Acute pancreatitis in dogs

Abstract

Objective: To summarize current information regarding severity assessment, diagnostic imaging, and treatment of human and canine acute pancreatitis (AP). Human-based studies: In humans, scoring systems, advanced imaging methods, and serum markers are used to assess the severity of disease, which allows for optimization of patient management. The extent of pancreatic necrosis and the presence of infected pancreatic necrosis are the most important factors determining the development of multiple organ failure (MOF) and subsequent mortality. Considerable research efforts have focused on the development of inexpensive, easy, and reliable laboratory markers to assess disease severity as early as possible in the course of the disease. The use of prophylactic antibiotics, enteral nutrition, and surgery have been shown to be beneficial in certain patient populations. Veterinary-based studies: The majority of what is currently known about naturally occurring canine AP has been derived from retrospective evaluations. The identification and development of inexpensive and reliable detection kits of key laboratory markers in dogs with AP could dramatically improve our ability to prognosticate and identify patient populations likely to benefit from treatment interventions. Treatment remains largely supportive and future studies evaluating the efficacy of surgery, nutritional support and other treatment modalities are warranted. Data sources: Current human and veterinary literature. Conclusions: Pancreatitis can lead to a life-threatening severe systemic inflammatory condition, resulting in MOF and death in both humans and dogs. Given the similarities in the pathophysiology of AP in both humans and dogs, novel concepts used to assess severity and treat people with AP may be applicable to dogs. (J Vet Emerg Crit Care 2003; 13(4): 201-213)

Monitoring Fluid Therapy and Complications of Fluid Therapy

“…As pulmonary interstitial pressure increases into the positive pressure range and the lymphatics are unable to remove this fluid, it leaks into the alveolar space. 33 In a prospective observational study of human septic patients, a positive cumulative fluid balance had a significant negative influence on survival. Experiments performed on dogs showed that pulmonary capillary pressure must increase to a value at least equal to the COP of the plasma inside the capillaries before clinically relevant pulmonary edema occurs.…”

Evaluation of fresh frozen plasma administration in dogs with pancreatitis: 77 cases (1995–2005)

“…However, the true incidence of the disease is unknown as some dogs may have subclinical signs or mild disease 5 . Acute pancreatitis, once diagnosed, has a reported mortality rate ranging from 27% to 42% although most dogs with mild clinical symptoms recover without complications 6 …”

Characteristics and outcomes in surgical management of severe acute pancreatitis: 37 dogs (2001–2007)

“…In humans, delayed surgical intervention has been reported to decrease morbidity and mortality in these cases 8,21 . While no specific guidelines have been established, currently accepted criteria for surgical intervention in dogs include evidence of infection, local complications (abscessation or biliary obstruction), diagnostic confirmation (of neoplastic versus nonneoplastic disease), persistent distant organ complications, and failure to respond to aggressive medical management 22–24 …”