Pancreatic function and disease Flashcards
98% of the pancreas is exocrine function. What is produced here?
Digestive enzymes - lipase, protease, amylase
High concentration of bicarbonate
2% of the pancreas is endocrine. What hormone is produced here?
Insulin
Specific assays for amylase and lipase are used to identify pancreatic cell inflammation/injury. What is a non-pancreatic cause for a mild increase in amylase/lipase?
Decreased GFR
Trypsin-like immunoreactivity (TLI) is available in cats, horses and dogs. What is this most useful for diagnosing?
EPI
less useful for pancreatitis
What causes most cases of acute pancreatitis?
Idiopathic
What animals (breed, sex, neuter status, diet) are predisposed to acute pancreatitis?
Spanies, terriers Female Neutered Obese High fat diet Concurrent disease or drugs
How is acute pancreatitis definitively diagnosed?
Biopsy
Care - anaesthesia may exacerbate pancreatitis
What clinical signs may pancreatitis cause?
Dehydration Anorexia Vomiting Weakness Abdominal pain Jaundice
What is seen on biochemistry with acute pancreatitis?
Hyperlipidaemia, increased pancreatic lipase, hyperglycaemia, incereased liver enzymes
Hypocalcaemia
What is seen on haematology with acute pancreatitis?
Leukocytosis
Neutrophilia and left shift due to inflammation
What is the treatment for acute pancreatitis?
Supportive Fluids Diet - low fat, small frequent meals Analgesia - paracetamol, buprenorphine, tramadol, gabapentin Anti-emetics + GI drugs
Are antibiotics indicated with acute pancreatitis?
Rarely
Most often sterile
Are NSAIDs indicated with acute pancreatitis?
No - AVOID
What other conditions is feline pancreatitis associated with?
Cholangitis
Hepatic lipdiosis
IBD
Diabetes mellitus
What are the symptoms of EPI in dogs?
Weight loss Polyphagia, pica, coprophagia Faecal changes - steatorrhea, large volumes Vomiting Poor coat condition
What are the 3 aetiologies of EPI?
Pancreatic acinar atrophy - GSD, rough collies
Pancreatic hypoplasia - congenital
Chronic pancreatitis - more in cats
How is EPI diagnosed?
Low Trypsin-like immunoreactivity
<2.5 (normal = >5)
What is the treatment for EPI?
Pancreatic enzymes
Highly digestible diet - no need to restrict fat but NOT high fibre
Cobalamin supplements if deficient
Is the pancreas normally visible on radiographs?
No - visible if enlarged
Pancreatitis, neoplasia
