Pancreatitis (Rudinsky - February 18th) Flashcards
Pancreatic Acini Vs Ducts
Enzymes are there to break down food, and NaHCO3- is there to ___________
buffer
- Secretion
- Digestive enzymes ***
- Bicarbonate ***
- Other
- B12 absorption (intrinsic factor)
- Energy, important for gut health (& every cell in the body), absorbed in the distal ileum
- Modulate mucosal function (trophic)
- Regulate commensals through antimicrobial proteins
- Trypsin inhibitor (protect from autodigestion)
Exocrine Pancreatic Functions
Definition:
A condition which occurs when the pancreas does not make enough of a specific enzyme the body uses to digest food in the small intestine
Pancreatic Insufficiency (EPI)
Acute pancreatitis is an …
Exocrine pancreatic disease
- the one that most vets deal with
How is pancreatitis diagnosed?
- All diagnostics have limitations
- Commonly rely on clinical diagnosis
- Diagnosis of exclusion
- Probably the most accurate way to diagnose pancreatitis
- Probably the most accurate way to Mis-diagnose pancreatitis
- Available through IDEXX laboratories
Spec PLI
What is the utility of abdominal radiographs?
for eliminating differential diagnosis
Pancreatic Imaging:
- Enlarged, irregular, hypoechoic, and may be ‘mass-like’
- Surrounding mesentery is hyperechoic
- +/- corrugated duodenum, fluid/gas distended and/or hypomotile intestines
Acute Pancreatitis
Pancreatic Imaging:
- Decreased pancreatic size, mixed echogenicity, nodular echotexture, acoustic shadowing/speckling
- Irregular pancreatic ducts
Chronic Pancreatitis
FNA Cytology of the Pancreas is more commonly done in what species?
Cats
List some treatment options:
- Fluid therapy
- Plasma therapy
- Electrolyte supplementation
- Analgesia (the inability to feel pain)
- Nutritional support
- Anti-emetics
- Pro-kinetics
- Gastric Protectants
- Antibiotics
- Surgery
What are my fluid therapy goals?
- Correct hypovolemia (vomiting, diarrhea, decreased intake, third space, diaphoresis, respiratory losses)
- especially splanchnic circulation
- Provide macro- and micro- circulatory support
- In humans, prognostic to treat based on BUN, Hcyand serum creatinine
- we don’t want to under hydrate the patient in this case
(T/F) Ideal Fluid is unknown
TRUE
