Todayโs path rounds are on ๐ฉ๐๐ง๐๐ซ๐๐๐ญ๐ข๐ญ๐ข๐ฌ! This was a request! 
๐๐ก๐๐ญ ๐ข๐ฌ ๐ข๐ญ?
๐๐๐ง๐๐ซ๐๐๐ญ๐ข๐ญ๐ข๐ฌ refers to inflammation of the pancreas, and can be ๐๐๐ฎ๐ญ๐ (sudden onset) or ๐๐ก๐ซ๐จ๐ง๐ข๐ (low levels of inflammation over a long period).
๐๐ก๐จ ๐ ๐๐ญ๐ฌ ๐ข๐ญ?
Technically any species can get this, however today we will talk about this condition in dogs and cats!
๐๐ก๐๐ญ ๐๐๐ฎ๐ฌ๐๐ฌ ๐ข๐ญ?
Most cases of pancreatitis are considered to be ๐ข๐๐ข๐จ๐ฉ๐๐ญ๐ก๐ข๐, meaning we donโt really know what causes them. However, there have been a few predisposing factors that have been identified!
The most commonly identified risk factor in dogs is ๐๐ข๐๐ญ๐๐ซ๐ฒ ๐ข๐ง๐๐ข๐ฌ๐๐ซ๐๐ญ๐ข๐จ๐ง, aka when your dog breaks into the garbage can and eats all kinds of wonderful, disgusting things. This typically causes acute forms of pancreatitis. Some types of infections, medications and even ๐๐ง๐๐จ๐๐ซ๐ข๐ง๐ ๐๐ข๐ฌ๐๐๐ฌ๐๐ฌ (diseases of the hormone producing organs) have also been linked to pancreatitis.
The basic underlying mechanism is premature activation of ๐ณ๐ฒ๐ฆ๐จ๐ ๐๐ง๐ฌ, which are the precursors to pancreatic enzymes. Under normal circumstances, these zymogens are excreted by the pancreas, and get activated once they are in the gut. These enzymes then help break down proteins and fats for digestion. In pancreatitis, something stimulates these zymogens to be activated while they are still in the pancreas. Because their job is to break down proteins, and the pancreas is made of proteinโฆ I bet you can guess what happens!
๐๐ก๐ฒ ๐ข๐ฌ ๐ญ๐ก๐ข๐ฌ ๐ ๐ฉ๐ซ๐จ๐๐ฅ๐๐ฆ?
Having your pancreas eaten by its own enzymes isnโt a very fun time! The destruction of the pancreatic cells leads to edema, bleeding, inflammation and ๐ง๐๐๐ซ๐จ๐ฌ๐ข๐ฌ (death of the cells). The destruction of basically an entire organ causes a ton of inflammation, which produces a lot of ๐๐ฒ๐ญ๐จ๐ค๐ข๐ง๐๐ฌ (proteins that stimulate inflammation) that can travel to other locations in the body and produce inflammation there. Even worse, sometimes the activated pancreatic enzymes can enter the bloodstream and digest other distant tissues!
All of this inflammatory soup can cause a few different clinical signs. Typically, animals present with vomiting, weakness, abdominal pain and dehydration. However, these signs are pretty non-specific! So itโs important to keep pancreatitis on your list of possible conditions whenever youโre presented with an animal feeling kind of crummy.
๐๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐๐ข๐๐ ๐ง๐จ๐ฌ๐๐?
Thereโs a few different methods for diagnosis, including X-rays, ultrasound, CT scans and even MRI. However, the best test veterinarians have is measuring something called ๐ฉ๐๐ง๐๐ซ๐๐๐ญ๐ข๐ ๐ฅ๐ข๐ฉ๐๐ฌ๐ ๐ข๐ฆ๐ฆ๐ฎ๐ง๐จ๐ซ๐๐๐๐ญ๐ข๐ฏ๐ข๐ญ๐ฒ (PLI), which measures the concentration of pancreatic enzymes in the bloodstream. If the PLI test comes back elevated, it is pretty much confirmed that youโre dealing with a case of pancreatitis!
๐๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐ญ๐ซ๐๐๐ญ๐๐?
These animals need lots of supportive care, particularly with fluid therapy to correct any dehydration. Often these animals also need a feeding tube to help get them back on their feet, since they often donโt want to eat! These animals typically require a low-fat diet moving forward, in order to reduce pancreatic enzyme secretion. Pain control and occasionally antibiotics are also used as part of these treatment plans to help stabilize the animal. In general, the prognosis for severe cases is pretty poor, so prompt treatment is extremely important.
๐๐ก๐จ๐ญ๐จ๐ฌ
1-2) Examples of sad, edematous and inflamed pancreases. Poor pancreas 
3) Another example of a sad pancreas, but this photo is particularly cool. See all those white plaques? Thatโs actually fat that has undergone necrosis from enzyme leakage. After necrosis, it gets calcium deposited on it, forming a chalky substance. This is actually a form of soap!
4-6) This is pancreas had chronic pancreatitis, and in this case the constant inflammation has led to scar tissue formation. Scar tissue has a tendency to contract, which results in a nodular appearance to this pancreas.
๐๐จ๐ฎ๐ซ๐๐๐ฌ
Maxie, G. Jubb, Kennedy and Palmerโs Pathology of Domestic Animals, Volume 1. Sixth Edition.
Steiner, JM. Pancreatitis in Dogs and Cats. Merck Veterinary Manual 2020.
Photos 1, 4-6 courtesy of University of Calgary Diagnostic Services Unit.
Photos 2-3 courtesy of Noahโs Arkive.
