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PANCREATIC ATROPHY

This information is provided by Provet for educational purposes only.

You should seek the advice of your veterinarian if your pet is ill as only he or she can correctly advise on the diagnosis and recommend the treatment that is most appropriate for your pet.

Note for Pet Owners:
If you have an animal diagnosed as having pancreatic atrophy there are some important guidelines that you should follow:

  • Always give the medications that your veterinarian has prescribed at the correct dose and at the correct times
  • Contact your veterinary practice if you are concerned that your animal is having a relapse, or if it appears to react abnormally following treatment.
  • Keep your animal on the strict diet that your veterinarian recommends and AVOID feeding high fat foods because fat intake can make the condition much worse. If your pet is a bin scrounger or likely to steal food - stop him/her . Many "snacks" are relatively high in fat - so cut them out !!
  • The condition may not be confirmed as genetically inherited in your animal - but you should assume that it could be, and so you must prevent your animal from mating and passing on the defect to another generation.

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Description

Atrophy means loss of normal tissue mass. This can be due to a loss of cells or due to a reduction in the size of cells. Pancreatic atrophy involves the loss of acinar cells - and these are the cells that manufacture and secrete digestive enzymes. Once there is a reduction of 85% of normal enzyme production clinical signs result.

Below is a photograph of a normal pancreas exposed during surgery of the abdomen. The pancreas is a normal size and flesh colour.

Below  is a photograph of a German Shepherd dog with pancreatic atrophy - the normal pancreatic tissue has almost all gone. Surprisingly there are still enough Islet of Langerhans cells left in the remaining tissue to produce insulin so many of these cases are actually not diabetic as well.

Cause
In the juvenile form which occurs most commonly in young dogs the cause is thought to be immune-mediated. In fact , although it is called "atrophy" it may be caused by "hypoplasia"(* see comparative note). In one study a protein-deficient diet caused pancreatic atrophy.

In older dogs it is likely that atrophy results from pancreatitis.

Breed Occurrence
In Davis, California at the University Teaching Hospital it has been reported that 1.4 cases per 1000 dogs have pancreatic atrophy and over 50% are in German Shepherd Dogs. In this breed the incidence is 5 times greater than would be expected form the population size.

Sign

  • Pancreatic acinar atrophy can be present and subclinical for many months or even years. Weight loss and diarrhoea with greasy, pale, bulky and foul smelling faeces due to the presence of large amounts of undigested fat (called steatorrhoea) are the typical signs seen in this disease. Weight loss can be severe and lead to emaciation.

Age
Most cases occur between 6 months and 5 years of age, but they can present as older patients.

Treatment
Treatment involves the use of replacement pancreatic enzymes given orally. Suitable products are available in powder or crushed non-enteric-coated tablets. Enteric-coated tablets are not usually recommended because dissolution of the coating by alkaline pH in the intestine is unreliable. Because some enzyme is denatured by acid in the stomach, premixing the enzyme supplement with the food and left for about three quarters of an hour at room temperature is sometimes recommended.

H2 - receptor inhibitors (e.g. cimetidine) are useful because they reduce gastric acid secretion, and so less pancreatic enzyme is denatured during passage through the stomach.

If bacterial overgrowth is present oral antibiotics (e.g. neobiotic) may be indicated.

With enzyme replacement and cimetidine (300g), or (if appropriate) 300g neomycin, faecal fat concentrations can be returned to normal.

The following dietary management is recommended:

  • Feed a highly digestible, palatable, complete ration. Avoid home made rations.
  • The ideal profile is a diet that is : low in fat content, contains medium-chained fatty acids, avoid excess carbohydrate, low fibre.
  • Feed multiple small meals (at least 3 times daily)

* Comparative note
Juvenile pancreatic atrophy in dogs does not share the characteristic signs of dwarfism, neutropenia and pancytopenia which are typical of a similar condition, Schwachman syndrome (congenital hypoplasia of the pancreas) in humans.

In addition, in dogs clinical signs are not evident for several months suggesting that enzyme production early in life is adequate.

  

Updated October 2013

 
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