A Systematic Review of the Association of Fat Content of Food with Canine Acute Pancreatitis

Abstract

Knowledge about acute pancreatitis has increased recently in both medical and veterinary fields. Despite this expansion of knowledge, very few studies explore the treatment interventions in naturally occurring disease in dogs, which are largely extrapolated from experimental models or general critical care principles. General treatment principles involve replacing fluid losses, maintaining hydrostatic pressure, controlling nausea and providing pain relief. The premise for early feeding is to improve the health of the intestinal tract, as unhealthy enterocytes are thought to perpetuate systemic inflammation. The evidence for early interventional feeding is not supported by robust clinical trials to date, but in humans there is evidence that it reduces hospitalisation time and is well tolerated in dogs. This review summarises the fundamental aetiologies, basic diagnostics and general treatment strategies across the literature of both veterinary and human medical fields. Nutritional support plays a pivotal role in the clinical management of patients with acute pancreatitis, however evidence based principles for its management are still lacking, thus the current literature on the potential effects of low fat diets containing different amounts and types of fatty acids will also be discussed. In all, this thesis supports the new premise of enteral feeding of dogs with acute pancreatitis early in the course of disease with low fat diets that are rich in high quality fatty acids.