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Appearance of the pancreas on ultrasound in (a) a clinical case of chronic pancreatitis in a dog (case 3) and (b) a normal dog. In both cases, the right limb of the pancreas is visualised ventral to the duodenum. Note the pancreatic duct has been visualised in the normal pancreas; in the abnormal pancreas, the right limb has an abnormal mottled, mixed hyperechoic and hypoechoic pattern
Source publication
This study reports the clinical, clinicopathological and ultrasonographic findings from dogs with chronic pancreatitis (CP). Fourteen dogs with clinical signs consistent with CP and histological confirmation of the disease were evaluated. Abdominal ultrasound and clinical pathology results were recorded. Sensitivities of pancreatic enzymes for diag...
Context in source publication
Context 1
... (case 4) had an abnormal pancreas on ultrasound. On 14 occa- sions, in 11 dogs, the pancreas appeared ultrasonographically abnor- mal, with a variety of findings ranging from a mixed hyperechoic and hypoechoic pattern (Fig 1) to a more uniform hypoechoic pattern and mass lesions that could be consistent with neoplasia in three cases. Neoplasia was ultimately ruled out in all three dogs based on patho- logical results, supported by a prolonged survival time in two dogs (the third was lost to follow-up). Ultrasound abnormalities showed no obvious predisposition to either pancreatic limb or the body. Three cases had abnormalities of the intestine and mesentery adjacent to the pancreas, including thickening of the small intestine and/or stom- ach wall, loss of layering and an apparent 'mass' effect invading the ...
Citations
... 1,2 Chronic pancreatitis in dogs is associated with refractory pain and reduced quality of life, precipitating progressive life-limiting impairment of pancreatic function. [3][4][5][6] There are currently few substantive pathophysiological studies in dogs with naturally occurring pancreatitis, so disease insight is often extrapolated from humans and animal models. [7][8][9][10] Antemortem diagnosis of pancreatitis in dogs is challenging, relying heavily on clinical history and a combination of diagnostic tests, all of which have limitations. ...
... [11][12][13] Improvements are reported in evaluating the pancreas through noninvasive imaging techniques such as ultrasonography and computed tomography, but a number of factors, including operator experience, can highly influence their diagnostic utility. 4,[14][15][16][17][18][19] All currently available circulating biomarkers for pancreatitis diagnosis have suboptimal testing accuracy depending on severity of disease, highlighting the need for better biomarker candidates. 11,14,[20][21][22][23][24] The most frequently used assay is canine pancreas-specific lipase immunoreactivity (cPL), available as both a quantitative (Spec cPL) assay and a semi-quantitative point-of-care (SNAP) cPL test. ...
Background
Pancreatitis is an important cause of disease and death in dogs. Available circulating biomarkers are not sufficiently sensitive and specific for a definitive diagnosis.
Hypothesis
Circulating microRNAs would be differentially expressed in dogs with chronic pancreatitis and could have potential as diagnostic biomarkers.
Animals
Healthy controls (n = 19) and dogs with naturally occurring pancreatitis (n = 17).
Methods
A retrospective case‐control study. Dogs with pancreatitis were included if they satisfied diagnostic criteria for pancreatitis as adjudicated by 3 experts. MicroRNA was extracted from stored serum samples and sequenced. Reads were mapped to mature microRNA sequences in the canine, mouse, and human genomes. Differentially expressed microRNAs were identified and the potential mechanistic relevance explored using Qiagen Ingenuity Pathway Analysis (IPA).
Results
Reads mapping to 196 mature microRNA sequences were detected. Eight circulating microRNAs were significantly differentially expressed in dogs with pancreatitis (≥2‐fold change and false discovery rate <0.05). Four of these mapped to the canine genome (cfa‐miR‐221, cfa‐miR‐222, cfa‐miR‐23a, and cfa‐miR‐205). Three mapped to the murine genome (mmu‐miR‐484, mmu‐miR‐6240, mmu‐miR‐101a‐3p) and 1 to the human genome (hsa‐miR‐1290). Expression in dogs with pancreatitis was higher for 7 microRNAs and lower for mmu‐miR‐101a‐3p. Qiagen IPA demonstrated a number of the differently expressed microRNAs are involved in a common pancreatic inflammatory pathway.
Conclusions
The significantly differentially expressed microRNAs represent promising candidates for further validation as diagnostic biomarkers for canine pancreatitis.
... 34 Dogs with EPI secondary to CP may have a history of intermittent gastrointestinal upset and abdominal pain. 35,36 Cats with EPI show fewer "classic" signs of EPI compared to dogs, with weight loss being the most commonly reported clinical sign across multiple studies. 13,14,37 The lack of "classic" clinical signs means that these cases can be easily missed in clinical practice, unless the veterinarian actively screens for such cases. ...
Exocrine pancreatic insufficiency (EPI) is a malabsorptive syndrome caused by insufficient secretion of digestive enzymes from pancreatic acini. The most common causes of EPI in dogs and cats are pancreatic acinar atrophy and chronic pancreatitis. EPI is diagnosed by measurement of species-specific immunoassays for serum trypsin-like immunoreactivity, the concentration of which directly reflects the mass of functioning pancreatic acinar tissue. EPI is treated by pancreatic enzyme replacement therapy, nutritional management (low-residue diets with moderate fat content), and supplementation of cobalamin. Some dogs and cats have persistent clinical signs despite these treatments. Growing evidence suggests that these clinical signs may be due to enteric microbiota dysbiosis or the presence of concurrent diseases such as chronic enteropathies. Management of these abnormalities may improve outcome in dogs and cats with EPI. The long-term prognosis for dogs and cats with EPI is generally good if high-quality medical therapy is provided. Future studies are needed to further understand the causes of persistent dysbiosis in animals with EPI following initiation of pancreatic enzyme replacement therapy and assess the efficacy of treatments to ameliorate these abnormalities.
... To our knowledge, there are no specific reports on ultrasonographic findings in dogs with EPI. Only in one study of about 14 cases of CP in dogs, of which 5 had EPI, ultrasound examination of pancreas was reported: in four dogs, the pancreas appeared unremarkable on the ultrasound, while in one dog the pancreas appeared abnormal [15]. ...
Exocrine pancreatic insufficiency (EPI) is a syndrome characterized by insufficient synthesis of pancreatic enzymes leading to clinical symptoms of malabsorption and maldigestion. There are no studies about ultrasonographic appearance of the pancreas with EPI in dogs. The purpose of this retrospective study was to describe ultrasound features of the pancreas during EPI in this species. Dogs with history and clinical signs of maldigestion, serum canine trypsin-like immunoreactivity (cTLI) values <5 µg/L, and abdominal ultrasound exam were included in the study. Size, shape, margin, echogenicity, echostructure, and pancreatic duct appearance of the right pancreatic lobe were valued. Additional sonographic intestinal findings were recorded. Thirty-four dogs were included. The mean pancreatic thickness in our population was significantly lower than the mean reference values of healthy dogs. In 68% of dogs, the pancreas had a normal ultrasound appearance. Ultrasonographic intestinal abnormal findings were identified in 85% of dogs and were suggestive of inflammatory bowel disease. Despite the fact that EPI is a functional diagnosis, ultrasound evaluation should be considered among the useful tests. The finding of a normal but thinned pancreas associated with sonographic intestinal signs of inflammatory bowel disease in dogs with typical history and supportive clinical signs could suggest a diagnosis of EPI.
... 6,8 Increase in serum cPLI is also known to reflect histological lesions in the pancreas. 7,9 More recently, substrate-based testing for pancreasspecific lipase, which can be measured using a small benchtop analyzer, has been developed. [10][11][12] FUJI DRI-CHEM v-Lip-P b (FDC-v-Lip) was designed to increase the specificity for pancreatic lipase using triolein as the reaction substrate, combined with colipase, bile salt, and sodium dodecylbenzene sulfonate. ...
... respectively, which was compara-ble to cPLI. 11 Currently, serum cPLI is the most sensitive and specific serum marker for diagnosing AP in dogs and has been validated in both clinical 17 and histopathological 7,9,18 studies. Increases in serum cPLI is known to reflect histological lesions in the pancreas. ...
... Increases in serum cPLI is known to reflect histological lesions in the pancreas. 7,9,18 Therefore, the postoperative increase of FDC-v-Lip may reflect histological damage in the pancreas. However, it should be noted that FDC-v-Lip and serum cPLI are not entirely interchangeable, and cPLI has better specificity for pancreatic lipase. ...
Objective
To describe the perioperative changes in blood pancreatic lipase activity and explore the contributing clinical factors associated with these changes.
Design
Prospective observational study.
Setting
University teaching hospital.
Animals
One hundred and four dogs underwent various surgical procedures under general anesthesia.
Interventions
None.
Measurements and Main Results
Blood pancreatic lipase activities, which were measured using FUJI DRI‐CHEM v‐Lip‐P (FDC‐v‐Lip), significantly increased postoperatively compared to preoperative measurements (premedian 58.5 U/L [range, 23–157] vs. postmedian 80 U/L [range, 22–1000], P < 0.0001). The patient with a postoperative increase in FDC‐v‐Lip over the normal range (35 dogs [33.6%]) had significantly higher preoperative FDC‐v‐Lip values.
Conclusions
In this study, dogs had significantly increased pancreas‐specific lipase activities after surgical procedures under general anesthesia. Direct contributors to the increase and its relevance to clinical and histological pancreatitis should be determined in the future.
... Várias doenças relacionadas ao metabolismo da glicose afetam o pâncreas, entre elas: neoplasias, cálculos, inflamações, atrofia, hiperplasia e distúrbios secretórios. O principal relato patológico em cães é a pancreatite, doença exócrina (Berman et al., 2020;Watson et al., 2010). Já na porção endócrina, a principal patologia é a Diabetes Mellitus, insulinoma e gastrinoma (Marcato, 2010). ...
A Diabetes Mellitus Canina (DMC) é representada como um grupo de doenças metabólicas autoimunes de etiologia multifatorial. Na DMC ocorre uma deficiência relativa ou absoluta de insulina que leva a uma insuficiência das células em obter e utilizar a glicose. Na maioria dos casos, os cães diagnosticados serão insulinodependentes por toda sua vida, e, quando não tratados a progressão da doença levará o animal à óbito. O objetivo desta pesquisa foi estudar a histopatologia e fisiologia do pâncreas para compreender a etiopatogenia da DMC, a partir da descrição das alterações patológicas pancreáticas decorrentes da mesma ou que favorecem sua ocorrência. A metodologia desta pesquisa foi a de revisão de literatura a partir de livros e produção científica em Medicina Veterinária, com base em pesquisa relacionada com as seguintes palavras chaves: Diabetes Mellitus Canina; Patologias Pancreáticas; Endocrinopatias em cães; em algumas bases de dados como: SciELO.org e Google Academy, nos últimos 12 anos. Atualmente não há um critério internacionalmente definido para a classificação da diabetes em pequenos animais. É comum a classificação da DMC segundo modelo humano; porém, alguns autores defendem o uso de DMC primária e secundária. As principais alterações histológicas do pâncreas em cães com DMC incluem a destruição parcial ou total das ilhotas de Langerhans, vacuolização e/ou degeneração hidrópica, presença de infiltração leucocitária, embora divergente entre autores. Os anticorpos quando imunomediada são descritos também depósitos amiloides, predispondo à glucotoxicidade. Algumas alterações pancreáticas são advindas da DMC como consequência; porém, o contrário também ocorre. Os mecanismos fisiológicos autoimunes em conjunto com fatores genéticos e ambientais, drogas antagonistas da insulina e doenças adjacentes têm um papel importante para o desenvolvimento e a progressão da DMC, tendo como resultado final a perda irreversível de função das células β-pancreáticas.
... Estudos apontam que a prevalência da pancreatite aguda e crônica ainda é desconhecida, em vista que a ocorrência de casos é maior do que o diagnóstico em si (Xenoulis et al., 2008). Informações publicadas sobre os achados clínicos, anatomopatológicos e histopatológicos de cães com pancreatite crônica, bem como quaisquer associações entre eles, são muito limitadas (Watson et al., 2010a;Watson et al., 2011). ...
Este trabalho tem como objetivo relatar um caso de fibrose pancreática esclerosante em um animal com diabetes mellitus, descrevendo os aspectos clínicos e anatomopatológicos envolvidos na doença em uma cadela, poodle, nove anos, atendida em um Hospital-Escola Veterinário. O animal apresentava picos de hipoglicemia e hiperglicemia, sem resposta ao tratamento insulínico e prognóstico desfavorável. No exame de autópsia, os principais achados anatomopatológicos foram atrofia e fibrose pancreática esclerosante, cistite supurativa e enfisematosa e degeneração hepatocelular gordurosa e glicogênica. Com o auxílio de métodos histoquímicos foi possível identificar a deposição/substituição do interstício pancreático por tecido fibroso.
... Animals with pancreatitis can show varying haematological abnormalities (Akol et al. 1993;Ferreri et al. 2003;Hess et al. 1998;Hill & Van Winkle 1993 ). Serum-specific lipase (cPL) has been shown to be both a sensitive and specific serum marker for pancreatitis in dogs (McCord et al. 2012;Steiner et al. 2008;Trivedi et al. 2011;Watson et al. 2010), with a sensitivity ranging between 72% and 78% (McCord et al. 2012) and a specificity of between 81% and 100% (Mansfield & Jones 2000;McCord et al. 2012;Neilson-Carley et al. 2011;Strombeck, Farver & Kaneko 1981;Trivedi et al. 2011). SNAP canine pancreatic lipase (cPL) has a sensitivity between 91% and 94% and a specificity between 71% and 78% for pancreatitis (McCord et al. 2012). ...
... No obvious breed predisposition was identified in this study, which agrees with previous studies that reported that dogs of any age, breed or sex can develop pancreatitis. Most dogs that are presented with pancreatitis are usually greater than 5 years of age (Cook et al. 1993;Ferreri et al. 2003;Hess et al. 1998;Watson et al. 2010). Various studies have highlighted differences in breed predilections because of different geographic regions. ...
Pancreatitis is a common clinical condition seen in companion animals. The correlation of the region of the pancreas affected to the presentation of clinical signs has not been previously described. A retrospective study on the clinical findings in 293 client-owned dogs diagnosed with suspect pancreatitis based on history, clinical signs, laboratory testing and abdominal ultrasonography was performed. Based on ultrasonography, dogs were divided into three groups: group 1: 41 dogs with ultrasonographic changes consistent with pancreatitis within the left lobe of the pancreas; group 2: 105 dogs with ultrasonographic changes compatible with pancreatitis within the right lobe of the pancreas; and group 3: 147 dogs with ultrasonographic evidence of diffuse pancreatitis. No significant differences regarding age, breed and sex were evident. Furthermore, statistical significance was demonstrated with the presence of pain in group 3; poor appetite in groups 2 and 3; and vomiting and diarrhoea in group 3. Pain is expected to occur with a higher frequency in diffuse pancreatitis, but it is not a common clinical sign. This may represent a more severe form of the disease when the pancreas is diffusely affected. Vomiting was more common than diarrhoea with both clinical signs more prevalent in dogs with diffuse pancreatitis, and this could be ascribed to gastric and intestinal tract involvement. Poor appetite occurred more frequently in dogs with diffuse and right lobe pancreatitis. A possible explanation can be attributed to the fact that the duodenum has many receptors and is referred to as the ‘organ of nausea’.
... 6 DM generally occurs in middle-aged and older dogs 2 7 8 ; some studies indicate that females are at greater risk, 7 8 and breed predispositions have been suggested. [7][8][9][10] Moreover, different risk factors, related to lifestyle 11 and the presence of concurrent diseases, [12][13][14] are believed to play a potential role in the development of DM in dogs. 15 Although the pathophysiological mechanisms, clinical aspects, diagnostic methods, treatment and monitoring options for dogs with DM have been investigated in a number of studies, only a few 3 8 have mentioned life expectancy and prognostic factors of the disease. ...
Background
Diabetes mellitus (DM) is one of the most common endocrine disorders in dogs, but prognostic factors are still largely unknown. The aim of this retrospective, single-centre, case series study was to determine overall survival time and identify the prognostic value of several clinical and clinicopathological variables in dogs with newly diagnosed DM.
Methods
Cases of DM were identified within the electronic medical records of one referral centre. Sixty-eight dogs with DM were included. Cox proportional hazards models were used to analyse variables associated with survival.
Results
The median survival time was 964 days (range 22–3140). In multivariable model analysis, length of survival was significantly shorter for dogs with higher haematocrit value (hazard ratio (HR) 1.06, 95 per cent confidence interval (CI) 1.00 to 1.13) and higher serum phosphate concentrations (HR 1.83, 95 per cent CI 1.13 to 2.97). Serum phosphate concentrations were above the reference interval in 24 of 65 (37 per cent) dogs.
Conclusion
Diabetic dogs have a good life expectancy. Hyperphosphataemia is a relatively common finding in dogs with newly diagnosed DM and represents a negative prognostic factor. The presence of pancreatitis might not be associated with an unfavourable outcome.
... A limitation of the present study was that serum lipase activity was determined using the 1,2-diglyceride enzymatic/colorimetric assay and not the canine pancreatic lipase immunoreactivity that seems to have higher sensitivity in detecting chronic pancreatitis. 16 However, the present study is focused on the comparison of the efficacy and safety of two different insulin products, rather than evaluating the possible causes of insulin resistance. ...
Clinical studies that compare lente insulin and neutral protamine Hagedorn (NPH) insulin in diabetic dogs are lacking. This is a prospective, randomised, controlled clinical study aimed to compare the efficacy and safety of lente insulin and NPH insulin in diabetic dogs. Thirty client-owned, newly diagnosed diabetic dogs were included. Animals were randomised into two groups and received lente insulin or NPH insulin administered every 12 hours. Follow-up re-evaluations were done at 1, 2, 4, 6, 8 and 12 weeks. At each re-evaluation, a physical exam, blood glucose curve, and serum fructosamine concentrations were performed. At the end of the study, the median insulin dose per injection was 0.61 U/kg (range, 0.34–0.92 U/kg) and 0.49 U/kg (range, 0.23–0.68 U/kg) in the lente and NPH groups, respectively. There was a significant improvement of polyuria and polydipsia and glucose concentrations in both groups. At the end of the study, the glycaemic control was considered good in 9/15 (60 per cent) and 11/15 (73 per cent) in the lente and NPH groups, respectively. These differences were not significant. Lente insulin and NPH insulin were similarly effective in the treatment of dogs with diabetes mellitus.
... Diabetic ketoacidosis is a commonly reported comorbidity in canine with Acute pancreatitis (Lem et al., 2008) [44] , causing trypsin activation and acinar cell necrosis, rather than the exocrine inflammation destroying the acinar cells (Bhoomgoud et al., 2009) [7] . Late-onset complications such as chronic relapsing pancreatitis and the subsequent development of exocrine pancreatic insufficiency or diabetes mellitus have been described in dogs (Watson, 2003;Watson et al., 2010) [77,78] . ...
... Diabetic ketoacidosis is a commonly reported comorbidity in canine with Acute pancreatitis (Lem et al., 2008) [44] , causing trypsin activation and acinar cell necrosis, rather than the exocrine inflammation destroying the acinar cells (Bhoomgoud et al., 2009) [7] . Late-onset complications such as chronic relapsing pancreatitis and the subsequent development of exocrine pancreatic insufficiency or diabetes mellitus have been described in dogs (Watson, 2003;Watson et al., 2010) [77,78] . ...
Acute pancreatitis is the more clinically recognized form of inflammation in pancreas. Failure of zymogens activation causes inflammation and necrosis of the pancreatic tissue thereby resulting in leakage of pancreatic digestive enzymes into the peritoneal space or the intravascular space. Chances of disease occurrence varies with respect to age, breeds etc. Dogs with acute pancreatitis attain "praying position" or "position of relief" in response to cranial abdominal pain. In addition, there is vomiting, anorexia and depression. Blood examination shows peripheral blood neutrophilia with a degenerative left shift, anemia and thrombocytopenia. Azotemia, hyperbilirubinemia, hypocalcemia, hyperglycemia and eleveted levels of liver enzymes are usual findings. Disease is diagnosed by radiography, ultrasonography, Computed tomography and immunological tests. Fluid therapy, plasma, analgesics, antiemetics are generally recomended. Also, dogs are provided healthy diet.
