Christmas Eve dinner was wonderful as always. All the family gathered, candles lending gentle light to the table, a nice roasted duck at center stage. The holiday was blissful as well. Now it’s late Christmas night, and you’re relaxing by the fire with a glass of wine, when your dog starts to vomit. OK, maybe he got hold of something he shouldn’t have. Then he vomits again. And again.
You know that’s just not right.
Time for a call to the veterinary clinic. “Has he eaten any table food?” “Well, yes.” “Was it fatty?” “Umm, yes.” “Bring him in. Right now.”
Fatty foods are usually to blame when a dog has a severe attack of pancreatitis. Photo © Can Stock Photo.
Have you guessed yet where this is headed? If not, it’s leading to a diagnosis of pancreatitis – an inflammation of the pancreas. That’s the organ often known for its secretion of hormones like insulin, but one of its key functions is the release of enzymes that help your dog digest and absorb food, according to Steve Wheeler, D.V.M., M.S., ACVIM diplomate and co-founder of the Veterinary Referral Center of Colorado. When functioning normally, those digestive enzymes are held in the pancreatic cells, he explains. Then, when a dog eats, the enzymes are released through ducts into the intestine.
But when the pancreas gets overloaded, its cells essentially start to eat themselves, Wheeler says. “The cells become activated inside the pancreas, and the pancreatic cells start digesting themselves, releasing a lot of mediators that cause inflammation to the pancreas. It’s more kind of like the pancreas is digesting itself.” In addition to vomiting, the dog may appear depressed.
And that’s an emergency – on Christmas night.
In many cases of pancreatitis, the actual cause of the inflammation is never discovered, known as “idiopathic.” However, Wheeler says it is often a case of a dog who has had too much fatty food over time or in just one holiday-bingeing, steak-devouring or trash-diving incident. Dog publications and websites often publish articles – like this one – around the holidays as a reminder, but Wheeler says, “I think it’s an all-year thing, though we probably see a little more around the holidays. There’s more tasty food around for dogs to get into. A high fat meal is certainly a risk factor. That’s a frequent stimulus.”
The fat from barbecued steaks can lead to pancreatitis in any dog. Photo © Can Stock Photo.
However, the classic story, he says, is about a dog whose family has a barbecue, then someone cuts the fat off of a steak and feeds it to the at-the-time, oh-so-grateful dog.
“The most frequent case we see is an overweight, older female dog,” he says, though pancreatitis can happen to any dog. The reason overweight dogs are more susceptible is that they tend to have higher fat levels in their blood all the time, he explains.“Obese dogs can be in a pre-diabetic state, so are more likely to develop high fat levels in the blood.” The reason it is seen more in females, he says, may be a higher incidence of obesity in female dogs. While the dog may get along fairly well on a daily basis, it may not take much increased fat intake to push the pancreas beyond its capacity.
The other “big risk factor” is that some breeds tend to have elevated triglyceride levels, known as “hyperlipidemia,” he says. About 60 percent of the hyperlipidemia cases his Englewood referral center sees are Miniature Schnauzers. That’s the only breed he is willing to single out, though the AKC Canine Health Foundation also points to Yorkshire Terriers. Dogs with hyperlipidemia may be predisposed to pancreatitis, but Wheeler says plenty of dogs with the condition never get pancreatitis.
“It’s an acute, severe disease,” he says, and “in many cases,” it initiates when a dog eats excessively fatty human food.
However, it can also be caused by severe trauma, surgery, anesthesia, other diseases and medications, according to the Merck Veterinary Manual. Wheeler says it’s “very uncommon” as a result of trauma, and he’s seen it “occasionally” when the pancreas undergoes a surgical procedure. It’s also “very uncommon” for an infectious disease or medication to cause it, he says.
Making the Call
So, now you’re at the 24-hour veterinary clinic with your dog. What’s next?
At Wheeler’s referral center you’re in luck, because the veterinarians have ultrasound equipment at their disposal. “We have a big advantage because we do a lot of abdominal ultrasound. Ninety-five percent of the cases, we’re going to see on an ultrasound. So we have a pretty high index of suspicion [that it’s pancreatitis],” he says. On an ultrasound, the echoes will show that the pancreas is enlarged and because the fat around the pancreas is affected, it appears abnormal.
In addition, the dog will be depressed, he says, unwilling to move around much, in pain and vomiting.
His center also uses two tests to diagnose pancreatitis: a CPL – canine pancreas-specific lipase – snap test, and the CPLI, or canine pancreatic lipase immunoreactivity, test. The CPL snap gives immediate results while the CPLI results take 24 hours, but are more accurate.
However, care is not delayed while waiting for test results.
Getting Needed Support
“A vast majority of these dogs come in as emergency cases,” he says. Because of that, they’re likely to be hospitalized. Depending on the severity of the case, they will be given fluids through an IV to combat dehydration due to vomiting. Nearly all cases get pain medication because they are frequently uncomfortable. Most dogs will also receive something to suppress vomiting.
In a more advanced case, a dog’s blood pressure drops, so treatment to support blood flow within the pancreas and other organs is needed.
“A large part of our treatment is supportive, especially making sure they’re hydrated and comfortable, and suppressing vomiting and making sure they’re blood pressure is well-supported,” Wheeler says.
“They can actually go into shock. It’s a very broad spectrum disease.”
On the Mend
“Often dogs are near death” when they arrive at the center, Wheeler says. “Invariably the dogs that have very severe pancreatitis we’re going to lose.” Despite that, he estimates that 80 to 85 percent survive. Most will spend two to four days in the hospital.
Unfortunately, that’s not usually the end of it. “Any dog that’s had an episode is probably more predisposed to future episodes,” Wheeler says.
To avoid ever having your dogs go through pancreatitis, Wheeler recommends feeding a low-fat diet and not giving dogs high-fat treats. If your dogs get into the trash, he says, arrange it so that’s not possible. Dogs with hyperlipidemia should be managed medically too. “If your dog is overweight, work with your veterinarian to help it lose weight,” he says.
“This is one of those cases where an ounce of prevention is definitely worth a ton of cure,” he says.
And it can make for a calmer, more peaceful holiday season too.
Veterinary Referral Center of Colorado is a specialty veterinary hospital which includes a 24-hour emergency hospital and critical care center. On-site are veterinary specialists offering expertise in cardiology, dermatology/allergy, emergency care, internal medicine, neurology/neurosurgery, oncology/radiation therapy, ophthalmology and surgery. More information about VRCC can be found at www.vrcc.com.