Gastrointestinal Diseases

Question 1

What is the aetiology of Pancreatitis?

Answer 1

Often idiopathic
Thought to be linked to:
- high fat diet
- some drugs e.g. corticosteroids
- may occur secondary to trauma or certain toxins

Question 2

What is the pathophysiology of pancreatitis?

Answer 2

Pancreatic enzymes are activated prematurely within the pancreas or an unable to exit the duodenum
The presence of these enzymes within pancreatic tissues results in autodigestion of pancreatic tissue.
This process causes inflammation and necrosis of the pancreas.

Question 3

What are the clinical signs of acute pancreatitis?

Answer 3

Anterior abdominal pain due to pancreatic tissue inflammation
Vomiting (due to electrolyte disturbance)
Depression
Anorexia (due to pain and nausea)
Shock - toxaemia
Pyrexia
Dehydration

Question 4

How can you diagnose Acute pancreatitis?

Answer 4

History and clinical signs
Physical exam
Spec cPL dogs & Spec fPL - blood tests to measure serum pancreatic lipase which indicates pancreatic damage. In house or external.
Trypsin-like immunoreactivity (TLI), amylase and lipase blood tests - less specific (high levels indicate pancreatitis; low indicate EPI)
Radiography - may be vague changes
Ultrasound - look at pancreatic tissue architecture
Biopsy - if suspected underlying neoplasia (care as can cause or further aggravate pancreatitis)

Question 5

What can pancreatitis lead to?

Answer 5

Exocrine Pancreatic Insufficiency

Question 6

What is the pathophysiology of Exocrine Pancreatic Insufficiency?

Answer 6

Inadequate production of digestive enzymes due to atrophy of pancreatic exocrine cells. (.i.e. failure of pancreatic enzymes to be activated or produced).
Animals are unable to digest foodstuffs fully leading to high volume of faeces containing undigested material.
Malabsorption leads to weight loss and increased appetite

Question 7

What are the clinical signs of Exocrine pancreatic insufficiency?

Answer 7

Polyphagic (always hungry) though losing weight
Large faecal volume
Stearorrhea (presence of fat in faeces) and undigested material
Flatulence
Poor coat condition
Muscle wastage (due to weight loss)

Question 8

What is the aetiology of exocrine pancreatic insufficiency?

Answer 8

Pancreatitis in cats - can leave pancreatic tissue damaged and with diminished function
Idiopathic
Fatty diet

Question 9

What are the preffered diagnostic tests for EPI?

Answer 9

1. Serum Trypsin-like immunoreactivity - looking for low levels to confirm disease
2. Faecal examination - looking for high volume and contains undigested food and fat