On the day after Thanksgiving Mr. Miles cradled a middle-aged Miniature Schnauzer in his arms, explaining, “Jelly won’t eat, and she keeps barfing.” Mr. Miles insisted that Jelly meant no harm at his in-laws’ dinner party when she snatched the turkey and consumed a significant fraction of it, including some of the stuffing.
On examination, Jelly was dehydrated and nauseated. When I pressed on her painful abdomen, she grunted, then retched, bringing up a puddle of yellow bile. Because of her dehydration and intractable vomiting, I hospitalized Jelly, placing her on IV fluids to rehydrate her while awaiting test results to assess her condition.
Jelly’s blood and urine tests showed large increases in her white blood cell count, elevated liver values, and some changes consistent with dehydration. X-rays of her belly showed no intestinal obstruction – a top possibility, considering her symptoms and history.
Later that day, a radiologist performed an ultrasound exam on Jelly’s internal organs. Just under her stomach, in the area where her pancreas resides, the ultrasound revealed a mass of irregular consistency, surrounded by fluid. The pancreas is a floppy strip of glandular tissue that is normally very difficult to find on ultrasound. In cases like this, when the pancreas is inflamed, it becomes more detectable. We had a likely diagnosis: Jelly probably had pancreatitis.
The pancreas is a small but important organ that has two main functions: regulating blood sugar and producing digestive enzymes. Normally, the digestive enzymes aren’t activated until the pancreas secretes them into the intestine. However, when things go awry, those enzymes can leak into the wrong places, digesting important tissues such as the pancreas itself, or its neighbor the liver. In very bad cases, these enzymes can cause inflammatory reactions throughout the body. This can alter the heart’s normal rhythm, disrupt the central nervous system, and even impair the substance that keeps the air sacs in the lungs from collapsing.
The cause of pancreatitis in dogs and cats is often a mystery, but it can be incited by direct physical trauma to the pancreas, such as being hit by a car. Certain infectious diseases, inflammatory conditions, drugs, and insecticides may also contribute. In dogs, pancreatitis is also associated with obesity and a big rich meal, such as a few pounds of turkey and stuffing.
Treatment of severe pancreatitis often involves hospitalization with extensive monitoring and care. Mild cases can be managed conservatively and patients are sometimes even discharged for care at home.
Jelly’s pancreatitis was severe enough to warrant hospitalization for several days. She received IV fluids, pain control, anti-nausea medication, and antibiotics. We monitored her closely for signs of complications. Mr. Miles began to anticipate Jelly’s homecoming as her white cell count and liver values moved closer to normal each day.
After five days of hospitalization, Jelly’s appetite was back to normal and her lab values were practically perfect. Throughout the day we slowly weaned her from IV fluids and she continued to do well. That evening, Mr. Miles arrived to pick up his friend and take her home. At home, he faithfully continued her special feeding requirements. At her one week recheck, Jelly looked wonderful and her bloodwork was normal.
Dr. Deirdre Brandes is a veterinarian at the Rancho Santa Fe Veterinary Hospital. She can be reached at www.rsfvets.com, or 858-759-8797. The cases described in Veterinary Vitals are true stories, but the author has changed details about the patients to protect their privacy.