Pancreas

Question 1

Acute Pancreatitis – Clinical Presentation

Answer 1

Anorexia/Weakness in dogs and cats
Vomitting in dogs
Dehydration in dogs
Dehydration

Question 2

Serum TLI (Trypsin-Like Immunoreactivity) vs Canine PLI (Pancreas-specific Lipase) which one more useful for acute pancreatitis diagnosis

Answer 2

Canine PLI (Pancreas-specific Lipase)

Question 3

cPL may also be increased/positive in dogs with …?

Answer 3

upper GI foreign bodies

Question 4

Is abdominal radiography useful in diagnosing pancreatic diseases?

Answer 4

Low sensitivity
Loss of serosal detail or an increase in opacity in the R cranial quadrant
Displacement of duodenum and/or transverse colon
Dilated gas-filled duodenum

Question 5

What is abdominal radiology useful in when dealing with suspected pancreatic disease

Answer 5

Abdominal Imaging is essential for ruling out concurrent gastrointestinal FB in dogs with positive cPLI

Question 6

Acute Pancreatitis: Potential Sequelae

Answer 6

Biliary tract obstruction
Pancreatic abscess formation
Necrotic masses
Pancreatic pseudocysts
Duodenal perforation/septic peritonitis

Question 7

Acute pancreatitis treatment

Answer 7

NO definitive treatment

Supportive and symptomatic management
Fluid and electrolyte balance
Analgesia
Anti-emetic and Anti-ulcer therapy
Nutritional support
Management of complications

Question 8

When should you suspect chronic pancreatitis?

Answer 8

Intermittent, low-grade clinical signs
Recurrent acute episodes of pancreatitis
Exocrine pancreatic insufficiency
Diabetes mellitus (PUPD, weight loss, polyphagia)

Question 9

Chronic pancreatitis: Management

Answer 9

For intermittent/low-grade relapsing presentation:
Analgesia (e.g. gabapentin)
Low-fat diet (particularly if hyperlipidaemia is a trigger)
Vitamin B12 injections - if low
Consider appetite stimulants (cats; e.g. mirtazapine)
Treat EPI if present or if chronic weight loss
Treat DM if present

Question 10

Clinical Signs of Exocrine Pancreatic Insufficiency (EPI)

Answer 10

Steatorrhoea (High fat in poop)
Diarrhoea
Poor hair coat
Weight loss but increased appt
Flatulence

Question 11

Exocrine Pancreatic Insufficiency (EPI)- Diagnosis

Answer 11

Measure Trypsin-like Immunoreactivity (TLI)
This blood test is highly sensitive and very specific for EPI
Sample after 12h fast

Question 12

Management of EPI

Answer 12

Cobalamin supplementation
Enzyme supplementation
No single best diet
Highly digestible, low fibre, moderate fat diet may help?
Little & often?