Updated: May 24
What is the pancreas?
The pancreas is an important organ which produces enzymes to assist in food digestion, and hormones - such as insulin and glucagon - to regulate blood sugar or glucose metabolism. Digestive enzymes are passed into the small intestine and the hormones enter the bloodstream.
What is pancreatitis?
The pancreas can become inflamed in dogs (regardless of the breed, sex or age) and this condition is called pancreatitis. It may be either acute or chronic.
Sometimes dogs that recover from the acute form can continue to have recurrent bouts of the disease, which is then called chronic or relapsing pancreatitis.
What causes pancreatitis?
Pancreatic enzymes in the small intestine normally begin the process of food digestion. In the case of pancreatitis, these enzymes are activated prematurely in the pancreas before they have been passed to the small intestine, resulting in the pancreas itself being digested. Clinical signs of this vary, and the severity of the disease depends on the amount of enzymes that were triggered too soon.
The underlying cause of most cases of pancreatitis is unknown - it might be provoked by a fatty meal or medication but in many cases it arises spontaneously.
What are the clinical signs of pancreatitis?
Common signs include diarrhoea, nausea, vomiting, fever, decreased appetite, lethargy, and abdominal pain. When suffering, dogs may lower their front legs and head to the floor whilst raising their rear-end. If an attack is severe then the dog is at risk from extreme depression, acute shock or even death.
How is pancreatitis diagnosed?
Pancreatitis is often suspected when blood levels of amylase and lipase are raised, but a more specific test (Canine Pancreatic Lipase) can confirm pancreatitis more accurately.
How is pancreatitis treated?
Painkillers will be given to control the pain and intravenous fluids administered to maintain fluid/electrolyte balance. Many cases may require antibiotics, anti-inflammatory drugs and medications to control vomiting and diarrhoea.
Some dogs with pancreatitis are hospitalised for two to four days while intravenous fluids and medications are administered and food is gradually re-introduced.
What is the prognosis?
The outlook for dogs with pancreatitis depends on the severity of the disease and the initial response to therapy. For dogs that require repeated hospitalisation the future can be uncertain but the majority of cases can - with careful handling - be considered manageable.
Will there be any long-term problems?
With severe or repeated episodes of pancreatitis, long-term damage can occur, leading to two potential serious conditions. In some cases, a large amount of cells that produce digestive enzymes are destroyed, which can lead to digestion problems. This is termed exocrine pancreatic insufficiency (EPI) and can be treated with daily administration of an enzyme replacement powder. In other cases, a significant number of insulin-producing cells are destroyed and this can lead to the onset of diabetes.
Management of these conditions is a very important factor in treatment success.
It can be disheartening but most dogs can live a comfortable life of normal length.
DIETARY MANAGEMENT OF PANCREATITIS:
It is common for fat levels to be lowered in diets intended for pets with pancreatitis as this may reduce the chances of pancreatitis recurring.
Fat recommendations vary a little depending on your pet. Current recommendations are to reduce fat to 10% by dry matter in pancreatitis cases where the dog is very overweight or has a concurrent condition called hypertriglyceridemia (high blood fats). For dogs who are a normal weight and have a normal level of blood fats, less than 15% dry matter is sufficient.
It is important to remember that low fat is NOT NO fat. Some fat is still necessary for normal living processes: some vitamins (fat-soluble ADEK vitamins) NEED fat to be transported and a total lack of it will result in deficiencies:
Lack of vitamin A can compromise vision.
Lack of vitamin D will result in osteomalacia (bone wasting).
Vitamin E is an essential antioxidant. Without it, cell damage occurs which is important since dogs with pancreatitis already need MORE vitamin E than usual.
Lack of vitamin K will cause bleeding disorders.
Omega 3s are fats but used at correct levels have very positive effects (explained underneath).
Linoleic acid is vital for the coat: dogs with pancreatitis can also have itchy, flakey hair.
Increasing EPA/DHA (specific types of omega 3s)
Increasing levels of these omega 3 fatty acids in the diet can reduce inflammation and evidence indicates that they can also reduce hyper-triglyceridaemia (high blood fats).
Given that hyper-triglyceridaemia is a predisposing factor to pancreatitis, this is very important.
VetChef recipes are formulated to supportive levels EPA/DHA. As a rough guide, we look to provide around 0.5g per 10kg of bodyweight although some pets may require more or less. This depends on concurrent conditions and other medications or ingredients in their diet.
Zinc is vital for the immune system as it improves the gut barrier and can reduce stomach acidity (this may improve nausea). It can also protect the liver.
Zinc absorption can also be reduced by antacids: these are commonly used in pets with nausea due to pancreatitis so providing plenty of zinc is especially important in these cases. The current recommendation is to provide around three times the usual minimum level of zinc.
Increasing B Vitamins
B vitamins are water soluble and are quickly lost from the body through diarrhoea, vomiting or low food intakes. Lack of B vitamins can exacerbate gut signs, cause anaemia and reduce the appetite so it’s important to provide plenty for pets that have pancreatitis. Vetchef recipes account for this with increased levels of vitamin B.
Does my dog need pancreatic enzymes?
Pancreatitis and pancreatic insufficiency are not the same condition although they can occasionally occur together.
If your dog has pancreatic insufficiency (diagnosed using a test called a TLI or Trypsin Like Immunoreactivity) then your vet will prescribe suitable digestive enzymes. Most pets with pancreatitis alone do not require pancreatic enzymes.
All chemical reactions in the body produce reactive ‘waste’ particles called ‘free radicals’ that have the potential to damage nearby cells. In normal pets these are neutralised by internal antioxidants, but in pets where levels of inflammation are higher, the number of free radicals are increased and can surpass the body’s ability to tackle them all.
Increasing antioxidants can help to combat this by nullifying as many free radicals as possible. These antioxidants include vitamins E and C as well as plant-based antioxidants like betacarotene or lycopene from fruit and vegetables.
There is some debate as to whether it is necessary to reduce dietary protein in pets with pancreatitis. Suggestions to reduce protein are mostly taken from human studies and it is currently unclear whether or not it is helpful in dogs.
Protein levels in VetChef pancreatitis diets are not deliberately restricted unless there are other medical conditions present that require it.
What if my pet also has IBD?
Some pets will have pancreatitis as part of a larger complex of diseases. This sometimes means there is inflammation of the gut or liver, too.
For these conditions, more dietary alterations might be required - for example using diets based on vegetarian proteins or diets made with less allergenic ingredients. Your VetChef nutritionist will help you to choose suitable recipes if your pet has multiple conditions.
If your dog suffers from pancreatitis, a VetChef Premium plan will provide Prescription Homemade recipes and supplements to support your dog's nutritional health.
Small Animal Clinical Nutrition - Mark Morris Institute
CONTROVERSIES IN THE NUTRITIONAL MANAGEMENT OF PANCREATITIS Justin Shmalberg, DVM, Diplomate ACVN & ACVSMR University of Florida
ACVN NUTRITION NOTES Peer Reviewed