Ady, a 9 year old spayed female Miniature Dachshund, presented to the Small Animal Internal Medicine Service at the Cornell University Hospital for Animals (CUHA) for evaluation of a two day history of vomiting and anorexia. Previously, Ady had been diagnosed with hyperadrenocorticism and diabetes mellitus, and both had been well controlled. However, the recent serum biochemical test results revealed increased alkaline phosphatase activity, hypercholesterolemia, hyperglycemia, hyperlipemia, hyperlipasemia, and hypoalbuminemia; urinalysis revealed substantial glucosuria and ketonuria.

On presentation at CUHA, Ady was quiet, alert, and responsive with a body condition score of 4/9. Her temperature was elevated at 103 degree F. Ady had bilateral mature cataracts, a grade II systolic mitral murmur, and a painful cranial abdomen. Routine hemogram showed leukocytosis with a degenerative left shift and moderate toxic changes in neutrophils. Serum biochemical panel and urinalysis showed changes similar to those noted previously with the additional findings of metabolic acidosis, hyperamylasemia, and mild hypomagnesemia. An abdominal ultrasound revealed an enlarged pancreas with surrounding hyperechoic fat, mild cranial abdominal peritoneal fluid, and mild hepatomegaly. The collective historical, physical, laboratory, and ultrasonographic findings were consistent with pancreatitis, ketoacidotic diabetes mellitus, and hyperadrenocorticism.

Ady received nothing by mouth and was treated with intravenous fluids supplemented with potassium and glucose. She also received intravenous magnesium supplementation, an antacid (famotidine), an anti-emetic (metoclopramide), an analgesic (butorphanol), and antibiotics, as well as titrated doses of regular insulin subcutaneously. She remained in the hospital for six days with steady improvement. Four days after discharge, however, she represented for vomiting. Repeat abdominal ultrasound demonstrated an enlarged gall bladder and repeat biochemical test results were consistent with cholestasis. Supportive care was reinstituted and a recheck exam one week later revealed resolution of the vomiting and a normal gall bladder.

This paper will provide a brief synopsis of pancreatitis with emphasis on pathophysiology and treatment options.