Category: gastrointestinal disease

The pancreas is a small organ located close to the stomach. It has an important role in the digestion of food and produces large volumes of digestive enzymes after each meal which are released into the gut to help digest food as it leaves the stomach. These enzymes are normally stored in specialised storage granules in the pancreas until they are needed.

Quite simply, pancreatitis is inflammation of the pancreas. Once the pancreas is damaged the digestive enzymes are released from the specialised storage granules into the pancreas itself and can start the process of self digestion. If large amounts are released the enzymes can start to affect other parts of the body.

The pancreas also has a second, and completely separate function, which is to produce the hormone insulin which helps to control levels of blood sugar.

Pancreatitis is usually a disease of middle-aged dogs. Some breeds of dogs are more at risk from pancreatitis – more cases are seen in small breeds of dogs, particularly Miniature Schnauzers. Obese dogs are more at risk and diet can have impact. Bouts of disease may be set off by scavenging or stealing fatty foods.

Occasionally some dogs have structural disease in the pancreas, e.g. cysts that increase the likelihood of pancreatitis developing. Some medications can cause pancreatitis so if you are worried about your dog in anyway always remind your vet what medications your dog is taking – even if you think the vet may know already. However, in most cases no reason is found for pancreatitis to develop.

As stated above, there is a range of severity of pancreatitis in the dog which can reflect the amount of inflammation in the pancreas and also the effects on the rest of the body.

The more severe forms of pancreatitis (also termed necrotising or acute pancreatitis) can be a frightening disease with sudden onset of severe signs such as vomiting and severe abdominal pain and sometimes jaundice. Dogs with acute pancreatitis show discomfort and may adopt a ‘praying’ stance – bowing down on their front legs – as they try to relieve the pain their tummy.

Other signs include diarrhoea and fever but these signs often look just like any other tummy upset. Dogs with pancreatitis are usually very miserable and don’t want to eat. In the most severe form of the disease large amounts of enzymes released from the pancreas start to move to different parts of the body which can result in difficulty breathing and bleeding from multiple sites in the body.

The milder form of the disease (also termed chronic pancreatitis) is a grumbling form of the disease which can affect dogs for months or years. In some patients there are no outward signs of pancreatitis in these pets.

Vomiting is a very common presentation in dogs and most dogs that are vomiting get better within a few days with no specific treatment. However, if your vet is worried that your dog has a more serious condition they will want to run some blood tests from your dog and probably take some X-rays or ultrasound your dog’s abdomen.

There are some special blood tests that can be run to diagnose pancreatitis and ultrasound examination may show changes in the pancreas itself to confirm the diagnosis and to assess for structural abnormalities. Ultrasound examination of the pancreas is an advanced ultrasound technique so your vet may wish to refer your pet to a specialist.

Mild cases of pancreas may recover without any treatment over a few days. Dogs with a more severe condition will need to be admitted to a veterinary hospital. Often dogs with pancreatitis will not want to eat; this is not a problem for 48 hours, but after this period measures may be taken to ensure food intake as current evidence suggests that maintaining nutritional intake can assist with recovery.

Drugs may be given to reduce nausea and vomiting which help control clinical signs and may help with appetite. In patients with severe pancreatitis feeding tubes are placed. In cases in which feeding tubes are not appropriate then intravenous feeding may be used.

Pancreatitis is a very painful condition and pain relief is an important component of management. Pain relief in most cases necessitates the use of opioid pain relief that can only be administered in hospitalised patients.

In very severe cases dogs become extremely unwell and need to be admitted to hospital for intensive care or maybe an operation. When pancreatitis is severe there can be serious effects on other organs in the body and intensive care including blood and plasma transfusions may be required.

Most dogs with pancreatitis get better within a few days to a week. Your vet will advise you on long term care of your pet after an episode of pancreatitis, which will depend on individual cases and whether any reason for the pancreatitis was found.

It may be necessary to provide your pet with a lower fat diet following its recovery from pancreatitis. Often dogs that have had one episode will be more likely to have repeated bouts later in life and these may need to monitored more carefully.

In dogs that have been severely affected there may be long term consequences of the disease. Damage to the pancreas can result in failure of its other functions. Loss of large amounts of pancreas can mean that the dog is no longer able to produce sufficient quantities of insulin (thus becoming diabetic) or not producing enough digestive enzymes (resulting in poor digestion of food and weight loss).

Unfortunately some dogs with the severe form of pancreatitis will die despite all treatment.

If you have any concerns about our dog contact your own vet for further advice.

Any dog can get something stuck in its oesophagus. However, the dogs most at risk are greedy dogs or dogs that like to scavenge because they have access to things that are more likely to cause problems. Small terriers also appear to be more at risk and this is partly due to their size, meaning that chop bones are a perfect fit for their oesophagus (whereas larger breed dogs may get away with swallowing the same bone).

The oesophagus is the tube that runs from the mouth to the stomach down which food, liquids and saliva pass after swallowing. It is a muscular tube and quite stretchy so that if larger objects are swallowed the oesophagus stretches out to accommodate them. However, there are a number of places along the oesophagus where the oesophagus is narrowed and larger objects may become stuck.

In dogs the most common foreign body is a piece of bone, rawhide chew or toys. The pieces of bone from chops, which may become wedged across the oesophagus, are a particular problem in smaller dogs such as West Highland White terriers. You should never allow your dog to get access to cooked bones.

Another common type of foreign body is a fish hook. Dogs may pick up and eat baited fish hooks and the hook can catch in the wall of the oesophagus. In many cases the fishing line is still attached to the hook and may be visible in the mouth. Never try to pull on line or string that your dog has swallowed but instead take your pet straight to the vet. If there is a hook embedded in the oesophagus and you pull on this the barbs may tear the oesophagus causing serious damage.

Immediately after swallowing something that has become stuck dogs are usually very distressed. They will often be gagging and retching but usually don’t produce anything except some frothy white saliva. Dogs may be very restless and may paw at their mouth. Most dogs with something stuck in their throat will not want to eat and if they do will not be able to swallow. Some make repeated gulping movements.

If the object is not completely blocking the oesophagus it may be present for several days before other signs are noticed. These dogs may still be able to swallow liquids. Regurgitation of food after eating may occur and you may notice a foul smell on your dog’s breath.

Signs of respiratory disease such as coughing may be present, and, if the oesophagus becomes torn, signs of generalised illness such as depression, high temperature and a reluctance to bend the neck (due to pain) may be seen.

Your vet will probably suspect that your dog has something stuck in its throat from what you describe of the history. In order to confirm what is there and where it is stuck your vet will want to take an X-ray of your dog. Blood samples may be taken to see if there are any effects of dehydration and intravenous fluids may be given.

Once the foreign object has been identified it can usually be removed without surgery but this can be a tricky procedure and your vet may want to send your pet to a specialist to perform the procedure.

If the foreign body has been present for sometime there may be damage to the wall of the oesophagus.

Foreign bodies can be removed from the oesophagus in a number of ways:

• Removal from the mouth by passing a tube through the mouth and grabbing hold of the foreign body and pulling it out.
• Pushing the object down the oesophagus into the stomach and then operating on the stomach to remove the object from there.
• In exceptional cases the object is completely wedged and cannot be moved up or down. In these cases surgical removal from the oesophagus is the only option. Surgery is also required if there is a tear in the wall of the oesophagus. This is the most serious situation due to the high risk of infection and shock.

Following removal of the object your pet will be quite sore for several days and will need nursing care at home or in a veterinary hospital. It is likely that they will also need a variety of medication to make them more comfortable and to reduce the risk of long term damage to the oesophagus.

The biggest risk is that the wall of the oesophagus may be damaged by the foreign body or torn when it is removed. However, long term problems can also occur as the oesophagus heals.

In most cases, minor damage and inflammation of the wall of the oesophagus heals quickly. However, more severe damage and tearing of the muscle layers takes longer to heal and more scar tissue forms. Large amounts of scar tissue can create a permanently narrowed area called a stricture that is unable to stretch to allow food past when the dog swallows. This can take several months to form. Signs that a stricture has formed normally include regurgitation of food, less often liquids.

It is not possible to guarantee that your dog will never swallow anything that can become stuck in its throat. However, there are a number of wise precautions you can take.

• Never feed your dog cooked bones and never give your dog a bone that it could potentially swallow whole.
• Ideally, avoid rawhide chews. If you do offer them, remove them from your dog once they have chewed them down to a size at which they might swallow them.
• Make sure that all toys are large enough that they cannot be swallowed whole and are strong enough that they cannot be chewed into pieces by your pet.
• Watch your pet closely when out for exercise to ensure they are not scavenging along the way.

An oesophageal foreign body is a potentially very serious problem for your pet. Long term outcomes are very dependent on early treatment so if you are worried that your pet may have swallowed something that has become stuck you should immediately get advice from your vet.

If you have any concerns about your dog contact your own vet for further advice.

Most dogs will have a reaction to their food at some time in their life. Usually this is a sensitivity to a particular food type (not a true allergy) and only causes a mild tummy upset. Once you recognized the reaction, and had avoided that food in future, the problem probably went away.

An allergy is a different matter altogether. If your dog is allergic to their diet, they produce antibodies against some part of their food. Antibodies are the body’s natural defence mechanism against unwanted invaders and are usually produced to fight off bugs which may cause disease. In an allergic animal the immune system is over-reactive and produces antibodies against things which should be found in the body.

The most common allergy in dogs is to beef or wheat. Each time that food is eaten the antibodies in your dog’s body react with the food and this reaction causes the symptoms. Once antibodies have developed, the immune system is able to remember that particular food for many years and if your dog eats it again the same reaction will occur.

Food allergies can produce many symptoms and so it can be difficult for your vet to make a diagnosis without doing further tests. The most common signs of an allergy to food are itchy skin or tummy upsets. Other changes that can occur are hyperactivity, weight loss, lack of energy or even aggression.

Eliminating the offending part of the diet should resolve the symptoms but it takes a long time for the old food to be completely eliminated from your dog’s body and, as such, a new diet may have to be fed for many months before any improvement is noticed.

In the past the only way to confirm a food allergy was to change your pet’s diet to avoid feeding any proteins or carbohydrates that were present in htheir normal diet (an elimination diet). If the symptoms improved on the new diet, one meal of the old diet is fed to see if the symptoms come back. An elimination diet trial is a very long process during which strict dietary control is essential – even one stolen treat may set the investigation back to day one!

A blood test is now available which allows your vet to see if there are any antibodies in your dogs blood to common things in his diet. This test may help your vet to choose the right diet for your dog immediately so that the signs resolve more quickly.

An elimination diet is a diet containing one type of protein and one type of carbohydrate, e.g. chicken and rice. This diet is fed for a number of weeks as the sole food (all titbits and additional food must be avoided). During this time all the old diet is removed from the body. The symptoms of allergy should improve as long as the new diet is being fed.

The problem with a home-made exclusion diet is that it is unlikely to contain everything that your pet needs for a healthy life. Having identified what diets resolve the problems in your pet, your vet will try to identify a commercially produced diet that you can feed your pet for the rest of its life.

Unfortunately it is not possible to cure a dog with an allergy to food. The simplest solution is to avoid the particular protein or carbohydrate in the diet which is causing the problem. Many pet foods contain a mixture of different proteins and so choosing a new diet for your allergic pet is not easy and you should discuss it with your vet. They will be able to recommend a diet that does not contain the offending food.

The part of the diet causing the problem must be avoided for the rest of your pet’s life. It is not uncommon for animals which have been allergic to one part of their diet to go on to develop other allergies so be watchful for symptoms recurring. In rare cases there may not be a suitable commercial diet available and you may be forced to prepare home cooked diets for your pet.

For further information on allergies in your pet contact the Pet Allergy Association which is a new charity related to the British Allergy Foundation: www.allergyuk.org

The pancreas is a small organ located close to the stomach. It has an important role in the digestion of food and produces large volumes of digestive enzymes after each meal, which are released into the gut to help digest food as it leaves the stomach. These enzymes are normally stored in specialised storage granules in the pancreas until they are needed.

In EPI the pancreas is not able to produce sufficient quantities of these enzymes and so food is poorly digested. The undigested food cannot be absorbed into the body and passes through the gut resulting in the production of smelly greasy faeces. Despite consuming plenty of calories the dog is only able to use a small fraction of these and the rest pass out unused in the faeces.

The pancreas also has a second, and completely separate, function which is to produce the hormone insulin which helps to control levels of blood sugar. It is unusual for pancreatic damage to be so severe as to cause loss of this function along with EPI.

In certain breeds, e.g. German shepherd dogs, collies and English setters, the condition is hereditary (passed from parents to their puppies) although the parents may not show any outward signs of EPI. EPI occurs due to atrophy (shrinking or withering away) of the pancreatic tissue. There is a hereditary component to the disease but factors for the disease developing are considered multifactorial. Recent studies suggest that the immune system plays a role in destroying the pancreatic cells. In a few animals EPI may develop in later life as a consequence of long term pancreas damage due to pancreatitis.

The most obvious sign of EPI is weight loss over several months despite an increased appetite. Faeces are bulky and they may be greasy or smelly and diarrhoea is common. In most cases dogs appear to be well in themselves although the haircoat may be poor. In some animals there is a history of previous pancreatitis (abdominal pain, vomiting and diarrhoea).

Your vet may suspect that your dog has EPI from the clinical signs. However, there are lots of other diseases that cause weight loss and diarrhoea and many investigations may be necessary. Diagnosis can be confirmed by blood tests.

Fortunately the management of EPI is relatively straightforward (at least in theory). If the disease is the consequence of an insufficient production of digestive enzymes then the treatment should be to supplement these enzymes. The enzymes are available as a powder or enteric coated capsules.

Dietary changes may be necessary to restrict the fat in the diet with additional triglyceride supplementation. Improvements in consistency of faeces should be seen within a few days of treatment although it may take several months for weight and appetite to return to normal.

In some cases short courses of antibiotics are also required to stabilise the bacterial population in the intestines. When untreated EPI results in a large amount of undigested food in the bowel and this allows the bacterial population in the bowel to flourish which can also affect bowel function.

In most dogs it is possible to manage the signs of EPI to allow dogs to regain and maintain their body weight (and maybe even put on some weight). However, the underlying problem will never go away and if diagnosed your pet will require treatment for the rest of its life. It is important to consider the cost implications of this when embarking on treatment initially.

If you have any concerns about your dog contact your own vet for further advice.