Pancreatic Insufficiency in the Canine

Pancreatic Insufficiency

The pancreas is an organ nestling in the duodenum which has two principal functions.

To produce insulin (when this is severely reduced your dog becomes diabetic).
To produce enzymes to help digest food. These pass down a tube into the intestine where the enzymes mix with food material changing them to forms that can be absorbed through the intestinal wall. There are three main groups of pancreatic enzyme. Protease to break down protein, Lipase to break down fats and Amylase to break down carbohydrates.

Failure to produce these enzymes in adequate amounts is known as 'Pancreatic Insufficiency'.

How the disease works in the body

The most common form of Pancreatic Insufficiency is caused by Pancreatic Acinar Atrophy. This is where the small glands producing the enzymes, wither and have reduced or no function. The degree of atrophy varies from dog to dog. This occurs mainly in the dog and is of unknown origin. Dogs may have a history of intermittent intestinal disease before the more chronic symptoms develop.

Chronic Pancreatitis is caused by a possible range of bacterial, viral or inflammatory sources which destroy the function of the secretory, acinar glands of the pancreas. Rectification of the primary cause is essential to prevent further damage. Together with this disease concurrent Diabetes Mellitus may also be present. See your veterinarian if in doubt.

Acute Pancreatitis and Pancreatic Cancer may both cause pancreatic insufficiency. However, as they are extremely serious conditions with pronounced and painful symptoms, owners are unlikely to notice the subtle changes relating to enzyme insufficiency. These conditions can only be diagnosed by your veterinarian.

Owner's assessment

Accurate diagnosis in the home is impossible. The idea of this article is to make you aware of the condition and, if your veterinarian has diagnosed the condition to give you a greater insight into the problem and to clarify certain important points.

Clinical signs

These vary depending on the cause and severity. However, in the most common manifestation, caused by atrophy of the pancreas, your dog may appear bright, may develop a slightly 'edgy' character, lose weight, maintain reasonable coat condition, have marked increase in apetite and will often have increases in volume and frequency of faeces passed. The faeces are often soft to loose, usually pale in colour and often have a foul odour, rather like rancid cheese. Increased flatulence may also occur. As described above there may be other causes of a more severe nature which requires a veterinary diagnosis such as acute infection of the pancreas or even a pancreatic tumour. Symptoms may include abdominal pain and severe colic as well as increased thirst as in Diabetes Mellitus.

If your dog is vomiting several times a day, has severe diarrhoea and passing copious amounts of wind (flatulence) we would advise a rapid consultation with your veterinarian. However, in the majority of cases owners present their dog with flatulence, intermittent diarrhoea and looking perfectly well in themselves. These animals can usually be treated at home. Possible complications as mentioned above can be more serious with chronic disease problems of the pancreas and small intestines. Severe flatulence will lead to further disturbance in the bowel bacteria and sufficient gas build up to cause marked colic pain. For this reason, the rapid implementation of dietary management changes and anti-flatulent products is important.

Diagnosis

Many laboratory tests have been described for Pancreatic Insufficiency but few have any degree of reliability. More recently a test known as a TLI test (serum trypsin-like immunoreactivity) has become popular and is reliable. This is a blood test for dogs which measures the serum concentrations of the enzyme precursor, trypsinogen. Marked reduction in this level indicates Pancreatic Insufficiency. Your veterinarian may well run some other tests looking for other upper intestinal disease at the same time.

Treatment

Treatment comprises of three areas

Enzyme Replacement: If your veterinarian has diagnosed Pancreatic Insufficiency, the use of pancreatic enzyme replacement is recommended. Tryplase Capsules have highly refined pancreatic enzymes for the three principle groups. Although you are unlikely to cause any harm to your dog by giving these capsules in their feed at the correct dosage (see product information sheet) they may cause gastritis if overdosed. A veterinary diagnosis is required.
Dietary Control: This is essential. A low fat, highly digestible, low fibre diet is required. Hills Canine i/d is specially formulated to suit the needs of this condition.
B12 Treatment: Malabsorption of vitamin B12 occurs commonly in conjunction with this condition. B12 is essential for red blood cell production and deficiency leads to anaemia and further reduction in bowel function. To keep your dog bright and aid blood cell production you need to give a B12 vitamin supplement preferably by injection from your veterinarian.