Page 133 - BSAVA Guide to Pain Management in Small Animal Practice

BSAVA Guide to Pain Management in Small Animal Practice

VetBooks.ir e ex p e Pancreatitis

ancreatitis involves in ammatory cell
in ltration of the e ocrine pancreas ut also
includes necrotizing and chronic
manifestations where in ammation is
minimal. ancreatitis is divided into acute
and chronic forms ased on the presence or
a sence of histopathological lesions such as
rosis and or atrophy.
HISTORY AND PRESENTATION
Although typically a ecting middle aged to
older dogs and cats, animals of any age In between bouts of vomiting, this
could be a ected. Certain dog breeds, such Beagle was repeatedly demonstrating
as Miniature Schnauzers, terriers, Cocker the ‘prayer position’, which continued despite
administration of intermittent doses of methadone.
Spaniels, Cavalier King Charles Spaniels,
Border Collies and Boxers, are more
commonly a ected but there is no known
breed predisposition in cats. Pancreatitis is TREATMENT
commonly idiopathic although several
potential risk factors have been identi ed in Medical management is supportive. The
dogs, such as hypertriglyceridaemia, drug main focus should be analgesia; untreated
reactions, prior surgery, dietary factors, pain delays recovery. Cats do not openly
infections and endocrine disease. show signs of pain in most cases; however, it
should not be concluded that they feel less
CLINICAL SIGNS AND SIGNS OF PAIN pain than dogs or humans. Acute pancreatitis
can be managed with continuous rate
Clinical signs vary from mild non speci c infusions of opioids, lidocaine (dogs only)
signs such as anorexia and lethargy, with or and ketamine, epidural opioids or local
without gastrointestinal signs, in chronic anaesthetics, regular opioid in ections and
subclinical pancreatitis to cardiovascular intravenous paracetamol (dogs only) (see
shock, disseminated intravascular Chapter . Chronic, subclinical cases can be
coagulation and death in severe acute managed with oral opioids, paracetamol
pancreatitis. Clinical signs tend to be more and, possibly, non-steroidal anti-
subtle in cats, particularly those with chronic in ammatory drugs NSAI s . luid therapy
disease. Pain results from in ammation of the is imperative in moderate to severe cases to
pancreas as well as the resulting local correct hypovolaemia and dehydration as
peritonitis. Pancreatitis manifests as cranial well as manage acid base and electrolyte
abdominal pain. The abdomen is typically imbalances. Additional management
tender on palpation and dogs may display includes providing nutrition, antiemetics,
the prayer position igure 7.6 . antacids and vitamin B1 , etc.

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