Pancreatic Abscesses In Dogs

A pancreatic abscess is defined as a localized, intra-abdominal collection of purulent material containing little or no pancreatic necrosis that usually occurs in the vicinity of the pancreas.

For pancreatitis, the earlier Atlanta classification system used the term “pancreatic abscess” to explain the occurrence of a circumscribed collection of purulent material (with/without necrosis) that is an outcome of episodes of acute pancreatitis.

However, because of no sufficient proof and lack of clarity surrounding the term, the revised classification guidelines in 2012 removed the term “pancreatic abscess” as an infectious component of pancreatitis.

Pancreatic abscesses and Necrotic mass lesions of the pancreas appear to be sequelae of pancreatitis and have been reported only in dogs. The clinical signs associated with necrosis, pancreatic abscesses, and pseudocysts are nonspecific.

Pancreatic Abscesses vs Pancreatic Pseudocyst:

The pseudocyst is filled with peripancreatic fluid and it is defined as a localized collection of pancreatic enzymes restricted to a retro-peritoneal area by a fibrous membrane lacking epithelium; an abscess is fluid and semisolid that has a collection of necrotic tissue and pus.

While in most cases, the clinical presentation of pancreatic abscesses is similar to that of pancreatitis and they are associated with mild chronic pancreatitis.

Pancreatic abscesses associated with acute pancreatitis will have more serious clinical signs, such as:

• Abdominal Pain
• Severe Lethargy
• Recurrent Vomiting
• Severe Dehydration
• Collapse and Shock (sometimes)

Pancreatic abscesses with chronic pancreatitis are typically asymptomatic:

• Decreased appetite to not eating at all.
• Abdominal Pain
• Vomiting
• Weakness

The treatment depends on the underlying disease or condition or any exposure to toxins.

• In more severe cases, hospitalization at 24-hour intensive care and monitoring.
• Pain Medications
• Intravenous Fluids
• Antibiotics, if a secondary bacterial infection is suspected.
• Anti vomiting Medication (Antiemetics)
• Pancreatectomy: Surgery to remove all or part of the pancreas.
• Other drugs and the need for surgery will be entirely at your vets’ disposal after determining the severity of abscesses.

Following a diagnosis of pancreatic abscesses in dogs, Life expectancy is related to the development of postoperative complications.

Life expectancy is greatly reduced for dogs that are not good surgical candidates or for owners who are not interested in surgery.

There is no way to prevent pancreatic abscesses.

Prevention or treatment depends upon the underlying cause and extent/severity of the problem.

Medications for medical conditions should be provided only as required.

Boxer, Collie, Dachshund, Miniature Schnauzer, Miniature Poodle, Cocker Spaniel, Cavalier King Charles Spaniel, Yorkshire Terrier, Skye Terrier, Sled Dogs

1. Causes:

• Repeated pancreatitis episodes.
• Gram-Negative flora bacteria - Escherichia coli, Pseudomonas and Klebsiella.
• Gallstones
• Penetrating Peptic Ulcers
• The extension of abscesses from nearby structures can occur.
• Medications
• Blunt Trauma

2. Types:

Pancreatic Abscesses Associated With Acute Pancreatitis: This is the active form of pancreatitis, in which the symptoms come on unexpectedly. A mild form of acute pancreatitis is temporary and the dogs usually recover on their own. However severe forms require hospitalization.

Pancreatic Abscesses Associated Chronic Pancreatitis: This is a long-term condition that originates from frequent damage to the pancreas. However, acute pancreatitis can also be a risk factor for chronic pancreatitis.

3. Morbidity:

In dogs with acute pancreatitis, infected necrosis (rather than pancreatic abscess) represents a major cause of mortality and morbidity. This can result from an infection of either an area of walled-off necrosis (WON) or acute necrotic collection (ANC).

Recognized complications of acute pancreatitis in dogs include acute fluid collections (i.e., pancreatic abscess or pseudocyst), diabetes mellitus, diabetic ketoacidosis, and extrahepatic bile duct obstruction.

4. Mortality:

The mortality rate of acute pancreatitis has remained at about 10-20%. Although the mortality rate of chronic pancreatitis is not available, it causes severe damage to your pancreas. So typically the survival Rate will be reduced if not treated properly.

5. Diagnosis:

• Complete blood count, electrolyte tests, and Pancreas-specific tests.
• Abdominal CT scan with contrast or contrast-enhanced magnetic resonance imaging (MRI).
• Ultrasound ( when CT scan or MRI cannot be performed).

6. Differential Diagnosis:

• Pancreatic Necrosis without associated infection.
• Pancreatic Pseudocysts
• Cholangitis
• Cholecystitis
• Gastric Ulcer
• Mesenteric Ischemia
• Perforated Viscus
• Bowel Obstruction

7. Prognosis:

Most dogs with mild acute pancreatitis recover within a week and the prognosis is good. However, recovery takes longer in severe acute pancreatitis cases, as complications may need additional treatment. Chronic pancreatitis worsens over time and there is no cure but the related symptoms and pain can be prevented or may be managed.

Contact your vet right away, if you notice any of the following:

• Abdominal Pain
• Recurrent Vomiting

Affected dogs should be fed based on their estimated Resting Energy Requirement (RER):

1. For dogs weighing < kg or >25 kg : 70 × (body weight in kg)⁷⁵.
2. For dogs weighing 5 to 25 kg : [30 × (body weight in kg)] + 70.

Avoid:

Abrupt changes in food type and composition.

High-fat diets

Access to trash or table scraps.

Fat content of diets = <30 g/1000 kcal.

For Hyperlipidemic dogs = 14 g of fat per 1000 calories.

Foods to feed:

• Protein: High protein diet comprising 40% of the dog's calories.
• Fats: Omega-3 and other healthy fats.
• Complex Carbohydrates: Fibers and starches (Whole Grains, Oatmeal, Brown Rice, Potatoes & Sweet Potatoes).
• Supplemental Dextrose
• Overweight dogs - Lower calorie diets, for underweight dogs- Higher calorie diets.
• Feed foods have a lower (or moderate) Glycemic Index and Glycemic Load than others.

When there is an underlying reason for your pet’s pancreatic abscess, such as a disease, infection, or trauma, then your vet may recommend further diagnosis as that condition must be treated in addition to the pancreatic abscess itself.

Mostly, abscesses in the pancreas are treatable and are not fatal to the dog. However, untreated abscesses may lead to other complications like necrosis.