What does the pancreas do?
The pancreas is a small organ that sits behind the small intestine and the stomach. The pancreas digests food and regulates a cat and dog’s blood sugar.
The pancreas produces and stores inactive enzymes that should only be activated when they enter the small intestine. Amylase for carbohydrate digestion, lipase for emulsifying and digesting fats and protease for digesting protein.
Most of the pancreas is composed of cells that produce digestive enzymes. These cells are arranged in clusters that are connected to a series of small ducts. Pancreatic enzymes and juices flow from the cells and minor ducts into the main pancreatic duct, leading to the duodenum. The pancreas also contains small “islands” of hormone-producing cells called the islets of Langerhans, which secrete insulin and glucagon,along with somatostatin, hormones that mostly regulate blood sugar metabolism.
What is pancreatitis
Pancreatitis is the intense inflammation and swelling of the pancreas. It can either be an acute case, where animals can be at high risk (sometimes fatal) from a sudden onset of mass inflammation, where this tends to go away in a matter of a few days to a week (if the patient survives it).
Chronic pancreatitis is a low grade inflammation over an extended period of time, leading to other possible health complications. Exocrine pancreatic insufficiency (EPI) is the termed coined when the pancreas is no longer able to produce digestive enzymes, this can result from chronic pancreatitis. When the pancreas is damaged, further complications such as diabetes may appear over time, if not managed effectively.
The prognosis depends on the severity of the disease. If left untreated, pancreatitis may lead to severe organ damage and even sudden death. Pancreatitis can cause a lot of pain and damage so if your pet seems uncomfortable, please do not ignore this, go to your veterinarian.
Common symptoms but not exclusive are;
· Loss of appetite
· Arched back
In milder forms, symptoms aren’t always obvious but may include loss of appetite, lethargy and diarrhoea. During an attack they may hunch the back, holding their bottom in the air with front legs and head low to the floor.
Why it is so prevalent
It is almost 50% more common in cats and dogs than in humans. A combination of environmental and genetic factors plays a role in the development of most cases of pancreatitis in pets.
You will find certain breeds such as cocker spaniels, dachshunds, miniature schnauzers and poodles are more susceptible to pancreatitis due to common genetic snips (SNP) in cats and dogs. It’s sometimes difficult to pinpoint the exact cause of pancreatitis but the following definitely play a part in the full picture of health.
· Scavenging; eating spoiled foods and incredibly high amounts of oxidised fat.
· Processed foods; eating processed foods, always high in sugars and sometimes grains are specifically high in carbohydrates.These carbohydrates put an unusual load on the pancreas. Cats and dogs are carnivores and naturally produce less amylase than any other digestive enzyme in the digestive system.
· Rancid fats; found in poor processed foods and poorly stored fats, leading to oxidation and inflammation and therefore, more than likely, leaky gut.
· Grains and Lectins; often contained in dry food due to being cheap ingredients, creates inflammation and up regulates a protein called zonulin. Zonulin is responsible for (and a new diagnostic biomarker of) intestinal permeability (leaky gut).
· Leaky gut/gut integrity/intestinal permeability; leaky gut is when the integrity of the ‘one cell epithelial’ lining of the gut, becomes compromised by inappropriate foods, allergens, toxins and so forth. These slack and under functioning junctures allow chemicals, including food stuff into the blood stream, that should not be permitted. Leaky gut is linked to many disease states and closely linked to a lowered gut immunity in pancreatitis.
· Inflammation and imbalanced immunity; acute and chronic pancreatitis are dynamic inflammatory processes. Immune cells playa critical role in pancreatitis progression so looking towards that intricate cascade and supporting stress are key.
· Pharmaceuticals; in recent years, a large number of commonly prescribed medications have been linked to drug-induced pancreatitis pathogenesis. Although mechanisms are proposed, the exact cause of injury is not well understood.
· Obesity; obese animals are predisposed to a wide variety of diseases affecting many organ systems. Endocrine disorders commonly associated with obesity include canine pancreatitis.
· Cushing’s disease; is an endocrine disease and is commonly associated in pancreatitis.
· High blood levels of fats; triglycerides, have also been listed as a risk factor to pancreatitis in canines.
· Infections such as Babesia canis or Leishmania have shown to be present in some canine pancreatic patients.
· Genetics; genetic polymorphisms are found in certain breeds, the most common being SPINK1. Feeding a processed diet and in a toxic environment (vaccinations included), are more likely to express this gene, however this is far too common a disease for it to be purely genetic.
Nutrition regime in pancreatitis
There’s a lot of conflicting advice out there for pancreatitis but I have worked in this with humans and pets and the aetiology, pathogenesis and therefore dietary plans are rather similar in terms of approach and the following can be very helpful.
I do not advocate any processed foods in this disease, only fresh, balanced, home cooked or raw food.
Once home, I always recommend to do a 24 hour fast to let the inflammation calm down, allowing the body to restore some kind of equilibrium. Giving broth takes a load off the pancreas and helps rehydrate providing a lot of wonderful nutrition. During the first week easily digestible food is helpful, I often suggest a light meaty broth with vegs and pureed foods that require less digestion.
There is often the suggestion that small meals spread over time is the best protocol in pancreatitis but this activates the pancreas, aggravating the inflammation further. When you start feeding fresh and balanced food over time, I find feeding twice a day, if your schedule permits it, feeding breakfast around 9am and then dinner at about 4pm, allowing a longer fast between dinner and the following breakfast. If your pet can tolerate being fed once a day, this might be even better but tread with caution.
Leaner meats at the beginning proceeding an attack should be fed, reducing fats whilst things get back into balance. However, as a general rule, fattier containing meats and good fats (around 40%) don’t necessarily exacerbate the pancreatitis in my experience. The importance is quality of meat and fats as opposed to the amounts moreover.
Fats and phytochemicals found in fish oil and olive oil have been shown to block cellular mechanisms involved in the development of acute pancreatitis, say researchers. Only look to restrict fats if your pet is in an acute phase. Fats are rarely the root cause but excess fats may be problematic in the short term until the animal starts to recover.
There is little need for carbohydrates in the diet, just some nice fresh vegetables, offering colour and variety offering beautiful antioxidants and phytochemicals that are shown to potentially help in pancreatitis.
Emerging evidence in the health sector, has highlighted nutrient supplementation is key to limit local inflammation and to prevent or manage pancreatitis associated complications.
The immune system is thought to play an important role in the disease pathogenesis of pancreatitis and this is how I focus my approach. Both humans and dogs share the same pathogenosis of pancreatitis so many findings have been interrelated.
Digestive enzymes; digestive enzymes such as protease, lipase, cellulose, hemicellulose, amylase and pancreatin are a fantastic addition for exocrine pancreatic insufficiency (EPI). It takes a load off the pancreas, reducing its activity and thus in turn managing the inflammation.
Probiotics; the effects of L. plantarum has been evaluated in human trials and the patients who showed attenuated disease severity, improved their intestinal permeability, and had better clinical outcomes in pancreatitis. I do use this probiotic strain and see a difference in dogs in particular but research is limited.
Slippery Elm and Glutamine; are best applied in chronic pancreatitis. Slippery elm is regarded as an adaptogenic mucilage that creates a beautiful film around the entire gastrointestinal tract, protecting the immunity epithelial, easing symptoms. Glutamine also helps support gut integrity. It’s very important not only supports immunity but also helps release a healthy amount of stomach acid (Hcl), that aids in protein and fat digestion. If gut integrity is poor this may put extra stress on the pancreas. Early studies also points to L-Arginine increasing digestive enzymes.
Omega 3 fatty acids (plus tocopherol); contrary to traditional beliefs, studies with omega-3 fish oil have shown to control inflammatory response and improve the outcome especially in hyper-inflammatory conditions such as pancreatitis. Fish source should be from purer forms such as anchovies or sardines and algae oil where the EPA and DHA fatty acids are provided. There needs to be from as little as 4 – 10 IU of natural vitamin E added per 1000mg fish oil capsule/liquid to prevent the fish oil from depleting a dog’s vitamin E levels and protecting the oil itself from oxidation. Any good omega 3 oil will provide a good source of tocopherol. Of course, caution should always be taken when supplementing fats to an animal with pancreatitis.
Phenolic and Vitamin C (antioxidants); recent research in phenolics (derived from olives and olive oil) and other antioxidants such as Vitamin C show great potential in protecting tissue and have shown to help the inflammation in pancreatitis. Phenolics cannot be used in a cat’s diets.
Ashwaganda; during times like this, one should think about reducing stress and inflammation and supporting the endocrine system that is intrinsically linked to the function of the pancreas. Ashwaganda is well known for supporting the stress response and holding court in the endocrine system.
Milk thistle; is proven to support liver function, digestion and emulsification of fats via the gallbladder. Looking to support fat digestion and detoxification helps support the pancreas.
Reducing stress is probably one of the most effective ways to manage disease. I always suggest looking at your pet’s emotional profile and ability to cope with stress.
Looking at natural alternatives for flea and worming treatments, titers as opposed to vaccinations and reducing the toxic overload in the household by using natural products are all helpful at approaching this disease holistically.
If your cat or dog is fed a fresh and well balanced diet and not dry food, has reduced toxicity exposure and experiences as little stress as possible, they have the best chance of a healthier outcome. And so therefore, diet, supplements, lifestyle and stress management are the core areas to consider in this disease.
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