Akut hasnyálmirigy-gyulladás kutyákban és emberekben : Irodalmi összefoglaló

Abstract

In this literature review the authors summarise the current knowledge about acute pancreatitis in dogs and humans. The authors compare the similarities and differences of acute pancreatitis in the two species, including aetiology, pathomechanism, symptoms, diagnostic procedures (haematologic and serum biochemistry examination, including the measurement of specific enzymes, diagnostic imaging, histology) and the difficulties of obtaining the correct diagnosis. They also summarise the current medical and nutritional management, and the different scoring systems used to predict the prognosis of the disease. Acute pancreatitis is a common disease in both species with possible severe consequences such as systemic inflammatory response syndrome (SIRS) or multiorgan dysfunction syndrome (MODS). Due to the nonspecific symptoms it is sometimes difficult to identify the disease. Diagnosis is often established by the presence of two of the three following criteria: clinical signs of gastrointestinal disease (e.g vomiting, abdominal pain, diarrhea, anorexia), serum amylase and/or lipase three times more than the upper border of the reference range (in humans) or an elevated canine pancreas-specific lipase (Spec cPL) in dogs, presence of characteristic signs of pancreatitis by abdominal imaging. There is no specific medication for the disease; the guidelines stress the importance of supportive treatment, especially fluid therapy to restore the normal microcirculation of the organ. As abdominal pain is often very severe the use of pain medications is always recommended. One of the main goals of the therapy is to start enteral feeding as soon as possible (in 24-48 hours in general) to provide energy to the pancreatic cells and the enterocytes. The diets used for this purpose are mostly low in fat based on empirical judgement. However, to date, the ideal composition has not been found, and no significant clinical differences have been found between the different diet compositions in any of the species. Because the clinical course and the treatment of the disease in the two species are similar, dogs can serve as a spontaneous animal model for the human disease.