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Healing & Alternative Health
Dr. Carson's Holistic Animal Care:
Signs of the Aging
Dog and Cat
Part 17:
Organs of the Abdomen: Diseases of the Pancreas: Diagnosis
by Kathleen M. Carson, D.V.M
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Last month I wrote about pancreatitis (inflammation of the pancreas), which is the most common disease of the exocrine (digestive-enzyme producing) part of the pancreas. I told about how, in acute pancreatitis, the digestive enzymes made by the pancreas are activated while they’re still in the pancreas and start digesting pancreatic tissue. In some cases, the activated enzymes escape into the blood stream and cause all kinds of damage throughout the body.
How would you know if your geriatric dog or cat had acute (coming on suddenly) pancreatitis? For dogs, the most common signs are vomiting; not eating; hunched stance; rapid, shallow breathing; depression; occasional diarrhea; occasional jaundice or icterus (yellowing of the eyeballs, gums, and skin); and, more rarely, shock/collapse.
As is typical with cats, signs of acute pancreatitis are often subtle: he/she may stop eating and be lethargic. Sometimes, there’s vomiting, and, less commonly, diarrhea, but these are much less frequent than in the dog. In more severe cases there is dehydration and shock, in which case your cat would have a dry mouth, pale gums, and would feel cold to the touch.
If you’ve read my earlier columns on other diseases, you’ll note that these signs, especially those of cats, are common to a lot of different conditions.
You should bring your animal to your veterinarian if he/she is showing these signs, especially if they are severe or have gone on for more than a day or two. (Right away if they’re very pronounced.)
How about the signs for chronic pancreatitis, in which the inflammation in the pancreas has been going on at a “low boil” for a long time? Over time, more and more pancreatic tissue is replaced by scar tissue. When the scarring is extensive enough, not enough digestive enzymes are formed. The result is chronic diarrhea.
On physical exam by your veterinarian, there are things he/she may find in your animal with acute pancreatitis, depending on the severity of the condition. In dogs, more than half will show signs of pain when the forward (cranial) part of their abdomens are felt (palpated); these dogs will probably be panting from the pain. Frequently, they will be dehydrated and show signs of weakness. Some will have the jaundice mentioned above. In severe cases, they’ll be collapsed with subnormal temperatures, pale gums, and other signs of shock. Severe pancreatitis can also cause cardiac arrhythmias (irregularities of the heartbeat).
In cats, the signs will be less specific in most cases. The most common physical findings of a cat with pancreatitis are weakness, dehydration and subnormal temperature. Cranial abdominal pain is only found in ~25% of cats with pancreatitis. As with dogs, cats with severe pancreatitis will show signs of collapse, shock and/or cardiac arrhythmias.
Your veterinarian will want to do some diagnostic tests. First on the list will be blood and urine tests. Until recent years, the test that was relied on to diagnose pancreatitis in the dog was an elevation of the pancreatic enzymes in the blood, especially lipase. If the lipase was extremely high, this was considered diagnostic for pancreatitis. However, unfortunately, other conditions could cause at least a mild to moderate elevation of pancreatic enzymes, confusing the picture. And, to make things even more confusing, some animals with pancreatitis had normal enzyme levels. The latter situation was almost always true with cats.
Fortunately, in recent years, blood tests which are more specific for pancreatits, like serum trypsin-like immunoreactivity (TLI) and the even more sensitive test, the pancreatic lipase immunoreactivity (PLI) have become available. These tests give us a much better, though not foolproof, way to diagnose pancreatitis through blood tests.
There may be other abnormalities in the bloodwork and/or urinalysis of your animal with pancreatitis. These could include an elevated white blood cell count (WBC), anemia, decreased platelets (thrombocytopenia), lipemia (excess fatty products in the blood), increased liver enzymes, increased bilirubin (which causes the jaundice), signs of acute renal failure (ARF)S, abnormal glucose levels, and/or abnormal electrolytes.
Additional diagnostic procedures may be called for, especially if the blood and urine tests don’t prove diagnostic. These could include: radiographs (X-rays), in which your doctor would look for increased opacity and haziness in your animal’s right cranial abdomen; abdominal ultrasound; and pancreatic biopsy. The last procedure has to be approached cautiously, because it involves abdominal surgery, which can be risky in a very sick animal.
Next month I’ll discuss the treatment of pancreatitis. |
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Dr. Kathleen Carson, DVM
Veterinarian & Author
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Dr. Carson received her Doctor of Veterinary Medicine degree from the University of California at Davis in 1968. She's been a small animal practitioner (dogs and cats ) for all the years since, except for a short stint at the San Diego Zoo when she first graduated.
She belongs to the American Veterinary Medical Association and the American Holistic Veterinary Medical Association.
Since 1974 she's lived and practiced in the South Bay Area near Los Angeles. She started the area's first house call practice in 1976 and the first pet crisis/loss group in 1989. The human-animal bond is of special interest to her.
She started exploring complementary veterinary medicine in 1987. Her practice became 100% holistic in 1996. She utilizes acupuncture, herbs, supplements, Bach Flower Remedies, homeopathic remedies, nutrition and medications for her patients in her practice.
She's currently taking a leave of absence from her house call practice due to health reasons but continues to do phone consultations and to write.
E-mail:
Critterhlr@aol.com
website:
http://www.holistic
vetconsult.com
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