How can you prevent pancreatitis in cats

Inflammation of the pancreas in dogs and cats

Pancreatitis

Pancreatic problems are relatively common in dogs and cats and can have serious consequences. Read here how inflammation of the pancreas is diagnosed and what it means for your animal.

What does the pancreas do?

The pancreas forms the so-calledPancreatic juice and releases it into the small intestine just behind the stomach. The smell of a meal not only makes the mouth water, but also the pancreatic juice in the duodenum, albeit only in small amounts. Only when the food reaches the small intestine from the stomach does the pancreas add its secretion in larger quantities. A dog weighing 10 kg can produce up to half a liter of this precious juice a day (around 1.5 liters for humans).

The pancreatic juice neutralizes stomach acid when the stomach contents enter the small intestine. In this way he creates optimal working conditions for those formed by the pancreasDigestive enzymesthat break down the nutrients from the feed:

  • Peptidases for the digestion of proteins
  • Amylase to digest carbohydrates
  • Lipases to digest fats
  • Nucleases to digest DNA and RNA

 

 

The amount of enzymes in the pancreatic juice can adapt to the type of food. For example, more amylase is released when a carbohydrate-rich diet is fed. Only after being broken down by the digestive enzymes can the nutrients from the feed pass through the intestinal wall into the blood and serve the body as energy suppliers.

What sounds relatively simple is actually a dangerous task for the pancreas, as it is in constant danger of digesting itself. To prevent this from happening, there are a number of protective mechanisms that ensure that the enzymes only start working in the small intestine. In particular, protein-digesting enzymes are released in the form of inactive precursors and together with inhibitors that are supposed to prevent activation in the pancreatic ducts. If these protective mechanisms fail, a painful inflammation of the pancreas occurs (Pancreatitis). 

Embedded in the glandular tissue of the pancreas are those named after their discovererLangerhans Islands. The islet cells mainly produce the hormones insulin and glucagon, which regulate blood sugar levels, but also hormones which, for example, regulate the release of pancreatic juice and create a feeling of satiety.

The glandular tissue that produces the pancreatic juice is called the exocrine pancreas, the hormone-producing islets of Langerhans is called the endocrine pancreas.

What causes inflammation of the pancreas?

In 9 out of 10 cases, the cause of the pancreatitis cannot be determined. However, a number of possible triggers or risk factors are known:

  • Ingestion of unsuitable food, especially if it was unsanitary and / or very high in fat (e.g. if the dog found food scraps outside)
  • very high-fat diet over a long period of time (dog)
  • Obesity
  • increased blood lipid values ​​(hypertriglizeridemia; e.g. hereditary causes in miniature schnauzers)
  • Circulatory disorders (blood pressure too low, e.g. also with stomach torsion, anemia)
  • hormonal diseases such as Cushing, diabetes mellitus or hypothyroidism
  • trauma
  • Administration of certain medications (e.g. certain anti-epileptic drugs)
  • various infectious diseases, especially in cats
  • chronic inflammatory bowel disease (IBD, especially in cats) and
  • Liver and gall bladder disorders (cat cholangiohepatitis)

Infectious diseases play a major role in the development of pancreatides, especially in cats. A connection with viral diseases such as FIP, FeLV, FIV, panleukopenia and feline herpesvirus I is known. However, toxoplasma infections are of particular importance because they can also be transmitted to humans.

Toxoplasma was found in a study in over 80 percent of the inflamed pancreas in cats!

Babesia infections (Babesia canis, the causative agent of dog malaria) can play a role in dogs.

The following breeds of dogs are known to be predisposed to inflammation of the pancreas:

  • boxer
  • Cavalier King Charles Spaniel
  • Cocker spaniel
  • Collies
  • small terrier breeds

Overall, pancreatic diseases are quite common in dogs and cats: about one in ten cats and slightly more than one in ten dogs will develop a pancreatic problem in their lifetime. Changes in the pancreas can be found in many animals after death, although they died or were euthanized for completely different reasons, i.e. no symptoms of pancreatitis were observed. This shows how sensitively the pancreas reacts to various processes in the body. Gastrointestinal diseases, stress, certain medications, metabolic and circulatory disorders can easily affect the pancreas. The likelihood of developing pancreatitis increases with age.

Pancreatic diseases often go undetected.

What happens when there is inflammation of the pancreas in the pancreas?

Even if the causes of pancreatitis range from unsuitable food to circulatory disorders to infections, the pancreas always reacts in the same way:

The excretion of digestive enzymes is reduced. As a result, these remain in the pancreatic cells longer than usual, with the result that they are still activated in the cells. The pancreas begins to digest itself, so to speak. Inflammatory cells migrate into the organ, blood vessels are damaged and the pancreas swells. In milder diseases, the inflammation is limited to the pancreas, while self-digestion continues in more severe cases, the surrounding fatty tissue is then saponified by the enzymes and a very painful fatty tissue necrosis develops. Abscesses are also possible.

What are the consequences of inflammation of the pancreas?

At a acute pancreatitis can heal the inflammation again without leaving any damage to the organ. However, it can also spread to the surrounding tissue and cause greater damage. Such acute necrotizing pancreatitis can become life-threatening if sepsis (blood poisoning) develops, which can lead to shock and organ failure.

A chronic pancreatitis, in which the inflammation flares up again and again, leads to the formation of scar tissue and the shrinking of the functional organ tissue, the result can be a weak pancreas, the so-called exocrine pancreatic insufficiency (EPI) and possibly diabetes mellitus.

According to one study, almost every third dog with diabetes has chronic pancreatitis.

 

How does pancreatitis manifest itself?

Unfortunately, the signs of pancreatitis are far from typical.

In pancreatitis, the animals show z. B .:

  • apathy
  • Loss of appetite
  • Vomit
  • stomach pain
  • Dehydration (especially cats)
  • diarrhea

Possibly also:

  • fever
  • Yellowing of the skin / mucous membrane (jaundice)
  • Weight loss
  • weakness

Vomiting, diarrhea, and abdominal pain are relatively common in dogs with pancreatitis, while cats often have very vague symptoms such as weakness, dehydration, loss of appetite, and weight loss.

While acute inflammation of the pancreas can cause very severe symptoms up to life-threatening circulatory problems - i.e. often represent an acute emergency chronic inflammation of the pancreas Especially in cats, they are often not noticed at all, although they are much more common in cats than acute pancreatitis. Chronic pancreatitis can progress slowly (subclinically), but also in the form of recurring acute attacks (chronically relapsing). Often times, pancreatitis in cats occurs at the same time as other liver, gastrointestinal, or diabetes mellitus diseases, so pancreatitis is masked by the other symptoms of the disease.

Since a combination of inflammation of the liver and biliary tract (cholangiohepatitis), inflammatory bowel disease (IBD) and pancreatitis is so common in cats, there is even a name for this disease: "Triaditis"(triple inflammation).

stomach pain Detecting it in dogs (less often in cats with pancreatitis) is sometimes not that easy. The so-called prayer position is a typical sign of pain in the front part of the abdomen, where the pancreas is located. The dogs lie with their front bodies on the floor while their back legs remain standing. However, this behavior is only observed in about one in ten dogs with pancreatitis, and many healthy dogs go into the prayer position to stretch or to encourage them to play. Other indications of abdominal pain can be stiff movements, a curved back, unusual lying positions or, for example, preferring to lie on cold tiles or on a warm surface.

How is pancreatitis diagnosed?

Special blood tests for diagnosing pancreatitis

Now there are both for dogs and cats Rapid testswho can detect high-grade pancreatitis right at the veterinary office. This greatly facilitates the quick diagnosis of severe inflammation. However, it can still be difficult to detect mild or chronic episodes of pancreatitis, as the tests, for example, in cats with minor problems can only detect a little more than two thirds of pancreatitis cases. In such cases or with test results in the gray area, it may be necessary to test several times or blood for even more precise measurements of the Pancreas-specific lipase activity be sent.

Further necessary examinations if pancreatitis is suspected

Pancreatitis is practically indistinguishable from other gastrointestinal diseases on the basis of the symptoms alone. Especially in young dogs with acute diarrhea, vomiting, fever and abdominal pain, infections, especially a parvovirus infection, always have to be considered and these can be excluded with the help of a special blood test. In cats, for example, feline leukosis and cat aids should be ruled out by a rapid test.

In the Routine blood test Although pancreatitis cannot be diagnosed with certainty (blood count and blood chemistry), it can be used to determine, for example, to what extent the disease is already stressing other organs such as the liver or kidneys, how dehydrated the patient is and whether he has lost a lot of electrolytes. It is therefore important for planning therapy and assessing the prognosis. In cats in particular, it makes sense to check for accompanying intestinal diseases by determining vitamin B12 and folic acid.

Likewise - especially in young dogs or cats with acute problems - a foreign body that has got stuck in the gastrointestinal tract is always considered, which is why one X-ray examination should be done, even if you can usually only make vague indications of pancreatitis on the X-ray.

A Abdominal ultrasound can also give clues to pancreatitis or its severity and help to differentiate it from other diseases of the gastrointestinal tract. However, even very experienced examiners cannot always find signs of inflammation in the organ in pancreatitis. In cats, the ultrasound scan can be used to determine whether they have liver or intestinal diseases at the same time, as is often the case with these animals.

Pancreatitis can be diagnosed with one hundred percent certainty based on Tissue samples (Biopsies) of the pancreas, which also allow a distinction between chronic and acute pancreatitis. However, this is very rarely done in practice.

How is pancreatitis treated?

The three most important measures to be taken in patients with inflammation of the pancreas are:

  1. Fluid therapy
  2. Pain management
  3. correct feeding (dietetics)

Depending on the severity of the inflammation, complications and any accompanying illnesses, other treatment measures, including intensive care, may be necessary, but the three above are crucial for every patient. For dogs and cats with creeping chronic pancreatitis, hydrotherapy may not be necessary, but their fluid and electrolyte balance should also be checked.

Fluid therapy for pancreatitis

Many pancreatitis patients are dehydrated and have acidic and electrolyte imbalances from diarrhea and vomiting. These problems can be life-threatening and usually need to be treated with IV fluids. Therefore, it usually makes sense to admit patients with acute pancreatitis as an inpatient.

Pain management in pancreatitis

People with pancreatitis clearly report how painful this disease is and animals often show significant pain. Even apparently pain-free dogs and cats with chronic pancreatitis often show a significant improvement in general well-being when taking painkillers.

This is why every dog ​​and cat with pancreatitis should receive pain management! Usually opioids (i.e., morphine-like) substances are used to treat pancreatitis pain. For example, they can be injected or put on the skin as a plaster. The pain medication is also one reason why inpatient treatment is often useful.

Feeding for pancreatitis

Here the recommendations of the experts have changed radically in recent years. While in the past every patient with pancreatitis had to fast for several days, the current recommendation is to feed again as early as possible and, if possible, not to leave the gastrointestinal tract without food for more than 24 hours.

What led to this change? The fasting recommendation was based on the observation that the pancreas releases fewer enzymes when there is no food in the stomach or small intestine. However, food deprivation also means that the intestinal wall cells are not supplied with energy, so that fasting has a negative effect on the intestinal barrier. In both humans and our pets, various studies have shown that early nutrition improves the healing rate.

That is why one has now switched to feeding the animals as soon as they no longer vomit constantly. Often they are given medication to stop vomiting (with the negative consequences for the fluid and electrolyte balance) and are initially fed with energy-rich liquid food through a tube.

In the case of very severe pancreatitis, experts recommend what is known as "microenteral nutrition", in which liquid food is administered drop by drop via a tube and the rest of the organism receives additional energy and nutrients via infusion (parenteral nutrition). In this way, the intestinal wall cells can be supplied with energy without the pancreas being stimulated to release enzymes.

In cats and dogs, feeding tubes are often placed under a short anesthetic without major surgical effort, for example as a nasogastric tube or as an esophageal tube (into the esophagus). Gastric or small intestinal tubes are rarely needed. The care of the probes is also quite uncomplicated, so that the patients often go home with the probe and continue to be cared for there until they have enough food themselves.

As a rule, instant foods for intensive care patients are initially used for tube feeding. Highly digestible special feeds are also recommended for feeding (moist or dry feed), which the gastrointestinal tract can easily utilize. In dogs, care should be taken to ensure that the food has a low fat content, as high-fat food can trigger a flare-up of pancreatitis. This relationship is not as pronounced in cats, but very high-fat food is also not recommended here (for recommended fat content, see long-term feeding).

What should I watch out for when feeding my dog ​​/ cat with a tendency to develop pancreatitis?

In general, one tries to relieve the pancreas with optimal feeding. Various measures have proven to be helpful:

Frequent meals

For example, it makes sense to feed many small meals a day instead of one or two large ones. A dog with pancreatitis should have about 4 meals a day. Cats, on the other hand, naturally eat around 10 to 15 tiny meals a day. If you are not at home all day, you can only mimic this natural rhythm if you give dry food to free disposal. You should always fill the bowl freshly with moist food so that it remains hygienically perfect. So if your cat only eats wet food, try to allow four meals or more a day.

Try to keep feeding times and meal size as consistent as possible.

High digestibility

The easier a food is to digest, the less work the pancreas or the entire gastrointestinal tract has to do to meet the nutritional needs of the body. Very high digestibility requires a high quality of raw materials and an optimal production process in which the nutrients are partially broken down in a gentle way. You will not find any information on digestibility on "normal" feed packaging; only certain veterinary special diets that have been developed for gastrointestinal patients provide reliable information. These are very easy to digest and especially recommended for dogs and cats with chronic pancreatitis or recurring pancreatitis.

The important thing in this context is Protein quality of the feed, because there should only be as much protein in the feed as the organism needs. A high protein content increases the production of pancreatic juice, which you usually want to avoid. However, so that there is no protein deficiency, the protein used in the feed must have a high "biological value", i.e. it must be able to be used almost completely by the body. Some dogs with chronic problems need real protein restriction to get the inflammation under control.

Because of these arguments, raw meat feeding is less recommendable for animals with pancreatic glands and the motto "high protein content = particularly healthy and high-quality" propagated by many feed manufacturers is not applicable to pancreatitis (and some other diseases).

Low-fat feeding

For overweight people dogs