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44 Cards in this Set

  • Front
  • Back
Which is more common - chronic or acute pancratitis?
chronic
What pathological changes should be expected with acute vs. chronic pancreatitis?
acute pancreatitis - no pathological changes
chronic pancreatitis - fibrosis and atrophy
What is the pause of canine pancreatitis?
Unknown, but suspect:
dietary indescretion
hyperlipidemia
heriditary - Min. Schnauzers
RX - but no convincing evidence (no steriods)
endocrine dz (weak)
dehydration (shock)
Pathogenesis of canine pancreatitis
Consequence of autodigestion from premature zygomen activation within acinar cells
C/S of K9 pancreatitis
V/D
weakness
depression
ABD pain
prayer position
DX canine pancreatitis
Rads - loss of abd detail
U/S
Clinical path changes for pancreatitis?
MC-thrombocytopenia (mild)
leukocytosis w. left shift
+/- mild increase in liver enz
low albumin
Why not use lipase and amylase for diagnosing pancreatitis?
poor SN/SP
This is the most specific test for pancreatitis
serum canine pancreatic lipase immunoreactivity
If cPLI is -
If cPLI is +
- = look for another DZ
+ = followed up by labratory measurement of serum spec cPL
This is a gold standard for diagnosing pancreatitis
biopsy
but can be negative due to being a focal disease
TX for pancreatitis
TX underlying cause-ideopathic
Fluid
w/hold food if vomiting -low fat diet
analgesia
antimetics
FFP
AB & steriods not recommended
Why is it not recommended to use metoclopramide with pancreatitis?
can affect spanchnic perfusion (GI tract)
What other disease with chronic pancreatitis can dogs get?
concurrent IBD
How is chronic pancreatitis TX?
No standard of care
This is a collection of steriole pancretic fluid enclosed by fiberous tissue and thought to be a complication of pancreatitis
pancreatic pseudocyst
TX of pancreatic pseudocyst
SX - external or internal drainage - U/S guided aspiration
This too can be a complication of pancreatits an many times is sterile
pancreatic abscess
TX for pancreatic abscess
medical option maybe viable due to high op complication rate
Exocrine pancreatic insuffiency occurs when
there is insuffiecent synthesis and secreation of pancreatic enzymes = lack of digestive enzymes
What is the MC cause of EPI?
atrophy or chronic pancreatitis
How much of the exocrine function must be lost for EPI?
90%
C/S for EPI?
Weight loss
loose stolls
poor hair coat
borboygmus and flatulence
increased appetitie
coprophagia and/or pica
What is the gold standard for diagnosing EPI?
TLI
trypsin like immunoreactivity
What are two senerios that TLI is normal, but they have EPI
1. isolated pancreatic lipase deficiency (only reported in one dog)
2. obstructed pancreatic duct (not been reported in dogs)
What is the treatment of choice for cEPI?
Exogenous replacement of digestive enzymes
- pork/beef - MC
1 tsp/10#
and slowly decrease to lowest effective dose
Which form of pancreatic enzyme is prefered?
powder to tablets
What is a side effect of EPI enzyme supplementation?
What test should be run?
Recent study of dogs have oral bleeding (3/25) when TX with pancreatic enzyme supplementation.
Run a coag profile - if normal then decrease dose
What should be done if dogs do not eat the pancreatitic powder?
Try raw pancrease (beef, pork, sheep, or game).
Divide into individual meals and freeze
What water soluable vitamin has been found to be deficient in 82% of EPI dogs?
cobalamin (B12)
How often is Cobalamin injected when there is a deficiency?
250-1500 ug/injection
1x/week x 6 weeks
EOW/x 6 weeks
What to do when dogs not responding to EPI TX?
re-evaluate - type formation and dose of enzyme supplement.
R/O IBD, DM, or SIBO
If have concurrent SIBO and EPI, what additional AB should be added to TX?
Tylosin
Metronidazole
What is the prognosis for canine EPI?
Life long TX< but normal life
Shorter survival with decreased cobalamin
What is a benign pancreatitic exocrine neoplasia? TX?
pancreatic adenoma - no TX
What is the neoplasic exocrine pancreatic neoplasia?
pancratic adenocarcinoma
partial pancreatectomy
grave prognosis - mets common
This type of pancreatic disease in cats occurs in youger aniamls and has inflammation with >50% neutrophils?
acute suppurative pancreatitis
This feline pancreatic disease has lymphocytes and plasma cells
chronic non-suppurative pancreatitis
What type of neoplasia affects cats MC
adenocarcinoma
What is the etiology for actue necrotizing pancreatitis
unknown etiolgies, but suspected:
conccurent billary tract infection (cholangitis)
concurent IBD
pancreatic ductal obstruction
Co-infection - FIV/FeLV, flukes, calici virus
What are clinical signs for acute necrotizing pancreatitis
young cats
anorexia
lethargy
hypocalcemia is common in cats
TX for feline acute necrotizing pancreatitis
Only w/hold food if vomiting
provide feeding tube
pain
antimetics
calcium gluconate (low Ca- ass. with worse prognosis)
Broad spectrum AB - maybe sterile, but help with necrosis
WHen IBD is conccurent with acute necrotizing pancreatitis, how do you TX?
TX IBD first with dietary modification.
What are complications of acute necrotizing pancreatitis?
chronic non-suppartive pancreatitis
EPI
hepatic lipidosis