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Poppy's pancreas- An article about pancreatitis.

Poppy is a very sweet 7 year- old Boxer dog. She came to the surgery last week in a very poor state. Her owner was beside herself with worry. Poppy had become extremely thin and ribby, was standing in a hunched and dejected way and her coat was spiky and unkempt. I admit that my initial thought was that she must have a tumour somewhere.

Her owner said she had been violently sick the previous day and was completely uninterested in food. She had become very withdrawn and seemed to be in a great deal of pain. Boxers have quite sad faces anyway but the look in her eyes was enough to melt anyone’s heart. She seemed to simply be asking for help. I know this is attributing human characteristics to an animal but when you have spent any length of time with animals it becomes obvious they can communicate in more ways that we know.

I started to examine her. Normally when we’ve seen her in the past she is very lively and bounces around, making it difficult to do much. On this day she simply stood there and let me do what I needed to. I started at her head as I always do and found her mucous membranes to be very red. These are areas such as the gums and the conjunctivae of the eye. A deep red colour is usually a sign of dehydration and toxicity. As I worked my way over her body I tried to gently palpate her abdomen. She was incredibly thin but the front half of her abdomen, as her owner had noticed, was very wide and hard. As soon as I touched her there she winced and looked round at me. I didn’t try to explore much further and told her owner that we would admit her straight away to do some tests and try to find out what was wrong. I told her owner to expect the worst. I try not to be too pessimistic at work but I would rather someone ended up pleasantly surprised than give them false hope and then leave them devastated.

The first thing we did was take some blood. I was fearful that she had liver disease and was expecting to see her liver enzymes massively raised on the bloods. I also wanted to check to see how dehydrated she was and whether there was any sign of inflammation or dehydration. While the bloods were running we got a drip set up for her and started her on fluids to try and redress her dehydration. This alone can be rapidly fatal and this was our first priority.

When you have been qualified for any length of time it is easy to have diagnoses in your head as soon as you look at an animal. I try to always start from first principles because I simply cannot afford to make assumptions. No drugs could be given until we knew which of her organs were affected because this can be very dangerous. To my surprise her liver was completely normal. The only value that was abnormal was an enzyme called amylase. This was raised to quite a high level and immediately everything started to become clear.

Amylase is an enzyme found in the pancreas. When the pancreas becomes inflamed the enzyme leaks out into the blood stream and this was what we were seeing. It may not sound like much but pancreatitis can be a devastating disease and left unchecked can be fatal. The pancreas has two parts. One of these controls things such as insulin release and is called the endocrine pancreas. The other is responsible for producing and releasing enzymes that digest our food. You can imagine what happens when these come into contact with our own tissues. During pancreatitis these enzymes leak out and start to digest the tissues around it. This is usually the intestines and the stomach. Now you can see how serious the situation is.

The fluids we had already started had to be kept going to support Poppy’s circulation and we immediately gave her a strong pain- killer to make her more comfortable. The next important thing was starvation. This is essential because the act of eating stimulates the pancreas to keep producing more enzymes. We had to try and get it to stop. We also gave her antibiotics because we could not be sure how extensive the damage inside was. Then all we could do was wait.

Every eight hours or so we topped up her pain relief and she was quickly much more comfortable. Amazingly after about 6 hours of fluids her coat had flattened down and had regained its shine and she seemed to be a bit more interested in her surroundings. I was called to the surgery at about 9pm that night to take charge of a stray dog and as I fed the dog I noticed Poppy watching my every move and standing at the bars of the kennel softly whining. I calculated that it was now more than 24 hours since she had last vomited and decided to offer her a small amount of food. She practically ate the bowl! I was absolutely over the moon. She was only allowed a mouthful because I still had to be careful. If she kept it down over night she could have some more.

The next morning Poppy was vastly improved and very, very hungry! We kept her for the day and fed her small, frequent meals of Hills i/d food. This is very low in fat and very digestible. It is the fat content of food that most stimulates the pancreas. That evening, once we were satisfied that her vomiting had stopped and she was comfortable she was allowed to go home. We spoke to her owners the next day and I saw her the day after that. She dragged her owner in to the surgery the way we would expect her to and listened to how she had got her bounce back!

Poppy was an unusual candidate for pancreatitis as it is usually seen in obese dogs or after a very fatty meal but there are always exceptions to the rules. Her other symptoms very fairly classic, so now you know what to watch out for. It’s another reason to watch your dog’s weight and avoid those table scraps. Apart from this, no one really knows what the triggers are but believe me, your dog will let you know if it’s a problem! Poppy is well on the road to recovery now but will need to stay on a low fat diet for a while yet, not that she seems to be complaining!

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