11 - exocrine pancreas disorders

Question 1

(pancreatitis)

1. cause not identified in most cases

Question 2

(pancreatitis - clinical signs in dogs)

1. recent meal with what is common?
2. 2 most common signs?
3. most frequent in what dogs?

Answer 2

1. a recent high fat meal
2. vomiting and abdominal pain
3. middle aged to older dogs

Question 3

(pancreatitis - clinical signs in cats)

1. Cx?

Answer 3

1. lethargy, anorexia, weight loss, with or w/o vomiting

Question 4

(pancreatitis - complications)

Question 5

(pancreatitis - diagnosis)

1. neutrophilic leukocytosis is common in dogs
2. serum amylase and lipase may be increased in dogs -> but what?
3. TLI always increased?

what test is more specific/sens?

4. what protein is a marker of systemic inflammation that is increased in pancreatitis?
5. ultrasound or radiographs more sens?
6. may need biopsy for diagnosis

Answer 5

2. lack spef/sens for dx of pancreatitis
3. may be increased, not always

serum pancreatic lipase immunoreactivity (PLI)

4. C-reactive protein
5. ultrasound

Question 6

(pancreatitis)

rarely need surgery

Question 7

(exocrine pancreatic insufficiency) (EPI))

(causes)

1. occurs when what percentage of pancreatic secretory capacity is lost?
2. the common cause in dogs is what?
3. chronic pancreatitis may result in EPI

Answer 7

1. 90%
2. pancreatic acinar atrophy (german shephards and collies most)

Question 8

(EPI)

1. Cx?

Answer 8

1. maldigestion, diarrhea, pale/fatty feces, wt loss, ^ appetite

Question 9

(EPI)

(diagnosis)

1. routine hematology, serum chem, UA, and radiographs are generally unremarkable
2. what is more accurate for dx, TLI or PLI?
3. fecal elastase activity may be useful
4. serum cobalamin is freq decreased in EPI but is also decreased in chronic intestinal disease

Answer 9

2. TLI

Question 10

(EPI)

(tx)

1. what is required for life?
2. what kind of diet is good?

Answer 10

1. pancreatic enzyme replacement therapy
2. highly digestible, low-fiber, low fat diet

Question 11

(exocrine pancreatic neoplasia)

1. usually what?
2. Cx are similar to what?
3. dx?
4. pancreatectomy may be palliative but is not curative. The prognosis is grave

Answer 11

1. adenocarcinomas which are aggressive with early metastasis
2. chronic pancreatitis
3. biopsy required - chem profile looks like chronic pancreatitis