Name 2 predisposing dog breeds for AP
Miniature schnauzer, miniature poodle, Yorkshire terrier, dachshunds, poodles, cocker spaniels, Alaskan malamutes...
Name 3 common CBC/Chemistry/UA findings expected in AP dogs and why?
Increased PCV, TP
Non-regenerative anemia
Inflammatory leukogram
Thrombocytopenia
Hypoalbuminemia
Azotemia
Elevated liver enzymes
Hyperbilirubinemia
Hypocalcemia (total/ionised)
Cylinduria
Proteinuria
What is the mainstay treatment for AP?
Supportive care: hydration, nutrition, GI support, analgesics
Which endocrinopathy can be seen as a complication secondary to severe/ recurrent pancreatitis
Diabetes mellitus
Name 2 endocrinopathies that are reported as risk factors for AP
Cushing's disease, Hypothyroidism, Diabetes mellitus
Name 3 ultrasonographic findings that could be seen in AP dogs.
pancreatic enlargement, altered pancreatic echogenicity, or hyperechoic mesentery
sensitivity ~70%
Is antibiotic indicated?
No. usually sterile inflammation.
- suspected pancreatic abscessation
- bacterial translocation from GIT
What are the 2 top differentials for a dog with a previous history of severe pancreatitis presented for chronic weight loss?
- Chronic pancreatitis
- EPI
Name a lipid disorder that could cause AP
Hypertriglyceridemia
How to interpret a negative and a positive snapCPL result?
Positive - indicate of AP. Consider other supportive evidence. Can verify with a spec CPL
Negative - rule out AP
What is the consensus on glucocorticoid use for AP patients?
Currently no consensus.
One clinical trial has proved its efficacy. Used anti-inflammatory dose when P fails to improve with supportive care in >3 days, severe inflammation, or with the constricted cost of care
What are the diagnostic criteria for SIRS?
SIRS:
Temp <100 or >104
Heart rate >140
Respiratory rate >40
WBC <6 or >19
What is the reported mortality rate for canine AP?
0-30%, 30-60%, 60-80%, 80-100%
30-60%
Name 3 medication/drug that could cause AP
L-asparaginase; AED (KBr, PB); Azathioprine; exogenous steroid (questionable); organophosphate;
Name 2 other concurrent diseases that could influence spec cPL concentration?
- Renal dysfunction: not directly related to GFR, more complex mechanism but currently unclear
- Heart disease: MMVD, the severity of CHF (hypoperfusion)
- Endocrinopathies: DM, HAC
What are the treatment options for severe hyperbilirubinemia secondary to severe AP.
- TPE
- Biliary decompression: centesis, cholecystoenterostomy, or choledochal tube stenting (rarely indicated and carried substantial risk)
Name 2 criteria to diagnose EHBO
- Hyperbilirubinemia
- ultrasonographic evidence of bile duct dilatation (common bile duct diameter greater than 3 mm)
What is the reported survival rate with EHBO secondary to AP?
30%, 50%, 80%, 98%
80% survival rate, good
- 94% survived with medical management alone.
What is the specific form of CP in English Cocker Spaniel
Autoimmune pancreatitis IgG4-related diseases
- IgG4-positive plasma cells in multiple tissues
- KCS, xerostomia, proteinuria, and other immune-mediated disorders
Does a normal pancreatic biopsy result rule out pancreatitis?
No. Because the disease has a patchy distribution
Name the new drug that recently is FDA conditionally approved
Fuzapladib
Leukocyte function antigen-1 (LFA-1) inhibitor that prevents extravasation of neutrophils into tissue
What adverse neurological effect can be seen with severe hyperbilirubinemia
- Kernicterus: neurologial damage secondary to bilirubin deposition in the gray matter of the brain (secondary to severe hyperbilirubinemia) Presented for obtudation, seizure
- Pancreatic encephalopathy