or be collapsed and severely unwell.
It is important to seek veterinary attention if your pet is showing some, or all, of the above signs. There are multiple conditions which can cause these symptoms and some resolve easily with very little treatment. However, some, like pancreatitis, can be very serious. It is important to diagnose the cause of the symptoms so that the serious conditions can be treated promptly.
The diagnosis of pancreatitis is reached with a combination of examination, blood tests, ultrasound scans and x-rays.
How is pancreatitis treated?
Treatment of pancreatitis depends on its severity. One of the key components of treatment is to stop stimulating the pancreas to produce enzymes, which means that we need to starve these animals long enough to allow the pancreatic damage to resolve. This often takes 2-3 days so most patients require hospitalisation during this time and sustenance through intravenous fluids. Severe cases can be very challenging and may need longer periods of intensive treatment in hospital. Fortunately, mild cases can sometimes be treated as out-patients. Rapid diagnosis and treatment improves the speed of recovery – so is always the best approach.
Intravenous fluids and pain relief are the most important medications used in treating this disease. They allow the pancreas to heal and keeps your pet comfortable, also reducing inflammation. Once the period of starvation is over and we reintroduce food slowly , the choice of food is extremely important – patients need to keep eating high quality nutrients to help the body heal, but with very low fat levels. Fat stimulates the pancreas further and sustains the inflammation.
Medications to treat nausea, gut ulceration and liver inflammation are also often required. Pancreatitis is not caused by bacteria so antibiotics are only required if we believe there is a secondary infection present.
Simple cases of pancreatitis are monitored by their clinical signs (such as improved demeanour and return of appetite) and can go home when they are feeling better. More complicated cases required ongoing blood tests and ultrasound scans to measure improvement and adjust treatment if necessary.
Can pancreatitis be cured?
Most of the time, yes. However once your pet has had pancreatitis once they are more likely to have future episodes. Often we will recommend they eat a low-fat diet permanently. Sadly, about 10% of pancreatitis cases are so severe that the pet does not survive, despite our best efforts.
As any cat will tell you, THEY write the rules, we just follow them… It is likely that almost half of all cats have some form of pancreatitis in their lives. Most of the time we don’t know why it occurs. It is not caused by diet. Many cases are mild, and go unnoticed by us mere humans. The most common sign is reduced appetite. About one third will vomit or show pain when their abdomen is touched. Diarrhoea can occur, particularly with chronic cases. Cats can also become rapidly and seriously ill, just like dogs. They are more likely than dogs to have involvement of the liver, or to also develop diabetes concurrently.
Just like in dogs, starting intravenous fluid therapy as soon as possible is the most effective way to treat pancreatitis in cats. Antibiotics are used if the liver and gall bladder is also involved. Continued nutrition is extremely important – our nurses are very good at tempting cats to eat! – and we can also place feeding tubes directly into their stomachs to supply food if necessary.
What foods should my dog avoid? The best thing to feed your dog is a balanced dog food. Treats should be plain and low fat – dehydrated liver or chicken is ideal. Large quantities of anything fatty or rich can cause a pancreatitis episode. Typical foods to cause pancreatitis are meats (especially off cuts and leftovers) cheeses, bones and marrow, sauces, pates, desserts and ice-cream. These foods are also likely to cause weight gain – and overweight dogs are far more likely to develop pancreatitis.
Some products marketed as dog treats are actually quite high in fat, food colourings and flavourings, so please choose pet gifts carefully! When looking at your treats you should aim for them to have a fat content of less than 10%. Raw veggies are often great treats for dogs who are susceptible to pancreatitis.
We realise that Christmas is a special family time and hope that you get plenty of opportunity to spoil your fur babies – just hold off on the crackling!