-
What makes up >90% of pancreatic mass, endocrine or exocrine pancreas?
exocrine pancreas
-
what are some factors that stimulate pancreatic secretions?
- -site, smell, consumption of food
- -acids in duodenum stimulate secretin which triggers release of bicarb rich fluids
- -food in duodenum stimulates cholecystokinin then release of pancreatic enzymes
-
What vitamin absorption does pancreas have special role in?
B12 (intrinsic factor)
-
what is the inactive form of enzymes released by pancreas? how are they activated?
zymogens reach duodenum then enterokinase cleaves inactive trypsinogen into active trypsin - then trypsin activates others in cascade effect
-
what is role of pancreatic secretory trypsin inhibitor made by acinar cells?
will inactivate any trypsin that is prematurely activated
-
should zymogens, amylase or lipase be found in normal patient's blood?
yes, small amounts leak into circulation but protease inhibitors bind/inactivate them
-
what blocks reflux of duodenal contents back to the pancreas?
muscular sphincters
-
what are two factors that can lead to increased severity of pancreatitis?
- poor perfusion of pancreas
- inhibitors overwhelmed/consumed
-
T or F: Pancreatitis always has the potential to be fatal; although this is not common if treated early/aggressively.
true
-
what are some possible end results of pancreatitis?
hypotension, DIC, shock, death
-
what are some risk factors for pancreatitis?
- nutrition (obesity/ hi fat diet)
- hyperlipoproteinemia
- duodenal reflux
- ischema/hypovolemia
- trauma/sx
- diabetes mellitus, cushings, (hypothyroidism)
- drugs: L-asparginase, anticonvulsants
-
what makes miniature schnauzers more prone to pancreatitis?
hyperlipidemia, hi triglycerides
-
Although variable, what are some common clinical signs?
- vomiting (90%)
- abdominal pain (right cranial or anywhere)
- weak, anorexia, depressed
- diarrhea
- fever, jaundice
-
what are some signs that pancreatitis is severe case?
- hemorrhagic diarrhea
- petechia/ecchymosis
- resp. distress, tachycardia
- shock/death
-
what will MDB show for pancreatitis patient?
- inflammatory leukogram
- azotemia (pre-renal, renal)
- elevated liver enzymes, elevated bilirubin
- hyperglycemia, hypoK (transient DM)
-
what is expected acid base balance with pancreatitis?
- marked metabolic acidosis
- if vomiting, may be alkalotic
-
What are some reasons other than pancreatitis that cause elevations in serum lipase/amylase?
- azotemia
- dexamethasone; cushings
- small intestine/other organs also have lipase/amylase
-
what is a reliable and convenient test for evaluating for pancreatitis?
canine pancreatic specific lipase (PLI)
-
what are expected findings with ultrasound?
- enlarged pancreas
- hypOechoic (darker than normal)
- surrounded by hyperechoic omentum
- (so dark structure surrounded by brightness)
-
what is usually the basis of a pancreatic abscess?
- *sterile inflammation*
- very rarely infectious
-
how is pancreatitis treated?
- fluids, electrolytes
- NPO in the beginning
- anti-emetics
- low fat diet
- potent analgesia
- plasma if coagulopathy
-
why do some give plasma even in absence of coagulopathy?
contains alpha 2 inhibitors that can inactivate circulating enzymes
-
what is reason for giving antibiotics for pancreatitis patient?
- *sterile* inflammation but leukopenia and duodenal inflammation can lead to sepsis
- *pancreatitis is NOT infectious*
-
what is cause of feline pancreatitis? how do they present?
- part of triaditis (pancreatitis not primary condition)
- often subclinical; vomiting NOT common in cats
|
|