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Spring 2017 Saber Tails 73

Petit Basset Griffon Vendéen Club of America

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variations in genes that
control pancreatic enzyme
activation, coupled with
environmental stressors
such as alcohol or tobacco
use. In dogs, it is likely that
genetic factors also play a
role since certain breeds

are predisposed to the disease.

hile alcohol and smoking are probably not contrib-
uting factors for the typical PBGV, there are drugs

that have been associated with pancreatitis in dogs. These
include azathioprine (used for immune-mediated disor-
ders), potassium bromide with phenobarbitone (used for
seizures), organophosphates (an insecticide), asparaginase
(a chemotherapeutic agent used for lymphoma), sulphon-
amides (an antibiotic), zinc (an essential trace element that
is toxic at high doses), and clomipramine (used to treat be-
havioral disorders). The interaction of specific drugs with
genetic susceptibilities to pancreatitis has not been proven
or disproven; to do so would require studying large num-
bers of dogs of various breeds.

he Amazing Al needs very little introduction. Al was
a TDI-registered therapy dog who entertained chil-

dren, seniors, and PBGV enthusiasts with his tricks and
performance routines. Unfortunately, Al always had a
sensitive tummy. Periodically he would pace in the night
and then throw up. When he was 13, he had an acute ep-
isode and tests revealed that he had pancreatitis. Al was
already on Dr. Jean Dodds’ liver cleansing diet of equal
parts of sweet potato, potato and white fish. He also got
baked chicken, eggs, white rice, and cottage cheese. After
the pancreatitis diagnosis, Dr. Dodds recommended con-
tinuing the liver cleansing diet. He did best when his mom
fed him 10 tiny meals every day. The only treats he was
allowed were chicken and Rice Chex. He could no longer
tolerate even the lowest fat kibble after the acute attack. Al
had these periodic pacing and vomiting episodes from the
time of his pancreatitis attack until his death. Of course,
they were usually at night. His family had medications on
hand to help him through, including Carafate to coat his
stomach, Reglan for nausea, Pepcid to settle his stomach,
and Tramadol for pain. Al’s career of entertaining came
to an end when he was 14 and a half. His mom said “The
pancreatitis didn’t get Al; he just wore out.”

ow is pancreatitis diagnosed? Diagnosis of pancre-
atitis is a challenge since the disease is characterized

by non-specific findings. Suspicion of pancreatitis should

be raised if a dog has clinical signs plus a potential risk fac-
tor, as described above.

ogs suspected of having pancreatitis should undergo
a complete blood count, serum biochemistry profile,

and urinalysis. These tests may exclude other diseases that
are suspected. Abdominal radiographs are also typically
taken to exclude other diseases.

he most sensitive test of choice, called Spec cPL,
measures a pancreas-specific lipase in the dog’s se-

rum. Transabdominal ultrasound is the imaging method
of choice for diagnosis of pancreatitis but its accuracy de-
pends upon the ultrasonographer’s expertise. There are
also more advanced diagnostic imaging techniques that are
used in humans; however, these are typically not available
for small animals and are also very expensive.

he gold standard of diagnosis is histopathology; how-
ever, that requires anesthetizing the dog for a biopsy

and is too invasive (and expensive) in most cases. Histolo-
gists will look for the presence of inflammatory cells, fi-
brosis and death or loss of exocrine tissue. Even histopa-
thology is not perfect, however, since inflammation might
be localized to one region of the pancreas and the biopsy
might be taken from another region that is normal. Alter-
natively, pancreatic lesions might be seen that are clinically
insignificant.

atch was 4 years old when he started vomiting and
showed signs of being in pain. Ultrasound and a pan-

creatic lipase test confirmed a diagnosis of pancreatitis. At
the time, he was overweight and had been put on grain-free
food. Patch received antacids and was switched to a low-fat
food. Fortunately, he has not had another bout of pancre-
atitis in the past 6 years. Patch has developed pulmonary
fibrosis, however, which is suspected to be a secondary in-
jury caused by the acute pancreatitis.

ow is pancreatitis treated? In human medicine, an indi-
vidual with signs of pancreatitis will be assessed with

clinical, pathological, and imaging tests. Their severity of
disease will be scored in a standardized manner. Humans
with acute pancreatitis receive standardized treatment that
includes early aggressive fluid therapy, analgesia (pain re-
lief), and early feeding. There is general agreement among
clinicians that this standardized diagnosis and treatment
has led to reduction in mortality from pancreatitis.

nfortunately, veterinary medicine does not have a stan-
dardized method for scoring the severity of canine

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