Articles
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Palliative medicine is care that is delivered as a dog approaches the end of life. The first step in creating a palliative care plan is to discuss with your veterinarian the expected course of the disease and how it will affect your dog's quality of life. Once a dog's activities of daily living have been identified, it is important to define family beliefs, family needs as care unfolds, and the goals for the dog as death approaches. An essential part of establishing goals of palliative therapy is understanding the expected course of the life-limiting disease. Knowledge about disease allows for the development of a personalized palliative care plan.
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Primary pancreatic tumors are rare in dogs and cats. Exocrine tumors include adenomas and adenocarcinomas, and endocrine tumors include insulinomas, gastrinomas, and glucagonomas. Insulinomas are the most common type of pancreatic tumor, followed by adenocarcinomas. Both tumors are more common in dogs than cats. Large breed dogs and Siamese cats may be predisposed. Insulinomas are usually diagnosed with the finding of hypoglycemia with normal to high insulin on bloodwork and concomitant clinical signs. Adenocarcinomas typically go undetected until the clinical signs of metastasis are evident. For both tumors, diagnostic imaging and exploratory surgery with tumor removal (or biopsy) and histopathology are needed for a definitive diagnosis. Insulinomas can be treated with surgery and chemotherapy. Surgery is possible with adenocarcinomas, but as the cancer is more diffuse and has usually metastasized by the time of diagnosis, the prognosis is poorer. Chemotherapy and radiation therapy are ineffective in the treatment of adenocarcinomas. Given the high rate of metastasis with these tumors, staging is recommended prior to surgery.
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The pancreas is a vital organ that produces enzymes to assist in food digestion and hormones such as insulin, which regulates blood sugar or glucose metabolism. Pancreatitis is inflammation of the pancreas. Common clinical signs include decreased appetite, nausea, vomiting, lethargy, diarrhea, and abdominal pain. Diagnosis is generally made with laboratory testing and/or abdominal ultrasound. Successful pancreatitis management will depend on early diagnosis and prompt medical therapy. The prognosis depends on the severity of the disease and the response to initial therapy.
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Pancreas-specific lipase is a form of lipase produced only in the pancreas and is highly specific to the pancreas. Blood values increase only when there is pancreatic inflammation. A version of the cPLI test can now be used in-clinic (SNAP fPL© from IDEXX). Ideally, the sample should also be sent to the laboratory to get an actual value of cPLI to help with treatment and monitoring.
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Pancrelipase is given by mouth and is used on and off label to treat exocrine pancreatic enzyme deficiency in dogs, cats, and birds. It is also used to treat fur balls in rabbits. Give as directed by your veterinarian. Common side effects at higher doses include diarrhea, cramping, gas, or vomiting. Do not use in pets that are allergic to pork. If a negative reaction occurs, please call your veterinary office.
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Panniculitis is a localized inflammation of the tissues under the skin, causing a firm swelling (nodule) that may ulcerate and drain fluid. It is a common problem in cats and is less common in dogs. There are several causes of panniculitis, but in younger animals with a single lump, the cause is often blunt trauma and, in cats, it is often caused by bite wounds from fighting. An accurate diagnosis relies on the microscopic examination of tissue and the most common treatment is the surgical removal of the lump(s).
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Chronic superficial keratitis (CSK), or pannus, is a potentially blinding disease affecting the cornea. Any dog breed can be affected by pannus, but it is predominantly seen in German shepherds, Belgian shepherds, and border collies. Diagnosis is based on medical history and clinical signs. Treatment involves using topical corticosteroids or other immune-modulating drugs. If diagnosed early and treatment plans are followed, many dogs can have a good prognosis and live a normal life.
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Panosteitis is a painful inflammation of the outer surface or shaft of one or more long bones of the legs. It is sometimes called growing pains. Panosteitis is a condition that affects young, rapidly growing dogs. Panosteitis will be suspected if the patient shows pain when pressure is applied to the affected bone(s). The diagnosis is confirmed by X-rays, which usually show a characteristic increase in the density of the affected bones. Although this disease will spontaneously resolve, during episodes of lameness the condition is very painful. At these times, treatment is supportive, using pain medication and anti-inflammatory drugs as needed.
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Papillomas are benign, sometimes multiple, tumors caused by viruses. They are commonly known as warts. The virus is transmitted through direct contact from an infected pet or the pet’s environment (e.g., toys, food bowls, or bedding) and gain access to the body when the skin becomes softened by moisture, through cuts and abrasions, or with the assistance of insects. Pets with immature immune systems such as young dogs and puppies, and those that are immune compromised, are more prone to developing papilloma tumors. The tumors often disappear within 1-2 months because the animal slowly develops an immunity to them. However, sometimes they persist, and surgical removal is necessary.
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Parathyroid tumors are uncommon in dogs and cats. Benign adenomas occur more often than malignant tumors. Keeshonds appear to have a genetic predisposition to developing parathyroid tumors, but no breed or genetic relationship has been established in cats. Pets may exhibit signs of lethargy, little or no appetite, vomiting, and muscle twitching. Diagnosis is confirmed with PTH testing and ultrasound of the neck region after hypercalcemia is observed on bloodwork. Surgery to remove the affected gland(s) is the typical treatment, but ultrasound-guided ablation may be pursued. Careful monitoring of calcium levels post-surgery is important, as some pets may develop transient hypocalcemia and require calcium supplementation. Prognosis is excellent, and the metastatic rate for these tumors is extremely low.