Acute pancreatitis is a common and important disease in dogs. While studies in both human and veterinary literature have investigated the underlying pathophysiology, the etiology remains unclear. Ultimately, an inciting factor triggers premature activation of pancreatic enzymes, auto-digestion, and eventually a systemic inflammatory state. Treatment relies on supportive care in the form of intravenous fluid therapy, anti-emetics, and analgesia. Early enteral nutrition has proved beneficial in improving outcome. The prognosis for acute pancreatitis depends on severity and ranges from good in subclinical cases, to grave with multiple organ failure. Approximately one third of dogs with acute pancreatitis have secondary extrahepatic bile duct obstruction. A full abdominal ultrasound is warranted in any dog presenting for biliary signs as pancreatitis is the leading cause of extrahepatic bile duct obstruction. Blockage typically subsides with control of pancreatic inflammation, but if biliary obstruction persists, surgically placed stents or bile duct decompression may be necessary.