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Pancreatitis in Dogs

Dr. Sushant Sadotra Canine Pancreatitis is one of the most common endocrine diseases occurring in dogs. However, it is more prevalent in dog breeds such as Miniature Schnauzers, Yorkshire Terriers, Cocker Spaniels, Dachshunds, Poodles, and sled dogs. Pancreatitis, a severe inflammatory condition of the pancreas, can be short-term or long-term, based on the level of pancreatic tissue damage. It can be of acute or chronic type. It can be related to various clinical or subclinical signs and potentially life-threatening.  Causes: Pathogenesis In the initial stages of Pancreatitis, the pancreatic juice is secreted in lesser amounts. Inside the pancreas, a series of steps lead to the activation of pancreatic enzymes. Co-localization of zymogen granules and lysosomes activates trypsinogen to trypsin, which further activates other zymogens. Premature activation of these digestive enzymes causes local damage such as edema, bleeding, inflammation, and necrosis of the pancreas. The inflammation process invites WBCs to the site and increases cytokine production. Altogether, this will cause further damage to pancreases and other distant complications such as generalized inflammation, disseminated intravascular coagulation, disseminated lipodystrophy, hypotension, renal failure, pulmonary failure, myocarditis, etc. Clinical Findings: Some of the most common symptoms in dogs are: The milder form of Pancreatitis can be related to subclinical or may have minor or nonspecific signs of anorexia, lethargy, or diarrhea. Diagnosis: Among all the methods discussed, histopathology is the gold standard for the diagnosis of canine Pancreatitis. However, a combination of mentioned techniques can be implemented in clinical practice for the most reliable and accurate diagnosis. Treatment: Careful monitoring and supportive veterinary care should be given in acute cases to prevent systemic complications. If a dog with chronic pancreatitis has no sign of improvement, additional trial therapy with an immunosuppressive agent such as prednisone, prednisolone, or cyclosporine may be prescribed for the treatment. Treatment for chronic pancreatitis is challenging because of systemic complications such as hypothermia, acidosis, hypocalcemia, and single- or multiple-organ failure. Reference: Watson, P. (2015), Pancreatitis in dogs and cats: definitions and pathophysiology. J Small Anim Pract, 56: 3-12. Whitley EM. Comparative Pancreatic Pathology. Pathobiology of Human Disease. 2014:1101–23. doi: 10.1016/B978-0-12-386456-7.03415-8. Epub 2014 Aug 21. PMCID: PMC7149520. Xenoulis, P.G. (2015), diagnosis of pancreatitis in dogs and cats. J Small Anim Pract, 56: 13-26.

Canine Chronic Hepatitis

Chavezlloyd Alexandria Baldago Chronic hepatitis is a condition in dogs that may occur due to various disease processes. It indicates a previous occurrence of inflammation and possibly cell death in the liver. The inflammation is caused by the infiltration of different types of white blood cells that are involved in the immune system. Necrosis, which refers to the death of a large number of liver cells, may also occur. The invasion of white blood cells and cell death in a dog’s liver can be due to previous damage caused by infectious agents like viruses or bacteria or as a result of toxic damage. Toxic damage may occur due to poisons ingested by the dog or abnormal accumulation of substances required by the body, such as copper. Though some breeds like Bedlington Terriers, Labrador Retrievers, Doberman Pinschers, Dalmatians, West Highland White Terriers, Welsh Corgis, Keeshonds, and others are notably affected, this toxicity can affect any breed of dog. Copper accumulation in hepatocytes can cause oxidative damage, and its presence can escalate hepatocyte damage caused by other factors. Until dietary recommendations are modified and implemented, this problem will continue to affect canines. Inflammation and cell death can also occur due to a primary attack by the immune system against liver cells, known as an “autoimmune” disease. Cancer in the liver is not called chronic hepatitis, even if it causes similar damage.   Chronic vs Acute The term “chronic” refers to a condition that has been causing damage for a prolonged period, typically lasting several weeks or more. On the other hand, “acute” hepatitis is usually characterized by a shorter duration of just a few days. While some cases of acute hepatitis can be treated successfully, many types of chronic hepatitis are not curable. However, with appropriate treatment and close monitoring, a significant number of patients with chronic hepatitis can maintain a good quality of life with minimal clinical symptoms for an extended period. Chronic hepatitis can affect any breed of dog regardless of gender or age, although it is more common in middle-aged or older dogs. Certain breeds may be more prone to specific types of hepatitis. For instance, some breeds may develop chronic hepatitis due to the accumulation of copper in the liver cells. The excessive concentration of copper harms the liver cells and, if left untreated, typically leads to severe chronic hepatitis. Symptoms The liver has multiple functions, therefore the clinical signs associated with liver disease can vary significantly. Symptoms of hepatitis in dogs can include: Lack of appetite Lethargy Vomiting Increased urination Excessive thirst and urination Swollen belly filled with fluid (ascites) Yellowish gums (jaundiced) and moist tissues Seizures, mental dullness Diagnosis Apart from obtaining a detailed history of the affected dog’s health prior to the appearance of symptoms, the next step would be to conduct a comprehensive physical examination of the dog, which includes carrying out a blood chemical profile, a complete blood count, an electrolyte panel, and a urinalysis. The results of the bloodwork will enable your veterinarian to identify any signs of impaired kidney function. To further evaluate the disease, complete abdominal ultrasonography is essential. This diagnostic tool screens for concurrent diseases and helps acquire bile. It’s important to note that the liver can appear normal upon examination, and changes seen in chronic hepatitis can include uniform increases in liver echogenicity, decreased distinction of portal vein margins, and normal to small liver size. Abnormalities in the liver parenchyma, biliary tree, portal vein, and peritoneum should be assessed, along with acquired shunting and the presence of free peritoneal fluid. In order to accurately diagnose chronic hepatitis, a liver biopsy is necessary. There are 3 ways to perform a liver biopsy, surgically, via laparoscopy, or through the skin using a special needle under ultrasound guidance. However, surgical or laparoscopic biopsies are more informative compared to ultrasound-guided biopsies. The information obtained from the biopsy is required to determine the type and severity of liver disease, as well as to assess your dog’s prognosis.   Treatment The treatment for chronic hepatitis in dogs is a complex process that depends on the severity and type of liver disease, as well as the clinical signs exhibited by the dog. In severe cases, hospitalization, intravenous fluid therapy, and supportive care may be required. The most common medications prescribed for treating the disease are immunosuppressive or anti-inflammatory. In some cases, dietary changes may be necessary. Certain medications may also be used in specific situations, such as dogs whose illness is linked to copper accumulation, abdominal fluid build-up, or neurological symptoms. Life Expectancy Although this condition cannot be cured with the available treatments, the good news is that the dog can still live a good quality of life for months and even years with continued therapy. Regular blood work is necessary to ensure the dog is responding well to the treatment. This helps to adjust the medication and keep the dog relatively free of clinical signs. References: https://bluepearlvet.com/medical-articles-for-pet-owners/chronic-hepatitis-in-dogs/ https://todaysveterinarypractice.com/hepatology/canine-chronic-hepatitis-diagnosis-treatment/ https://www.msdvetmanual.com/digestive-system/hepatic-diseases-of-small-animals/canine-chronic-hepatitis#:~:text=Canine%20chronic%20hepatitis%20is%20a,be%20predisposed%20to%20chronic%20hepatitis.