Chapter 113 - acute pancreatitis Flashcards
what factors have been associated with increased mortality in dogs with severe acute pancreatitis?
middle aged/older
overweight
history of prior/recurrent GI disturbances
concurrent endocrinopathies (DM, hypoT, hyperA)
dog breed predispositions to panc?
Yorkies
Miniature schnauzers
Cockers
4 most common clinical findings in cats with acute panc?
lethargy, anorexia, dehydration, hypothermia
+/- icterus, pallor
+/- signs of concurrent disease may predominate
(vomiting & abdominal pain less frequent)
common concurrent diseases in cats with panc?
hepatic lipidosis IBD interstitial nephritis/other kidney disease DM cholangitis/cholangiohep
proposed initial event in studies of animal models of panc?
abnormal fusion of normally segregated lysosomes with zymogen granules (catalytically inactive pancreatic enzymes)
–> premature activation of trypsinogen to trypsin +/- changes in signal transduction, intracellular pH, increased intracellular iCa2+
trypsin –> activates other proenzymes
how does does phospholipase A2 promote development of ALI/ARDS?
degradation of surfactant
how does trypsin effect the kallikrein-kinin system?
effects?
actives;
- -> vasodilation, hypotension, possibly AKI
- -> coagulation & fibrinolytic pathways - microvascular thromboses, DIC
how does elastin effect vascular permeability?
increased permeability - degradation of elastin in vessel walls
relative polycythemia in pancreatitis is associated with more severe disease in dogs - T/F
F - not known in dogs, assoc with more severe disease in humans
why may a dog with pancreatitis by hyperglycemic? is this common?
common
- stress induced increases in endogenous cortisol and catecholamines (increased glycogenolysis, decreased insulin production, peripheral insulin resistance)
- increased glucagon production by alpha cells in islets of langerhans (increased glycogenolysis)
- overt DM
risk factors for increased morbidity/mortality in cats with acute panc?
ionised hypocalcemia (common) hepatic lipidosis other concurrent diseases
radiographic signs of pancreatitis in dogs
increased density & loss of detail in right cranial abdomen
displacement of descending duodenum to the right
widening of angle between proximal duodenum & pylorus
caudal displacement of transverse colon
gastric distention
static gas patterns suggestive of ileus in descending duodenum & transverse colon
when is calcium supplementation indicated in hypocalcemic patients with acute panc? why not sooner?
signs of tetany
potential for exacerbation of free radical production and cellular injury
how did low-dose dopamine (5mcg/kg/min) effect pancreatic inflammation in an experimental feline model of acute panc?
reduced panceatic inflammation by decreasing microvascular permeability
DDx for tachypneic dogs with acute panc
ALI/ARDS aspiration pneumonia pleural effusion PTE overhydration pre-existing cardiopulmonary disease pain metabolic acidosis hyperthermia
