Page 650 - Small Animal Internal Medicine, 6th Edition

622 PART IV Hepatobiliary and Exocrine Pancreatic Disorders

TABLE 37.1
VetBooks.ir Differences in Pancreatic Structure, Function, and Diseases in Dogs and Cats CATS

DOGS
FEATURE
Anatomy (but many Usually two pancreatic ducts—large Usually single major pancreatic duct joining
variations; some dogs are accessory duct from right limb to minor common bile duct before entering
like cats, and vice versa) papilla in duodenum, small pancreatic duodenum at duodenal papilla 3 cm
duct from left limb to major duodenal distal to pylorus
papilla in duodenum next to (but not 20% of cats have second, accessory duct;
joining) bile duct occasionally ducts remain separate
Sphincter of Oddi unlikely to be of clinical Sphincter of Oddi may be as important as
significance in humans
Pancreatic function Intrinsic factor secreted largely by pancreas Intrinsic factor secreted entirely by pancreas
but also some in stomach; vitamin B 12 so vitamin B 12 deficiency very common in
deficiency common in exocrine exocrine insufficiency; vitamin K deficiency
insufficiency but sometimes normal also common because of concurrent liver
and intestinal disease further reducing
absorption
Pancreatitis—disease Common association between pancreatitis Common association with cholangiohepatitis
associations and endocrine disease (see text) and/or inflammatory bowel disease
Association with liver and small intestinal High risk of concurrent hepatic lipidosis
disease not recognized May also be associated with renal disease
Emerging association in some breeds with
immune-mediated diseases, particularly
keratoconjunctivitis sicca and
glomerulonephritis (see text)
Exocrine pancreas, other Incidental pancreatic nodular hyperplasia Incidental pancreatic nodular hyperplasia
pathology common common

Pancreatitis
Spectrum of disease Most cases acute at presentation Most cases low-grade, chronic interstitial
Low-grade chronic disease increasingly disease, challenge to diagnose
recognized and more common than Acute severe cases also recognized
acute on postmortem studies
Diagnosis Histology is gold standard Histology is gold standard
(see Chapter 34) Variety of catalytic and immunoassays Most catalytic assays no help
available Immunoassays more helpful
Ultrasonography quite sensitive Ultrasonography less sensitive than in dogs
Obvious or suggestive clinical signs in Clinical signs usually low grade and
acute cases nonspecific, even in acute disease
Causes of exocrine Often pancreatic acinar atrophy—increased Most cases end-stage chronic pancreatitis
pancreatic insufficiency prevalence in certain breeds (especially Pancreatic acinar atrophy rare
German Shepherd Dogs) Occasionally due to raccoon pancreatic
End-stage chronic pancreatitis also fluke (Eurytrema procyonis) in eastern
common, underrecognized, particularly United States.
in middle-aged to older dogs of specific
breeds (see text)