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9- SA- Gastrointestinal and Hepatic Disease > Pancreatic disease > Flashcards

Pancreatic disease Flashcards

(53 cards)

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1
Q

how many lobes of the pancreas are there

A

2

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2
Q

what is the pancreas closely associated with

A

the duodenum and the stomach

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3
Q

how many pancreatic ducts do dogs have and where do they open

A

2 - one opens next to the common bile duct on the major duodenal papilla and the other opens on the minor duodenal papilla

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4
Q

how many pancreatic ducts do cats have and where do they open

A

1 - fuses with the bile duct before opening on the major duodenal papilla

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5
Q

why do we see pancreatitis more regularly in cats

A

due to the design flaw of the opening of the pancreatic duct

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6
Q

what is the role of the pancreas

A

exocrine tissue secretes digestive enzymes, endocrine tissue secretes hormones

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7
Q

why do the enzymes in the exocrine pancreas not digest the pancreas itself

A

enzyme inhibitors prevent enzymatic digestion in the pancreas

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8
Q

Define acute pancreatitis

A

inflammation of the pancreas, sudden onset, little or no permanent changes after recovery

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9
Q

Define chronic pancreatitis

A

continuing inflammatory disease, irreversible morphological changes (fibrosis and atrophy), can lead to permanent impairment

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10
Q

What is EPI

A

exocrine pancreatic insufficiency

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11
Q

What is DM

A

diabetes mellitus

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12
Q

List 7 risk factors for pancreatitis in dogs

A

genetics
hyperlipidaemia
high fat meals
obesity
pancreatic ischaemia or hypoxia
trauma

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13
Q

List 5 risk factors for pancreatitis in cats

A

GI disease causing bile reflux can irritate the pancreas
genetics
hyperlipidaemia
pancreatic ischaemia or hypoxia
trauma

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14
Q

Describe triaditis in cats

A

pancreatitis, Inflammatory bowel disease and cholangitis
seen together

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15
Q

List the clinical signs of acute pancreatitis

A

Lethargy
weakness
anorexia
vomiting
diarrhoea

Severe acute:
shock
collapse

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16
Q

List 6 clinical findings that suggest pancreatitis

A

Abdominal pain - only 20% of cats
cranial abdominal mass
mild ascites
dehydration
fever- not all cases
jaundice (uncommon)

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17
Q

List 3 changes seen on haematology that suggest pancreatitis

A

anaemia
haemoconcentration
leukocytosis

Non-specific

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18
Q

List 7 things that can be seen on biochemistry that suggests pancreatitis

A

Azotaemia (pre renal)
Increased liver enzymes (ALP)
Hyperbilirubinaemia
Hyper or hypoglycaemia
Hypoalbuminaemia
Hypertriglyceridaemia
Hypercholesterolaemia

Non- specific

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19
Q

List 4 electrolyte changes that can be seen with pancreatitis

A

Hypokalaemia
Hypochloraemia
Hyponatraemia
Hypocalcaemia

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20
Q

What immunoassays are available in diagnostics of pancreatitis?

A

Spec PL
Snap PL

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21
Q

Is radiography useful to diagnose pancreatitis

A

no but it is useful to rule out other differentials

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22
Q

What can you see on abdominal ultrasound in pancreatitis case

Study These Flashcards
A

enlarged pancreas
localised peritoneal effusion
changes to echogenicity
pancreatic duct dilation

23
Q

what does decreased echogenicity of the pancreas indicate

Study These Flashcards
A

pancreatic necrosis

24
Q

what does hyperechogenicity of the pancreas indicate

Study These Flashcards
A

pancreatic fibrosis

25
Describe how to treat pancreatitis
treat underlying cause correct fluid deficits- to increase perfusion to pancreas analgesia antiemetics antibiotics if infectious cause identified steroid may be useful in some cats change of diet
26
what analgesia do we provide to pancreatic patients
opiods first line buprenorphine in cats methadone first then buprenorphine when pain decreasing in dogs Avoid NSAIDs
27
What anti-emetics to give to a pancreatitic patient
Maropitant Metoclopramide- but as CRI
28
What antibiotics should we use if infectious cause of pancreatitis idenitified
trimethoprim/sulphonamide marbofloxacin metronidazole clindamycin
29
what should we feed dogs after pancreatitis
high carbs (rice/potato/pasta) and a low fat commercial diet
30
what should we feed cats after pancreatitis
base the diet on any concurrent disease they may have
31
how should we feed anorexic cats
NGT or oesophagostomy tube
32
why do we want to get cats home as soon as possible
we have a better chance of getting them to eat at home
33
Describe long-term management for pancreatic patients
avoid high-fat meals (maybe even a fat restricted diet) oral pancreatic enzyme application can help steroids may be worth a trial in some cats
34
Describe the prognosis with pancreatitis
mild/moderate- good Acute pancreatitis can be life-threatening Poor prognosis if continue to refuse food
35
T/F pancreatic neoplasia is common
False Rare
36
List 3 types of pancreatic neoplasia
pancreatic adenomas pancreatic adenocarcinoma sarcomas
37
List the clinical signs of pancreatic neoplasia
similar to chronic pancreatitis vomiting anorexia diarrhoea weight loss signs associated with metastatic lesions paraneoplastic alopecia- cats
38
describe paraneoplastic alopecia
shiny skin disease in cats - alopecia of the ventrum, limbs and face
39
what can you see on radiography of pancreatic neoplasia
decreased contrast in the cranial abdomen, may see a mass, spleen may be caudally displaced
40
what can you see on ultrasound of pancreatic neoplasia
soft tissue mass in pancreatic region, +/- peritoneal effusion
41
how do we get a definitive diagnosis of pancreatic neoplasia
biopsy or histology
42
Describe how to treat pancreatic adenomas
benign - only treat if cause clin signs If find mass during ex-lap- partial pancreatectomy to establish diagnosis
43
Deacribe how to treat pancreatic Adenocarcinomas
Often metastatic disease present by time of diagnosis. surgical resection- clean margins rarely acheived prognosis grave
44
Describe Exocrine Pancreatic Insufficiency
Loss of pancreatic acinar cells. Causes malabsorption Signs don’t occur until most of exocrine tissue has been lost.
45
what is the most common cause of EPI on dogs
Pancreatic acinar atrophy- most commonly occurs in young dogs
46
What is the most common cause of EPI in cats
Chronic pancreatitis Rare in dogs
47
Describe the history seen in dogs with EPI
weight loss but increased appetite Diarrhoea - large volume, yellow, fatty, frequent Flatulence borborygmi water intake may be increased
48
List 4 clinical signs seen with EPI
Weight loss- can be severe Muscle wastage Minimal body fat Poor hair coat
49
Describe how to diagnose EPI
TLI (Low serum trypsin-like immunoreactivity)- diagnostic
50
Describe how to treat EPI
Pancreatic enzyme replacement- with each meal Dietary modification Vitamin supplementation- cobalamin antimicrobial therapy- if not responding to enzyme supplementation
51
Describe the dietary modifications for EPI treatment
feed more then recommended initially to encourage weight gain If not improving on normal diet, use highly digestible low fibre diet Avoid low fat diets
52
Describe the prognosis associated with EPI
Underlying processes normally irreversible Lifelong treatment required Prognosis good with treatment
53
What are the differences between a Spec PL and a Snap PL test?
Spec PL= Laboratory test, Quantitative and More specific SNAP PL= In practice test, Normal or abnormal result and More sensitive

9- SA- Gastrointestinal and Hepatic Disease (14 decks)

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