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A6: Pancreatic Disorders
Terms in this set (20)
List four causes of acute pancreatitis, which is most common?
1. Ingestion of high fat meal (most common) 2. Drugs, esp high dose glucocorticosteroids, tranquilizers 3. Immune mediated 4. Infections
Acute pancreatitis tends to affect what signalment of animal? It is also seen in dogs with disorders of ____ metabolism (e.g. _______, _________)
-Obese, middle aged female dogs -Lipid metabolism -Diabetes, hypothyroidism
What actually happens when acute pancreatitis occurs? (5)
-1. Activation of pancreatic enzymes 2. Released into the circulatory system and peritoneal cavity 3. Cause ischemic necrosis, inflammation and edema of adjacent organs and activation of other systems like the coagulation cascade - 4. Liver can be damaged resulting in congestion and necrosis 5. Bile duct can become obstructed due to inflammation and edema resulting in icterus
List the clinical signs of acute pancreatitis.(5) The clinical signs in cats are variable and _____
(Varies depending on severity) 1. Depression 2. Anorexia 3. Vomiting with or without diarrhea 4. Fever 5. If severe- abdominal pain (praying pose) and shock -vague
How do we diagnose acute pancreatitis? (7)
1. Leukocytosis 2. Dehydration (increased PCV and TP) 3. Hyperglycemia 4. Elevated liver enzymes (amylase and lipase more specific) 5. Lipemia 6. U/S 7. Biopsy
There is a new test available for dogs to determine if they have acute pancreatitis, what is it called?
cPLI (canine Pancreatic Lipase Immunoreactivity) Has a much greater sensitivity than CBC and Chem
What do we administer as therapy for Acute Pancreatitis? (3)
1. IV fluids 2. Antiemetics 3. Analgesics
Describe the initial treatment of acute pancreatitis (8)
1. Remove cause if apparent 2. NPO including water to stop pancreas secretions 3. Maintain fluids and electrolytes 4. Analgesia (CRI) 5. Antibiotics (not usually necessary) 6. Antiemetic treatment (important) 7. Fresh frozen plasma (replenish antiproteases) 8. Dietary management once vomiting is controlled
Describe the recovery management of Acute Pancreatitis
1. Maintain on IV fluids until dog is able to eat and drink sufficient quanitites 2. Offer water, if tolerated, begin low fat, digestible diet feeding small amounts frequently 3. Gradually return to normal amounts and frequency, continuing with low fat diet for rest of life
Describe the dietary therapy for acute pancreatitis (3)
1. Low fat diet for rest of life (susceptible to repeat bouts) 2. If obese- weight loss program 3. Avoid high fat anything including treats
T or F Dogs and cats with acute pancreatitis should be fasted asap to stop the pancreas secretions
F -Cats should not be fasted even if vomiting (give a highly digestible diet with moderate protein and low fat)
List some possible complications of Acute Pancreatitis (5)
1. Canine Exocrine Pancreatic Insufficiency 2. Extrahepatic bile duct obstruction (EBDO) 3. Diabetes mellitus 4. Chronic pancreatitis 5. Organ failure (liver, kidney)
What is Canine Exocrine Pancreatic Insufficiency caused by? When do clinical signs appear?
-The decreased production and secretion of pancreatic enzymes, especially lipase -When enzyme levels decrease to 10-15% of normal
What are the two types of Canine Exocrine Pancreatic Insufficiency?
1. Juvenile (Breed predisposition to post natal atrophy in GSD, Dobies, Labs, can also be idiopathic or familial 2. Secondary (to acute or chronic pancreatitis)
What exactly happens to cause Canine Exocrine Pancreatic Insufficiency?
-Loss of pancreatic acinar cells results in decrease production of digestive enzymes which then results in failure of absorption of nutrients
List the clinical signs of Canine Exocrine Pancreatic Insufficiency (5)
1. Chronic diarrhea (predominantly small bowel, large quantities) 2. Weight loss with ravenous appetite 3. Usually alert and active 4. Coprophagy common 5. Poor coat due to poor nutritional status
How can we diagnose Canine Exocrine Pancreatic Insufficiency? (4)
1.Rule out parasites (three floats and smears) 2. Identify fecal fat 3. History is suggestive 4. Serum TLI (Trypsin-Like Immunoreactivity) for a definitive diagnosis
Id there a cure for Canine Exocrine Pancreatic Insufficiency?
No, only control
Describe the management of Canine Exocrine Pancreatic Insufficiency
1. Highly digestible, low fat diet 3-6 times daily 2. Add pancreatic enzyme to foor, allow to sit for 20-30 minutes then feed 3. May require a H2 blocker 30 minutes before meal to decrease gastric acidity (improves response to enzyme) 4. May require antibiotics for bacterial overgrowth 5. Add medium chain triglyceride oil
There is a _________ nutritional approach to controlling Canine Exocrine Pancreatic Insufficiency and then there is a more ______ one. Describe each
TRADITIONAL: Highly digestible, low fibre, with moderate fat (prevents diarrhea stimulated by presence of fatty acids which then stimulates water loss) -RECENT: A high fat diet, supposedly improves fat absorption and clinical signs compared to maintenance or fat restricted diets. This is because they result in increased conservation of lipase in the pancreatic supplement and favor energy consumption in under weight animals
THIS SET IS OFTEN IN FOLDERS WITH...
E2: Spinal Cord Disorders
E3: PNS Disorders
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