Pancreatitis

Question 1

whats unique about the pancreas and pancreatitis?

Answer 1

Its an endocrine/exocrine gland that creates digestive enzymes. Pancreatitis is unique in that its heterogenous which makes diagnosis difficult.

Question 2

supportive findings of pancreatitis on bloodwork

Answer 2

inflammation, liver enzyme elevation, hyperbilirubinemia (cats especially) with secondary complications of AKI and electrolyte abnormalities

Question 3

what might you seen on ultrasound and radiographs that suggestive of pancreatitis?

Answer 3

Rads may show a decrease in detail in the cranial abdomen and seeing the right kidney on a VD projection in a dog is suggestive.

Ultrasound has a low specificity even with highly skilled radiologist but may be helpful with identifying masses/other causes of disease.

Question 4

what would you look for on FNA of a pancreatitis case?

Answer 4

look for a mixed population of inflammation

Question 5

Snap cPL’s look at __ immunoreactivity and are best used to rule __ disease

Answer 5

Snap cPL’s look at pancreatic lipase immunoreactivity and are best used to rule out disease

Question 6

Pancreatitis treatment

Answer 6

supportive care, tx the symptoms you can’t necessarily fix the disease

Consider fluids, pain management (ketamine bc no GI signs), nutrition (just hi quality) and antinausea/emetics (maropitant)

Question 7

what would be an adequate pain management plan for a patient with pancreatitis?

Answer 7

To start out, ketamine is a good choice because it provides pain management with no GI side effects. A local anesthetic for an epidural would also be a good choice while using things such as opiods, alpha 2’s and NSAIDs should be avoided since they can cause GI side effects.