Chronic pancreatitis-dogs

RE: Chronic pancreatitis-dogs

Martin Atkinson — Thu, 13 Jul 2017 17:21:43 GMT

[quote user="Bob Russell"]

Flare up probably settled as you would expect. It will be back!

I have more than a few dogs and cats with a provisional diagnosis of chronic pancreatitis despite negative results even during a flare up!

[/quote]I believe that it is the great hidden epidemic. I've posted before that one survey showed something like half of cats on post mortem examination when they had died from some other reason had evidence of pancreatitis. The incidence is probably higher in dogs. Most of the time they have a grumbly tummy and go off their grub for a couple of days then settle down and never get seen or just get treated symptomatically for a bout of gastro-enteritis when they rock up for the last appointment on a Friday night!!

RE: Chronic pancreatitis-dogs

Bob Russell — Wed, 12 Jul 2017 17:15:51 GMT

Flare up probably settled as you would expect. It will be back!

I have more than a few dogs and cats with a provisional diagnosis of chronic pancreatitis despite negative results even during a flare up!

RE: Chronic pancreatitis-dogs

Nicola Cole — Wed, 12 Jul 2017 16:33:55 GMT

Appointment was cancelled...

RE: Chronic pancreatitis-dogs

Nicola Cole — Wed, 12 Jul 2017 09:35:24 GMT

Brilliant, many thanks for your replies. I'm seeing them later today so I'll update with details once I've spoken to them and examined the dog.

Reading the cryptic clue attached to the appointment booking I just wanted to make sure I wasn't out of date on diagnostics for the discussion with them...

RE: Chronic pancreatitis-dogs

Martin Atkinson — Tue, 11 Jul 2017 18:49:44 GMT

What are the symptoms? Are we talking about acute on chronic bouts of pancreatitis here or pancreatic insufficiency? cPLi is only really use in the acute phase, TLI gives more information in pancreatic insufficiency but I confess I've not used DGGR lipase but it doesn't seem anymore sensitive than cPLi.

I agree with Andrew that biopsy is the only way to make a diagnosis but I'm not sure what would be achieved unless you're looking for neoplasia as dietary control is the way forward. If I was going to biopsy I would do it on ex lap so you can view the whole organ, I wouldn't like to rely on ultrasound.

Owners are terrible at sticking to diet and the ones who complain the most about them not getting better are usually the ones who precipitate their own dog's demise by letting them scavenge or feeding titibits. The true acute on chronic pancreatitis cases I've seen have remained stable in the long term as long as the owners stick to the recommended diet, in our case Royal Canin Gastro Low Fat.

RE: Chronic pancreatitis-dogs

Andrew Kent — Tue, 11 Jul 2017 17:17:21 GMT

Hi Nicola,

[quote user="Nicola M"]What's the best way to diagnose chronic pancreatitis?[/quote]

That's the million dollar question!

Unfortunately there is no definite answer to that as its about a combination of compatible things including signalment, history, compatible blood testing (cPLI/DGGR lipase being the most useful but as you show nowhere near 100% sensitive), and compatible imaging (usually ultrasound).

Ultimately only histopathology will give you a certain answer but a small biopsy can still miss disease.

I doubt anybody can provide what an owner like this is looking for!

Hope that helps,

Andy

RE: Chronic pancreatitis-dogs

Anthony Dennison — Tue, 11 Jul 2017 16:14:30 GMT

A raised TLI may indicate a chronic pancreatitis.