internal med Flashcards
Pancreatits diagnostics-
total lipase
pancreatic lipase
cannot diagnose pancreatitis on lipse levels alone:-
azotemia and dehydration can effect levels- excreted in kidneys
steriods!- exogenous + endogenous vcan raise leves
gastric fb
gastric upsets
diagnostic imaging-
ultrasound- better for pancreatitis
radiography- better for other adbominal differentials
RARELY-
pancreatic biopsy- cats more than dogs as more often present chronic
not appropriate for acute cases
maybe part of full caelotomy
usefull in chronic cases in dog to but signs very vague
pancreatitis treatment
medical disease (rather than surgical, surgical need rare: severe jaundice or bile duct obstruction indication but even then, sterile abcess? )
supportive care:-
pain relief- opiods: methadone( more effective but can cause d++), buprenorphine (first line)- dependent on severity. Tend to avoid NSAIDs. Paracetamol in dogs (NOT CATS!!!)
antiemetic drugs- maropitant (licensed! Ease of use), ondazetron, mataclopromide( some vet specific versions. some prokinetic benefits)
fluid therapy- hartmans: dehydration? Losses? 2-3x maintenance if in dobt and monitor and adjust.
Electrolytes based on biochem- potassium
Check for shock
nutritional support- feeding- do not rest pancreas
survival imrpoved with food- get them eating once stopped vomiting OR place tube for nutrtional support. appities stim drugs poor choice
enterostomy tubes gold standard but impractical - o tube best
fat content in early stages unimportant
cri good in persistant vomiting cases- no tube
low fat more usefull in recovery phase
steroids- if immune mediated (cats)
to control inflammation (dogs)
