pancreatic dz Flashcards
reasons why the pancreas does not digest itself
- secrete inactive enzymes
- PSTI and alphaM available to bind to active trypsin and stop it
- intracellular compartmentalization
- enterokinase is extra-pancreatic
- low intracellular Ca
how do zymogens get activated ?
trypsinogen meets up with enterokinase, which is made by brush boarder cells in the duodenum, this enzyme cleaves trypsinogen into trypsin which in turn activates other zymogens
what is the colocalization theory
something is obstructing apical binding, leading to trypsin being stuck and mixing with lysosomes; ends up causing inflammation -> edema -> hemorrhage -> fat necrosis in the pancreas
what are the risk factors for pancreatitis (7)
- dietary
- pancreatic ischemia
- reflux of duodenal contents- bile
- drugs (combo of pheno + KBr)
- genetic factors (mini schnauzers)
- idiopathic (50%)
true/ false
pancreatitis has less dramatic presentation in the cat
true
average age for pancreatitis
dogs >4yrs
cats >1yr
pancreatitis signs in the dog
- vomiting (90%)
- weakness
- abdominal pain
- dehydration
- diarrhea
pancreatitis signs in the cat
- lethargy (100%)
- anorexia
- dehydration
- hypothermia
pancreatitis lab findings in the dog
- neutrophilia + left shift
- thrombocytopenia
- anemia
pancreatitis lab findings in the cat
- anemia
- leukocytosis
- leukopenia
- hemoconcentration
how to diagnose pancreatitis
canine and feline pancreatic lipase; 200-400 is maybe; 400< is pancreatitis
-> snap test is positive over 200 so might cause false positives
true/ false
biopsy is commonly indicated for pancreatitis
false
pancreatitis tx
- supportive care (fluids, pain meds, anti emetics)
- GI rest
- analgesics
- parenteral antibiotics are usually not needed
- fast 3-5d or until no vomiting for 24hrs
what are the 2 cases where surgical exploration is indicated for pancreatitis
pancreatic abscess and prolonged bile duct obstruction
what breed is likely to get EPI
german shepherds
