I remember my first experience with Pancreatitis in dogs – it was Thanksgiving at my mother-in-law’s house and their pup Hunter was getting his normal Turkey Dinner “special” which consisted of all the Turkey organ meats. It was a tradition for him, and you could tell he knew the drill. However, little did we know that Hunter would be spending the week after Thanksgiving hospitalized due to Pancreatitis.
Hunter’s story is a common tale seen in veterinary practice, after holidays many pups are hospitalized because of eating foods that they don’t normally eat and/or that are very high in fat. However, eating new or fatty foods is not the only cause of pancreatitis in dogs.
What is Pancreatitis?
Pancreatitis is simply the inflammation of the pancreas. Pancreatitis comes in two forms – one of which is acute in nature – like after thanksgiving or a holiday where a pet might eat a large fatty meal – or it can be chronic.
Both acute and chronic forms can be mild to severe in nature. This means that you might have a mild chronic form of pancreatitis that causes symptoms once a month, or symptoms might be so severe that your pup requires a daily management strategy to prevent from having active flares.
Function of the Pancreas
In order to understand why pancreatitis can be such a life-threatening condition, it’s important to understand what and how the pancreas functions within the body.
- Secretes digestive enzymes
- Secretes insulin and glucagon, which help regulate how dogs utilize the nutrients within the foods that they eat.
In essence – the pancreas is one of the main drivers for nutrient absorption and digestibility of ingredients.
What Causes Pancreatitis in Dogs?
There are many different documented correlations and potential causes of pancreatitis in dogs, the three most common of which are:
- Eating food items from the trash
- Eating an unusual or new Ffood prior to episode
- Eating table scraps over the paste week.
However pancreatitis has many other potential causes…
- High fat diet
- High calcium
- Cushing’s Disease or Hyperadrenocorticism
- Diabetes Mellitus
Breed Predisposition: Miniature Poodles, Miniature Schnauzers, Terriers, Non-sporting dogs.
What Happens during Pancreatitis?
The pancreas which usually houses digestive enzymes suddenly gets triggered to release those enzymes prematurely causing inflammation and irritation to it and the surrounding tissues/organs.
Clinical Signs of Pancreatitis in Dogs
- Not eating (aka inappetance, anorexia)
- Loose stools
- Pain – behavioral changes
Diagnosis of Pancreatitis in Dogs
The diagnostic process for pancreatitis is typically much easier to diagnose in severe cases, but can be much more difficult to diagnose in mild cases. Usually pancreatitis is diagnosed with a combination of factors, including: clinical signs, examination findings, bloodwork and possibly imaging (ultrasound). Usually after a physical examination, a veterinarian will run bloodwork to rule out other conditions with similar clinical signs – like liver or kidney disease – then will proceed to more specific testing methods for pancreatitis.
Preliminary Diagnostic Tools
- CBC – Complete Blood Cell Count
- Blood Chemistry
- +/- Free T4
- +/- Urinalysis
Pancreatic Diagnostic Testing
- Specific Canine Pancreatic Lipase (Spec CPL) – this is a 30 minute test done in house by the veterinary team by drawing blood and using a laboratory test kit. The CPL test is the most common test used to diagnose pancreatitis in dogs. The reason for this is because the test is relatively in-expensive, and simple to perform. It also gives more accurate results than that of other forms of bloodwork or imaging (83% accurate).
- Radiographcs – 24% accurate for diagnosis of pancreatitis.
- Ultrasound – 68% accurate for diagnosis of pancreatitis
- Pancreatic Biopsy – The most accurate test of pancreatitis, however it is highly invasive and not commonly performed.
Treatment of Pancreatitis
Depending on how severe the clinical signs are will determine on how aggressive the treatment needs to be. Some dogs with severe acute pancreatitis will struggle to eat or drink anything at all. Others will have minor symptoms that show up weekly or monthly the basically cause underlying discomfort. After your veterinarian does their physical examination on your pup and perform some preliminary diagnostic testing they will discuss with your what the treatment options are.
Severe Acute Pancreatitis
In severe cases, aggressive treatment strategies will be needed – this usually involves Hospitalization for a couple days or up to a week. Depending on the veterinary practice and if they offer 24/hr support for patients they may transfer your pup to a larger specialty or emergency hospital in order for your pup to receive the around-the-clock care they need.
For severe cases of Pancreatitis your veterinarian will first place a catheter and start fluid therapy to help re-hydrate your pup from any fluid loss from vomiting or diarrhea that is commonly associated with pancreatitis, and support the body during it’s recovery.
FASTING VS TUBE FEEDING
There are two different methods that your veterinarian may use to help your pup through the first couple of days of treatment – one is fasting, and the other is called enteral nutrition. Enternal nutrition is where your veterinarian would sedate your pup to surgically place a feeding tube past the point of the small intestine where the it would stimulate the pancreas, allowing the small intestine to still absorb nutrients and preventing atrophy of the intestines (where the intestines shrivel up and stop being able to absorb nutrients anything).
At this time there is no research in dogs to suggest one of these options is better than the other – however in people retrospective studies have shown better outcomes with tube feeding during beginning stages of acute pancreatitis versus fasting. The reason for this is because tube feeding maintains the health of the rest of the gastrointestinal tract (namely the intestinal villi which aids in digestion), and helps provide essential vitamins and minerals that may aid in the recovery process.
The main goal of both of these therapies is to allow time for the pancreas to rest and not overstimulate it during the recovery period. This allows the body to heal any damage caused by the premature release of the digestive enzymes.
Similar to if you were hospitalized – your pup will also be attached to monitoring equipment if they tolerated. Most commonly we will try to use a Pulse Ox to monitor blood oxygen levels, and then we will take a temperature, heart rate, respiratory rate, blood pressure, capillary refill time (at the minimum) every couple of hours.
Basic bloodwork or other labwork may be monitored during hospitalization depending on initial bloodwork and examination findings.
Medications will be given in order to help improve symptoms such as vomiting and diarrhea, pain due to inflammation, treat any secondary infections, and help with recovery.
GOING FORWARD AFTER INITIAL TREATMENT
After the initial treatment period, once your pup is stable and able to go home, your veterinarian may place your pup on a new specialized diet for a certain period of time – between two weeks to several months – in order to allow the pancreas to continue to heal. Your pup may also need to come in for bloodwork rechecks in order to continue to monitor this recovery.
For many dogs pancreatitis resolves complete with no lingering effects – these dogs can go back onto their normal diet going forward.
It is also possible that irreversible damage was done during treatment… If this occurs, long-term management of pancreatitis may be required or may lead to the need for other supplements or treatment protocols (depending on the condition). The three most common diseases that happen as a result of pancreatitis are…
EPI or exocrine pancreatic insufficiency – this disease happens when the pancreas can no longer produce and excrete digestive enzymes. If your pup is diagnosed with EPI they will be placed on digestive enzymes.
Diabetes Mellitus – basically due to the inflammatory damage done to the pancreas. Your pup may no longer be able to produce insulin in order to regulate their blood sugar.
Hepatic or liver disease – Since the pancreas secreted digestive enzymes into the surrounding tissues, it’s possible that the liver was heavily affected. This may reuire your pup to be put on both a diet that is specific to liver disease long-term, along with starting certain supplements like Denamarin or Milk Thistle.
Chronic Pancreatitis in Dogs
Treatment and management of chronic pancreatitis is different from that of acute pancreatitis – in that some dogs can get acute pancreatitis once, and never get it again. Chronic Pancreatitis in comparison is a long-term condition that needs to be managed carefully over their lifetime. It also has further considerations for long-term health.
How does Chronic Pancreatitis happen?
Sometimes chronic pancreatitis will occur after an initial insult and hospital stay due to acute pancreatitis, or after several less significant acute pancreatic flares. Other times pancreatitis may be related to a heritable condition or related to something that happened very early in life (like if a dog had Parvovirus as a puppy). Chronic Pancreatitis can also be associated with many different diseases and conditions that may lead to inflammation to the pancreas such as diabetes, obesity, and in humans it has been associated with immune mediated conditions like Lupus, and some types of cancer.
Management of Chronic Pancreatitis
The management of chronic pancreatitis is all about finding the right diet to keep pancreatic-related “flares” to a minimum while also balancing any other underlying conditions – like IBD, Food Allergies, or even Liver Problems – no one diet will be appropriate for all dogs.
Food for Dogs with Pancreatitis
After the first couple of days or weeks of hospitalization, pups are then slowly transitioned off tube feeding and onto a low-fat diet. The goal when placed onto one of these diets is to slowly work the pup up to their daily nutritional energy requirements.
Often when pets are first placed on a diet after tube feeding veterinarians will choose a diet that meets certain nutritional parameters…
Any diet given to a dog with pancreatitis needs to be highly digestible. Specialists recommend diets that are over 85% digestible on a dry matter basis.
Since protein is a major stimulant of the pancreas often dogs do better on a moderate to low protein diet to start, with a protein level of less than 30% on a dry matter basis. However, some dogs can tolerate higher protein diets once stabilized.
Fats are probably the most well known stimulant when it comes to pancreatitis in dogs. Specialists recommend keeping fat levels to less than 15% on a dry matter basis for dogs at a good body condition. However some dogs will need even lower fat content, this is especially true for dogs who are overweight – which are recommended to have a fat content of less than 10% on a dry matter basis. It should be noted that though fat is the primary nutrient that nutritionists are concerned about in regards to pancreatitis, and lower fats diets seem to be correlated with better patient outcomes – not all dogs need a fat restricted diet to the same degree or even at all.
Having a food that is easily digestible is extremely important for dogs with pancreatitis – we don’t want to force the gastrointestinal tract or the pancreas to work harder than it needs to in order to get the nutrition that they need. Gel-forming soluble fibers should be avoided such as: gum arabic, guar gum, carrageenan, psyllium gum, xanthan gum, carob gum, gum ghatti, and gum tragacanth. Other forms of fiber that provide prebiotic support to the gut, such as flax seeds and beet pulp are actually recommended for dogs with pancreatitis as long as the total fiber content stays below 5% on a dry matter basis.
Foods that have a high moisture content are ideal because they actually move through the digestive tract faster than ones without moisture (with the same diet composition). In situations like that of pancreatitis, we want gastric emptying to be quicker in order to limit pancreatic stimulation. Moisture rich foods also help maintain overall hydration status in the dog.
Diets for Dogs with Pancreatitis
There are many diet options for dogs with pancreatitis, and although the ones mentioned below are a good start for a pup that has the condition, they will not work for ALL dogs. The reason being is that some dogs with Pancreatitis may have other diseases/conditions they are managing at the same time – like allergies, IBD, or even cancer.
Your veterinarian will be able to guide you to which diet is most appropriate for your dog. If some situations contacting a board certified veterinary nutritionist to advise you on which diet may be best suited to your pup’s needs may be ideal. For some dogs, conventional diets may not be the best solution – in which case they would be able to guide you through formulating and preparing a homemade diet for your dog with pancreatitis.
When comparing diets it is important to note that you CANNOT compare diets based on the guaranteed analysis that is listed on the pet food bag. The reason for this is that that guaranteed analysis includes MOISTURE. Dry foods by law are required to have less than 12% moisture, whereas canned foods may have upwards of 80% moisture, and freshly cooked might have closer to 70% moisture.
You can adjust for this by converting the guaranteed analysis to dry matter using a simple calculation. Most veterinarians will give you a dry matter fat content to “stay under”. I’ve seen recommendations as low as 5% fat on a dry matter basis, to 20% fat on a dry matter basis.
Prescription Low-Fat Diets
- Rayne Clinical Nutrition Low-Fat Kangaroo Maintenance
- Hill’s Prescription i/d
- Royal Canin Veterinary Diet Gastro-intestinal Low Fat
- Purina Veterinary Diets EN Gastroenteric
- Purina Veterinary Diets HA Hydrolyzed
- Blue Buffalo Gastrointestinal Low Fat
- Just Food For Dogs Balanced Remedy, Hepatic and Metabolic
Low-Fat Over the Counter Diets
Prior to switching to an over the counter diet, what you need to know is that the fat content listed on the diet’s guaranteed analysis is just a MINIMUM, there is no guaranteed MAXIMUM like there are with prescription veterinary diets. For some dogs this variability is fine, however for other dogs with severe pancreatitis this variability is too harsh for them, and they cannot tolerate it. There also no established variation in fat, so it might be as little as a couple percent points to double-digits.
Homemade Diets for Pancreatitis
Another option for dogs with Pancreatitis is a homemade diet – homemade diets are great because they are the most customizable option, and on average homemade diets also tend to be more palatable at lower fat levels. You can work with your veterinarian to create a complete and balanced diet through a tool like BalanceIT – which is a website that was created by a board certified veterinary nutritionist to create simple balanced diets for dogs. However, if your pup has multiple conditions it may be better to consult with a board certified veterinary nutritionist in order to create a recipe for your pup.
If you have a dog with pancreatitis it’s important to realize that althrough pancreatitis may be at the top of your list of concerns for your pup, it is not the only thing you should consider when choosing a dog food. It’s also important to consider if the food is appropriate for your dog’s age, lifestyle, breed, and your own budget. You should also research the pet food company to look at their formulation, quality control, testing, and research to make sure you are aware of any areas where the company needs to improve their practices and so you are mindful of what those “holes” are in their quality control moving forward.
Supplements for Dogs with Pancreatitis
There are two main supplements that many people recommend for pancreatitis in dogs. The first of which is fish oil, and the second is digestive enzymes.
Now you might be thinking – but isn’t fish oil a fat? Yes – however research has found that the addition of omega 3 fatty acids may reduce inflammation resulting from pancreatitis. The hard part about adding fish oils into the diet of a dog with pancreatitis is that there is no generally accepted or established dosing, and some dogs cannot handle the additional fat regardless of its “anti-inflammatory” properties.
Board certified veterinarians recommend speaking to your veterinarian directly about the addition and dosing of fish oils to your dog’s diet, as dosing may vary based upon circumstances.
Below are three brands of fish oils that have the ideal EPA to DHA ratio in order to provide anti-inflammatory properties in dogs.
The following links are amazon affiliate links, and if used I will receive a small commission on purchase at no additional cost to you.
Using digestive enzymes for pancreatitis in dogs is commonly done for dogs with EPI – or exocrine pancreatic insufficiency. They are sometimes given for the first couple weeks after being released from the hospital after having acute pancreatitis.
However long-term use once the pancreas has recovered is very controversial, and possibly unnecessary… Scientific research has also looked at the addition of digestive enzymes (both plant and animal based) and found no change in the overall digestibility of food with the addition of digestive enzymes in healthy dogs.
This is again an area where working directly with your veterinarian is important – they should be able to direct you as to if digestive enzymes are appropriate for your pup.
Although pancreatitis can be very frightening and potentially life-threatening in it’s acute form, a full recovery is possible if recognized and treated early on. Chronic pancreatitis is definitely a manageable condition, though at times it might take some trial and error to find a food that fits your dog’s nutritional needs best.
Remember – we as pup parents are the best advocates for our dog’s health. If you notice anything abnormal with your pup, make sure to contact your veterinarian for further advise. As always – I hope you all have a wonderful time with your pups, if you have any questions feel free to reach out or join the community on Instagram and/or Facebook. I hope to see you around and chat with you soon!
Park KS, Lim JW, Kim H. Inhibitory mechanism of omega-3 fatty acids in pancreatic inflammation and apoptosis. Ann NY Acad Sci 2009; 1171:421-427. 25. Lei QC, Wang XY, Xia XF, et al. The role of omega-3 fatty acids in acute pancreatitis: A meta-analysis of randomized controlled trials. Nutrients 2015; 7:2261-2273. 26. Bauer JE. Therapeutic use of fish oils in companion animals. JAVMA 2011; 239:1441-1451
Villaverde, C., et al. (2017). “Effect of enzyme supplements on macronutrient digestibility by healthy adult dogs.” J Nutr Sci 6: e12.
Today’s Veterinary Nurse: “Key Nutritional Factors in Treating Pancreatitis”
Today’s Veterinary Practice: “To Feed or Not to Feed? Controversies in the Nutritional Management of Pancreatitis”
Veterinary Information Network: “Redefining Chronic Pancreatitis”
Veterinary Information Network: “Canine Pancreatitis: From Clinical Suspicion to Diagnosis and Treatment”
Veterinary Information Network: “Update on Pancreatitis in Dogs”
Veterinary Information Network: “Diagnosis and Management of Canine Acute Pancreatitis”
Veterinary Information Network: “Pancreatitis in Dogs”