Ch 9 Pancreas Flashcards
What is the approximate reference thickness of a normal pancreas in a medium-sized dog (15–30 kg)?
a) 0.5 cm
b) 1 cm
c) 2 cm
d) 3 cm
b) 1 cm
Which of the following statements about the canine pancreas is TRUE?
a) The pancreatic duct is not visible in normal dogs.
b) Pancreatic thickness correlates with age but not body weight.
c) A diffusely hyperechoic pancreas can still be normal if the size is appropriate.
d) The pancreas is always hypoechoic in normal dogs.
c) A diffusely hyperechoic pancreas can still be normal if the size is appropriate.
In older cats, the pancreatic duct diameter ______________.
increases - it can dilate up to 2.5mm without concurrent disease (Hecht, 2006, 2007)
In acute pancreatitis, the pancreas is:
Diffusely enlarged and hypoechoic, with hyperechoic surrounding fat
Acute pancreatitis
Which changes of the stomach and duodenum can happen concurrently with pancreatitis?
Mural thickening and edema. This can occasionally also affect the transverse colon.
Why is surrounding fat hyperechoic in acute pancreatitis?
Can be due to edema, inflammation or fat saponification.
What did Penninck et al. (2013) find regarding pancreatic thickness and duct diameter?
a) They correlate with age but not body weight.
b) They correlate with body weight but not age.
c) They do not correlate with age or body weight.
d) They correlate equally with age and body weight.
b) They correlate with body weight but not age.
Causes of pancreatic edema (“tiger stripes” appearance)
Pancreatic edema may be associated with pancreatitis (Figure 9.8A,B), although it can also be caused by hypoalbuminemia or portal hypertension (Figure 9.8C) (Lamb 1999).
Pseudocysts are caused by ________, contain _______ (fluid content) and are surrounded by __________ (type of tissue). They have been reported in ______ (species - dogs/cats/both). On occasion, they can cause _______ (a complication).
- pancreatitis
- secretions from a ruptured duct (NOT inflammatory or cellular)
- fibrous tissue capsule
- cats and dogs
- EHBO
Retention cysts are caused by _____________.
blockage of the pancreatic duct
What 3 types of cysts occur in the pancreas?
- Congenital cyst
- Pseudocyst (caused by cavitation, burst ducts - secondary to pancreatitis)
- Retention cyst (caused by duct obstruction, also secondary to pancreatitis)
Pancreatic abscesses are more common in dogs/cats.
dogs
Can you differentiate retention cysts from pseudocysts or congenital cysts on US?
no; they can also be mistaken for a pseudobladder (dilated segment of the pancreatic duct, unknown cause)
The CBD is more readily visible in dogs/cats.
cats
In dogs, the CBD diameter has a normal maximum of ___ mm.
3mm
In cats, the CBD diameter has a normal maximum of ___ mm.
4mm
How does pancreatitis cause EHBO?
(pancreatitis associated bile duct obstruction (PABDO))
Inflammation causes swelling of the pancreatic duct (which is close to the common bile duct) and if chronic, fibrosis. Also cysts secondary to pancreatitis can cause mechanical compression > EHBO.
What is the most likely diagnosis in this elderly cat’s pancreas (the hypoechoic nodules)?
nodular hyperplasia
https://todaysveterinarypractice.com/radiology-imaging/small-animal-abdominal-ultrasonography-pancreas/
Why (in theory) do cats (but not dogs) get triaditis?
Because the CBD and pancreatic duct are fused before entering at the major duodenal papilla, and any reflux of duodenal juices/bacteria is likelier to be shared into both the pancreas and bile ducts.
In dogs, the CBD and pancreatic duct are separate and so sharing of bacteria is less likely.
German Shepherd dogs are more prone to which pancreatic disease?
EPI
EPI is more prevalent in which dog breed?
German Shepherd dogs
Which cells are affected with EPI?
Acinar cells, which produce amylase, lipase and trypsin
How does the cause of EPI typically differ in dogs versus cats?
In dogs (like GSD) it is usually caused by acinar cell ATROPHY, whereas in cats, it is caused by end-stage pancreatitis - the acinar cells are damaged (e.g. fibrosis).
