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Pancreatic Abscesses in Small Animals

By Jörg M. Steiner, DrMedVet, PhD, DACVIM, DECVIM-CA, AGAF, Associate Professor and Director, Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A & M University

By definition, a pancreatic abscess is a collection of pus, usually in proximity to the pancreas, containing little or no pancreatic necrosis. Pancreatic abscesses are considered a complication of pancreatitis, and thus their clinical presentation is similar to that of pancreatitis, although most cases are associated with mild chronic pancreatitis, and clinical signs may be more vague. A bacterial infection may or may not be present, but almost all cases reported in small animals have been sterile. Increased serum trypsin-like immunoreactivity and pancreatic lipase immunoreactivity concentrations have not been reported in dogs or cats with a pancreatic abscess, but anecdotal reports suggest that both serum parameters are increased in these animals. Surgical drainage and aggressive antimicrobial therapy are the treatments of choice in human patients with an infected pancreatic abscess. Dogs and cats may also respond favorably to surgical drainage. However, in one report, only slightly more than 50% of animals survived the immediate postsurgical period. Thus, given the mixed results and risks, difficulties, and expenses associated with anesthesia, surgery, and postoperative care, surgery may not be warranted unless there is clear evidence of an enlarging mass and/or sepsis in a medically managed animal.