Pancreatitis Revisited

Pancreatitis is a diagnosis that has become extremely common for both dogs and cats. Pancreatitis simply means inflammation of the pancreas. It can come on acutely, as seen when a pet gets into garbage or is fed grease or cooked fats, or it may be a chronic condition that progresses over time. Some pets will develop acute pancreatitis with no changes in diet or dietary indiscretion, leaving pet owners perplexed as to the cause of the onset. While the symptoms may suddenly progress to an acute presentation, there has often been a "sub-clinical" simmering inflammation or imbalance in the body going on for some time.

Symptoms may include restlessness after eating or assuming a "prayer position" with the hindquarters in the air stretching the abdomen. This may progress to drooling, nausea, lip-licking, regurgitation, vomiting, yellow or bloody diarrhea, and dehydration.

The pancreas is a delicate organ which is easily damaged by inappropriate diets, stress, inflammation, obesity, and over-use of drugs such as steroids, diuretics, antibiotics, and NSAIDs. Inflammation of surrounding organs including the small intestines, stomach, liver, and gallbladder may contribute to inflammation in the pancreas. 

Diagnosis can be made with laboratory testing of the blood. An abdominal ultrasound is the best test to determine the stage and severity of disease. 

Intravenous fluids with electrolytes, anti-nausea injections, pain medications, and anti-diarrheal therapy are usually given as treatment by the veterinarian. Once the vomiting is controlled, the pet is placed on a low-fat diet. Unfortunately, some pets will continue to have pancreatitis attacks even while being fed those prescription diets because the underlying cause has not been determined and corrected.

From a Traditional Chinese Veterinary Medicine (TCVM) standpoint, there are four patterns that can lead to pancreatitis: 

1. Liver Qi Stagnation - Prolonged emotional stress or frustration, overwork, or irregular diet can result in this condition. The Liver aids the digestive function that transforms and transports nutrients; when the Liver stops providing that aid there is pain and rebellious Qi (energy) or vomiting.

Symptoms include belching, nausea, vomiting, bloating, and pain. With Qi Stagnation the food becomes stagnant and does not descend into the intestines. Heat develops in the stomach, leading to vomiting and diarrhea with a very strong smell. The tongue will be red/purple, especially on the sides.

Foods that can be supplemented include turkey, yellow squash, barley, turnip, and bitter greens (dandelion, mustard). Foods to avoid include raw foods, large meals, dry kibble, animal lard, and vinegar. It is recommended to start with congee when putting these pets back on meals. 

Avoid overwork and extreme, prolonged physical stresses. 

The herbal medicines Jia Wei Xiao Yao Wan or Liver Happy can help resolve Liver Qi Stagnation leading to chronic pancreatitis.

2. Food Stagnation - Retention or stasis of food in the stomach leads to abdominal pain and a feeling of fullness. These animals will have decreased appetite and bad breath, even in the absence of dental disease. The stool may be loose or dry. The tongue will be red and dry with a thick, greasy coating. When food stagnates it generates Heat which leads to the signs of dryness in the stool and tongue. 

Foods that can help resolve stagnation include turnips, parsley, chicken, crab, dandelion greens, mustard greens, radish, garlic, and ginger. Foods to avoid include greasy or heavy foods, highly processed foods (dry kibble), and large meals. 

Avoid feeding late in the day. Increase exercise to move Qi. 

The herbal Bao He Wan is very effective at resolving food stagnation.

3. Damp-Heat Spleen - These animals are lethargic, have a loss of appetite, diarrhea with a foul odor, pain on abdominal palpation, vomiting, and fever. This may be the result of acute or chronic indigestion. Damp weather or environment, Damp-generating or Hot (energetically) food (dry kibble), or chronic enteritis (intestinal inflammation) can also lead to this condition. The tongue will be yellow or red with a thick, greasy, yellow coating. These animals may progress to being jaundiced if the Damp-Heat affects the liver and gall bladder. 

Foods to supplement include barley, squash, turnips, chicken, turkey, and mackerel. Small meals should be fed frequently. Avoid dairy, fat, lamb, venison, and highly processed foods (dry kibble). 

Diet is the chief contributor to this pattern. The diet should be changed to include freshly cooked, low-fat foods that nourish the Spleen (digestive function). Congee and yellow foods that nourish the Earth (digestive) element are appropriate: chicken, squash, pumpkin, sweet potato, Shiitake mushrooms.

4. Spleen Qi Deficiency with Damp - Symptoms include loss of appetite, diarrhea, fatigue, poor hair coat, loss of body weight, and possible vomiting. The tongue will be pale and may have a white coating. The Spleen (digestive function) may be deficient from starvation, overwork, underwork, overfeeding, or chronic illness. When the Spleen is weak it will not transform fluids and Dampness results. Damp may also invade from the environment. Excess damp can lead to belching, regurgitation, or vomiting, as well as diarrhea. The diarrhea may include undigested bits of food and will not have a very foul odor. These animals tend to be colder rather than hot.

The use of congees with yellow vegetables are the ideal starting point for treating this problem. The addition of chicken may be beneficial once the vomiting has stopped and the appetite has improved. Foods that may be beneficial include white rice, yellow vegetables, chicken, beef, and oats. Avoid dry kibble, foods high in vegetable oil, vinegar, duck, and ocean fish (cold foods).

Avoid excess activity or strenuous exercise. Avoid foods that are cold or damp. Avoid cold or damp environments.

The herbal formula Shen Ling Bai Zhu is very helpful for this condition.

Home-prepared meals are the solution to acute and chronic pancreatitis problems. Highly processed, dry pet foods can contribute to obesity, TCVM imbalances such as Heat, Damp, and Stagnation, and chronic inflammation. 




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