Pancreas

Question 1

What are clinical signs of GI and Exocrine Pancreatic Dz?

Answer 1

Anorexia, vomiting, diarrhea, weight loss +/- abdominal pain, fever

Question 2

What are 2 common exocrine pancreas disorders?

Answer 2

Pancreatitis, Exocrine Pancreas Insufficiency(EPI) - chronic dysfunction of exocrine pancreas, or maldigestion

Question 3

What is the function of the exocrine pancreas?

Answer 3

Produces several digestive enzymes by acinar cells

Question 4

What 5 mechanisms prevent autodigestion?

Answer 4

Digestive enzymes are made as zymogens, Zymogens are stored with trypsin inhibitor, Protease inhibitors are in circulation(anti-trypsin, alpha2-macroglobulin), Duodenal enteropeptidase activates trypsin, Trypsin activates other zymogens

Question 5

What are the clinical signs of pancreatitis in a dog?

Answer 5

pain, vomiting, diarrhea

Question 6

What are the clinical signs of pancreatitis in a cat?

Answer 6

dehydration, weight loss, increased heart rate, anorexia, and lethargy. More likely to have icterus and often presents as mild liver disease or IBD

Question 7

What are possible CBC abnormalities with pancreatitis?

Answer 7

Neutrophilia with left shift +/- toxicity, Lymphopenia, Eosinopenia

Question 8

What are possible biochemical abnormalities with pancreatitis?

Answer 8

Hypercholesterolemia, increased ALT(liver leakage enzyme), Increased ALP(cholestatic enzyme), Hyperbilirubinemia due to cholestasis, Hypocalcemia, Hyperglycemia - hyperglucagonemia or diabetes

Question 9

What species have salivary amylase?

Answer 9

Humans and Pigs

Question 10

Where is amylase produced?

Answer 10

Pancreatic Acinar Cells, Small intestine, Liver

Question 11

Where is amylase cleared?

Answer 11

Kidney

Question 12

What 6 conditions can cause increased amylase?

Answer 12

Pancreatic disease, GI disease, Hepatic disease, Corticosteroids, Renal Failure, Severe dehydration

Question 13

What 4 diseases of the pancreas can cause an increased amylase?

Answer 13

Inflammation, Trauma, Necrosis, Neoplasia

Question 14

When you see a greater than 3 fold increase in serum amylase, what is the most likely disease?

Answer 14

Pancreatitis

Question 15

Where is Lipase produced?

Answer 15

Pancreatic acinar cells, Gastric mucosal cells, Small intestine, Liver, Adipocytes, Myocytes

Question 16

What would you suspect if you saw a greater than 3 fold increase in Lipase?

Answer 16

Pancreatitis

Question 17

What can cause a decreased Lipase?

Answer 17

Exocrine Pancreatic Insufficiency

Question 18

Where is lipase cleared?

Answer 18

kidney

Question 19

What tests can measure specifically pancreatic lipase?

Answer 19

Spec cPL and Spec fPL, send out or snap test

Question 20

What is maldigestion?

Answer 20

Not enough digestive enzymes from the pancreas to breakdown for subsequent absorption - EPI

Question 21

What is malabsorption?

Answer 21

Not absorbing food breakdown products - GI tract disease, GI lymphatic disease

Question 22

What are clinical signs of EPI?

Answer 22

Chronic, severe weight loss, voluminous, cow patty stool

Question 23

What causes EPI in dogs?

Answer 23

Pancreatic atrophy of aplasia

Question 24

What causes EPI in cats?

Answer 24

Chronic bouts of inflammation and scarring

Question 25

What breed of dog is overrepresented with EPI?

Answer 25

German Shepherds

Question 26

What additional problems can EPI be associated with?

Answer 26

concurrent diabetes, secondary small intestinal bacterial overgrowth, secondary cobalamin(b12) deficiency(consumed by bacteria that have overgrown)

Question 27

At what secretory capacity will EPI develop?

Answer 27

When exocrine secretory capacity is reduced to less than 10-15% of normal

Question 28

What are 7 causes of EPI?

Answer 28

Congenital abnormality, Chronic pancreatitis, Pancreatic duct obstruction, Ischemia, Immune-mediated disease, Toxic Damage, Infection

Question 29

What CBC findings are often associated with EPI?

Answer 29

usually normal but may have normocytic, normochromic anemia

Question 30

What chemistry findings are often associated with EPI?

Answer 30

Usually normal but may have low cholesterol, hyperglycemia, and/or mild to moderate increase in ALT, ALP

Question 31

With what diseases will you see an increased Trypsin?

Answer 31

Pancreatic necrosis, Renal Disease, Inflammatory bowel disease, Hepatic lipidosis

Question 32

With what disease will you see decreased Trypsin?

Answer 32

EPI

Question 33

What test is used to diagnose EPI?

Answer 33

Serum trypsin-like immunoreactivity (TLI) - antibody test

Question 34

What TLI results are diagnostic for EPI in dogs?

Answer 34

values below 2.5 micrograms/L

Question 35

What TLI results are diagnostic for EPI in cats?

Answer 35

8 micrograms/L