Pancreatitis in cats and dogs

Pancreatitis is inflammation of the pancreas. It can follow very different courses, from a mild loss of appetite to a serious illness that needs intensive care. In cats in particular, the signs can be quite vague.

The pancreas makes the enzymes that help digest food, and it releases hormones involved in regulating blood sugar. In pancreatitis the tissues around the organ can be affected as well. That is why assessing the disease means looking not only at the pancreas but at the patient’s general condition.

If you see these signs, do not wait

Pancreatitis does not produce the same signs in every patient. But if any one of the following is present, the animal needs to be assessed the same day:

• Repeated vomiting, or vomiting that will not stop
• Vomiting even after a drink of water
• Marked lethargy, or a lack of interest in its surroundings
• Stopping eating altogether
• Severe abdominal pain
• Reacting when its belly is touched
• Reluctance to get up, or marked weakness
• Severe diarrhoea
• Blood in the vomit or the faeces
• Yellowing (in the whites of the eyes, the gums or the skin)
• Pale gums
• Fainting, or a change in consciousness
• Rapid or laboured breathing
• Marked dehydration

Of these, if there is fainting, pale gums or laboured breathing, do not wait: set off straight away.

Waiting a long time is particularly unwise in young or elderly cats and dogs, and in those that already have another illness.

Our clinic is open around the clock. If you cannot tell whether to come now or wait until morning, nights and weekends helps; every emergency sign is on the emergency page.

Why pancreatitis can be harder to spot in cats

Cats with pancreatitis do not always vomit. In some cats, the first signs anyone notices may be no more than these:

• Eating less
• Hiding
• Sleeping more than usual
• Moving around less
• Weight loss
• Grooming less

So in a cat that has been clearly off its food and subdued for a few days, the absence of vomiting does not rule out a serious illness. What to look for in a cat that will not eat is covered in my cat is not eating, and for a cat that is vomiting, in my cat is vomiting.

In cats, pancreatitis can also occur together with disease of the intestines and the bile ducts. So during the assessment, it matters that the abdominal ultrasound examines the other organs too.

What pancreatitis looks like in dogs

In dogs, vomiting and abdominal pain are usually more obvious.

Loss of appetite, lethargy, diarrhoea and dehydration may also be seen. Because of abdominal pain, some dogs stretch their front legs out along the floor and lower their chest while keeping their hindquarters raised; this is called the “prayer position”.

Even so, these signs are not specific to pancreatitis. With repeated vomiting in particular, emergencies such as a foreign body or an intestinal obstruction have to be told apart from it. The other causes of vomiting are in my dog is vomiting.

How pancreatitis is diagnosed

Pancreatitis is usually not diagnosed with a single test.

The vet first finds out when the illness began and whether there has been any vomiting, and asks about appetite, water intake, bowel movements, any medication the animal is on, and whether a similar problem has happened before.

The physical examination then assesses body temperature, dehydration, the mucous membranes (such as gum colour), the heart and breathing, pain in the abdomen, and the patient’s general condition.

When pancreatitis is suspected, blood tests and imaging are used together.

A single normal test does not always rule pancreatitis out. In the same way, a single high pancreatic test should not be interpreted apart from the patient’s whole clinical picture.

What the blood tests look at

When pancreatitis is suspected, blood tests are not there only to assess the pancreas. It also matters to understand how far the disease is affecting the rest of the body.

Full blood count

This assesses the red blood cells, white blood cells and platelets. It gives information about inflammation, possible infection, anaemia and some systemic changes.

Biochemistry

Depending on the patient, these values may be checked:

• Kidney values
• Liver enzymes
• Bilirubin
• Blood sugar
• Total protein and albumin

An important reason for this is that pancreatitis does not always occur on its own. In cats especially, disease of the pancreas, of the liver and bile ducts, and of the intestines can be present at the same time.

Electrolytes

Values such as sodium, potassium, chloride and, where needed, ionised calcium are important.

Vomiting, not eating and dehydration can upset the electrolyte balance. These changes can make the patient more lethargic, and they can also affect how the intestines move and how the heart and muscles work.

So in seriously ill patients, electrolytes may be measured not only at the first examination but again during treatment.

Pancreas-specific blood tests

When pancreatitis is suspected, tests aimed specifically at the pancreas can also be used.

fPL in cats and cPL in dogs are important tests that support a diagnosis of pancreatic inflammation. Both measure the amount of pancreas-specific lipase in the blood.

However, the results need to be interpreted together with the physical examination, the other blood values and the ultrasound findings. Reading a single laboratory result on its own as “pancreatitis” or “no pancreatitis” is not always right.

Which test is requested, and why, is explained on the internal medicine and laboratory page.

Why ultrasound matters

The pancreas is a small organ inside the abdomen, closely connected with the stomach and intestines around it. That is why abdominal ultrasound has an important place in assessing pancreatitis.

Blood tests give information about how the organs are working and about systemic changes in the body, while ultrasound makes it possible to assess the structure of the pancreas and the tissues around it. These features of the pancreas can be assessed:

• Its size
• The structure of its tissue
• The fat tissue around it
• The pancreatic duct
• Whether there is fluid around it

An ultrasound examination does not look only at the pancreas. In the same examination, the stomach and intestines, the movement of the intestines, the liver, the gallbladder and bile ducts, the kidneys, the spleen and the lymph nodes inside the abdomen can be examined as well.

This matters because vomiting, loss of appetite and abdominal pain are not seen only in pancreatitis. A foreign body, an intestinal obstruction, disease of the liver and bile ducts, and other conditions inside the abdomen can produce similar signs.

How the examination is done is on the abdominal ultrasound page.

Does ultrasound show pancreatitis for certain

Not always.

What pancreatitis looks like on ultrasound can change with the stage and severity of the disease. In mild or early cases especially, the pancreas may show no obvious change on ultrasound.

So a pancreas that looks normal does not, on its own, rule pancreatitis out completely. The reverse also holds: ultrasound findings have to be interpreted together with the patient’s history, the examination and the laboratory results.

Is an X-ray needed

In some patients, yes.

An X-ray is not as detailed as ultrasound for showing pancreatitis itself. But it can be used, especially in an animal that is vomiting, to look for a foreign body, an intestinal obstruction or another problem inside the abdomen.

That is why the vet may use ultrasound and X-rays not as alternatives to each other but, when needed, as two methods that complement each other.

How it is treated

There is no single standard treatment for pancreatitis. Treatment is tailored to the patient’s signs, dehydration, pain, blood results and any accompanying diseases.

The main aims of treatment are usually these:

• Correcting the fluid and electrolyte balance
• Controlling nausea and vomiting
• Reducing pain
• Restoring adequate nutrition
• Treating any accompanying diseases
• Recognising complications early

Not every patient with pancreatitis needs antibiotics. In the same way, the medicines used and the fluid therapy are not the same for every patient.

Why nutrition matters

In the past, keeping animals with pancreatitis without food for long periods was a common approach. Today, in suitable patients, it is important not to delay feeding unnecessarily.

If the patient is not eating of its own accord, nausea and pain need to be brought under control.

Cats that go without eating for a long time can also be at risk of fatty liver (hepatic lipidosis). So in cats, getting them eating again is particularly important.

In some patients small, frequent meals are enough; for patients that cannot eat enough on their own, the vet may consider supportive methods such as a feeding tube.

In dogs, particularly in some cases of pancreatitis, a diet with controlled fat content may be preferred. In cats, on the other hand, the feeding plan is worked out separately, according to the patient’s accompanying diseases and nutritional state.

When hospitalisation is needed

Not every patient with pancreatitis needs to be hospitalised.

Some patients whose general condition is good, whose dehydration is mild and who can eat by mouth can be monitored at home, if the vet considers it appropriate.

However, hospitalisation may be needed in the following situations:

• Repeated vomiting, or vomiting that cannot be brought under control
• Marked dehydration
• Being unable to eat or drink
• Severe abdominal pain
• An electrolyte imbalance
• A significant change in blood sugar
• Jaundice
• Deteriorating kidney or liver function
• Marked lethargy or a circulatory problem
• Breathing difficulty
• Needing medication or fluid therapy more often than can be managed at home

The decision to hospitalise does not rest only on the question “is it pancreatitis?” but on the patient’s overall condition.

What is done during a hospital stay

A hospitalised patient can have an intravenous line placed and fluid therapy started according to its needs.

During treatment, the following are monitored:

• Body temperature
• Pulse and breathing
• Fluid balance
• Pain
• Nausea and vomiting
• Appetite
• Urination and bowel movements
• Blood sugar
• Electrolytes and other blood values, in patients that need it

In seriously ill patients these checks are made more often, and treatment can be changed during the day according to how the patient responds.

This is one of the important advantages of hospitalisation in pancreatitis: treatment is not only a matter of giving medicines, but also of following how the patient responds to them.

How a hospital stay works at our clinic is on the inpatient care page.

What to watch for after going home

After discharge, give the medicines at the times you have been told and keep to the feeding plan.

At home, keep a particular eye on:

• Appetite
• Water intake
• Vomiting
• Bowel movements
• How active the animal is
• Signs of abdominal pain

If vomiting starts again, if the animal stops eating altogether, or if marked lethargy or pain develops, contact the vet without waiting for the planned check-up.

Frequently asked

Is pancreatitis contagious

No. Pancreatitis is not a disease that passes from one animal to another.

Is pancreatitis only caused by fatty food

No. In dogs in particular, fatty food may be linked to some cases, but it is not the only cause of pancreatitis. In most patients no definite cause can be found.

Does a normal blood test mean there is no pancreatitis

No. A single normal test does not always rule pancreatitis out. In assessing pancreatitis, the examination, the pancreas-specific tests and the imaging results are considered together.

Does a normal pancreas on ultrasound rule out pancreatitis

Not always. In mild and early cases especially, the ultrasound findings may not be obvious.

Does pancreatitis clear up completely

Many patients with mild or moderate pancreatitis can recover with appropriate treatment. But the disease does not follow the same course in every patient. In severe cases life-threatening complications can develop, and more intensive monitoring may be needed.

Can pancreatitis come back

Yes. Some animals have a single acute attack, while in others the disease can come back or become chronic. In recurring cases it is important not only to treat the current attack but also to look for other diseases that may accompany pancreatitis or predispose the animal to it.

How long does recovery take

It depends on how severe the disease is. Mild cases can respond quickly to appropriate supportive treatment, while severe pancreatitis may need a longer hospital stay and close monitoring. So the patient’s response in the first hours and days of treatment matters as much as how it looks on the first day.

Can I give human medicine at home

No. Some painkillers used in people, in particular, can cause serious poisoning, damage to the stomach and intestines, or kidney problems in cats and dogs. Do not give any medicine your vet has not recommended.