Treatment of acute canine pancreatitis

Content sponsored by Ceva Animal Health

Pancreatitis is a complex disease with metabolic complications and often requires clinical findings, laboratory testing, and imaging studies to properly diagnose.¹ The most important window of treatment for acute pancreatitis is within 36 to 48 hours. Unfortunately, most patients do not make it to the clinic until after a few days of consistent vomiting and abdominal pain. David C. Twedt, DVM, DAVCVIM, walked through various treatment options for severe acute pancreatitis, how they affect the patient, and which ones to avoid.

What causes acute pancreatitis?

High-fat diets are a trigger for pancreatitis as are high triglycerides since they are activated by pancreatic lipase, and subsequently produce pancreatitis.¹ A study conducted primarily with Yorkshire terriers, toy poodles, and miniature Schnauzers dove into the main causes of acute pancreatitis. What these researchers determined were seven key risk factors: dog breed and size of the breed, a lack of weight management, a prior history of gastrointestinal diseases, diabetes, hyperadrenocorticism, and hypothyroidism.² With a disease that can easily lead to a poor prognosis, the right treatments are crucial.

What therapies to stay away from

During his session, Twedt covered a number of therapies to avoid and his reasoning behind that decision:

1. Anticholinergics

These drugs reduce GI motility—which is the movement and exiting of food throughout the body—and do not benefit patients with ileus in their GI tract.

2. NSAIDS

Twedt said, “If an animal is hypovolemic and has renal compromise, [NSAIDs] can cause renal failure.” They also will negatively impact any GI ulcerations in the patient.

3. Corticosteroids

Years ago, veterinarians believed corticosteroids were the cause of pancreatitis, which was ultimately disproven, Twedt explained. The outlook has shifted to questioning if they should be used as a treatment. Twedt informed the audience, “There was a nice study done that was published in 2021. Veterinarians reviewed the literature which looked at 5 dog studies—4 or 5 that were experimental—5 human studies, and 21 rodent studies, and found that steroids can influence a positive outcome.” For dogs with chronic pancreatitis, steroids seem to help, especially with an autoimmune component. However, studies to confirm this effect are ongoing and Twedt hopes to have clarity within the next couple of years on if corticosteroids will truly help patients.

Conclusion

Closing out the talk, Twedt insisted, “Early nutrition is very important to the patient. We try to get them interested in that as soon as we can.”

References

1. Twedt DC. Treatment of Acute Canine Pancreatitis in Dogs: Are We Ready for a Paradigm Shift? Presented at: American Veterinary Medical Association; Denver, Colorado. July 14-18, 2023.
2. Hess RS, Kass PH, Shofer FS, Van Winkle TJ, Washabau RJ. Evaluation of risk factors for fatal acute pancreatitis in dogs. J Am Vet Med Assoc. 1999;214(1):46-51.