Pancreatitis

Question 1

What is the difference per definition between acute and chronic pancreatiis

Answer 1

acute - completely reversible after romoval of the inciting cause

chronic - irreversible histopath changes

differences - mostly histopathological, not necessarily clinical

Question 2

What is the most common “cause” for pancreatitis in cats?

Answer 2

> 95% idiopathic, without specific cause identified

Question 3

Which digestive enzyme is autoactivated in pancreatitis as the inciting cause?

Answer 3

trypsinogen

not implicated in chronic panc, just acute

Question 4

List implicated causes for acute pancreatitis in cats

Answer 4

• autoactivation of trypsinogen
• thrombin activating zymogens
• sepsis/SIRS - systemic inflammation and NFkappaB pathways
• alterations in Ca++ signaling –> colonization of lysosomes and zymogens granules + trypsinogen activation
• hypoperfusion and thrombosis
• bile acid and trypsin reflux

Question 5

How does the echogenicity of a normal pancreas compare to the liver?

Answer 5

normal pancreas - similar echogenicity (isoechoic or hypoechoic compared to surrounding mesentery)

Question 6

Which lob of the feline pancreas is larger?

Answer 6

left

right - small and difficult to find

Question 7

What is the sensitivity of AUS to detect acute pancreatitis in cats?

Answer 7

wide range reported - 11-67% - depends on severity and operator

Question 8

How accurate is fPLI for the diagnosis of pancreatitis in cats?

Answer 8

• sensitive to detect pancreatitis
• less specific

i.e., normal results make pancreatitis unlikely