pancreas

Question 1

acute pancreatitis etiology

Answer 1

dogs: idiopathic
cocker spaniel, yorkie
obesity, dietary indiscretion, trauma, neoplasia, toxins, endocrinopathies

cats: less clear, bacterial infection

Question 2

pancreatitis pathophysiology

Answer 2

tripsinogen activation-> intracellular digestive enzymes activated
inflammation, necrosis, edema-> compromised circulation-> SIRS-> MODS

Question 3

pancreatitis C/S

Answer 3

variable
dogs: lethargy, anorexia, v+, painful abdomen, d+, fever icterus

cats: lethargy, anorexia, weight loss, hypothermia, v+

Question 4

acute pancreatitis ddx

Answer 4

GI FB, ulcers, GB disease, toxin ingestion, infectious gastroenteritis, neoplasia, metabolic disease

Question 5

acute pancreatitis dx

Answer 5

BW- neutrophilia w left shift, hemoconcentration, low platelets. increased liver enzymes, bilirubin, low cholesterol/Ca

cPLI/fPLI- detects pancreatic specific lipase (SNAP or spec test) SNAP to r/o, SPEC has cut off value

AXR- signal loop duodenum, effusion
abd U/S- hyperechoic fat, free fluid, FNA/biopsy

Question 6

acute pancreatitis tx

Answer 6

1. fluids, anti emetic, analgesia, nutrition (feeding tube)
2. abx when proven infection , FFP in DIC
3. panoquell (blocks neutrophil activation)

Question 7

chronic pancreatitis

Answer 7

long term inflammation-> fibrosis, atrophy
waxing and waning C/S

Question 8

chronic pancreatitis C/S

Answer 8

dogs: intermittent anorexia, GI Signs (v+, weight loss)

cats: intermittent anorexia, GI signs, concurrent conditions

Question 9

chronic pancreatitis dx

Answer 9

1. check for risk factors of pancreatitis
2. check for concurrent diseases (cholangiohep, IDB)
3. dx testing (bw, abd U/S, spec cpl)

Question 10

chronic pancreatitis tx

Answer 10

1. nutrition (low fat), highly digestible
2. antiemetic/analgesia as needed
3. address enzyme loss
4. tx concurrent disease

Question 11

exocrine pancreatic insufficiency

Answer 11

chronic pancreatitis (cats), acinar atrophy
C/S- chronic d+ w weight loss, PP

dx- decreased TLI, hx, C/S
tx- digestive enzyme replacement, highly digestible diet
cobalamin supplementation, H2 blockers, abx