Changes: Pancreatitis

Latest revision as of 09:42, 11 February 2013

Pancreatitis is acute or chronic inflammation of the pancreas. It may be caused by infection, or irritation from the pancreas' own production of digestive enzymes. Pancreatitis, whether chronic or acute, usually requires a lowering of dietary fat levels^[1]^[2], which can be tricky to combine with the low-carb diet required by diabetics. This condition plus diabetes usually requires a custom-designed medium-carb diet.

Signs

While both dogs and cats can suffer from chronic pancreatitis, the species differ when it comes to signs of it. Dogs tend to have repeated acute episodes while cats appear to have gradual inflammation with difficult to pinpoint signs of illness^[3].

Some research indicates that male cats are more prone to be sufferers of chronic pancreatitis than females^[4].

Having diabetes puts dogs at a greater risk of acute pancreatitis^[5].

Concurrent with Diabetes

There is evidence to suggest that chronic, subclinical (unable to be ascertained through present testing methods) pancreatitis is common in canines with diabetes^[6]. A study conducted by Drs. Fleeman and Rand puts the estimate of canine diabetics with pancreatitis--either acute^[7] or chronic^[8]--at about 40%^[9]. Dr. Fleeman also states that it is chronic pancreatitis and the damage it causes to the organ that is responsible for 1/3 of canine diabetes cases^[10]; Dr. Greco echoes this thought^[11].

This 2000 lecture given at the District of Columbia Academy of Veterinary Medicine regarding managing acute pancreatitis in dogs and cats refers to an (uncited) study suggesting that cats with pancreatitis are quite sensitive to insulin^[12]. A 1989 study of persons with pancreatitis-caused diabetes also seems to point to the same effect in humans^[13], noting that those in the study had low glucagon levels which did not respond normally.

The lack of normal glucagon action, which raises blood glucose levels, appears to indicate problems with the way the body responds to hypoglycemia. It goes on to mention that their epinephrine responses to insulin-related hypoglycemia is also abnormal.

With epinephrine aka adrenalin acting counter to insulin by raising blood glucose levels, this would seem to further signal problems with the way the body is able to respond to hypoglycemia for those with pancreatitis and diabetes.

Another human-based study^[14] suggests that there is a correlation between the endocrine pancreas associated with diabetes and the function of the exocrine pancreas associated with pancreatitis. Insulin-dependent diabetics were rated as having the most severe exocrine pancreas deficit. Those who were able to control their diabetes with oral medications in the sulphonylurea class were deemed as having intermediate exocrine pancreas deficit. Those who were able to control their diabetes with oral medications of the biguanide class--with or without the help of diet alteration and those who are diet-controlled without any medications, were considered to be free from exocrine pancreas deficit.

Causes

Some possible causes of pancreatitis:

Obesity/Overweight: This is true for many dogs diangosed with pancreatitis. It is also more likely to develop when a high-fat diet is being fed^[15].

Hyperlipidemia:or high fat content in the blood. The levels of fat in the blood often rise after eating, but for those without hyperlipidemia, this is a temporary state. Metabolic problems in both pets and people can prevent the removal of fat from the blood. Some studies show that hyperlipidemia can be a cause of pancreatitis^[16]. A low-fat or restricted fat diet is suggested for all diabetic dogs, as it may prevent pancreatitis^[17]

Infections--from either viruses (viral) or bacteria (bacterial) can cause pancreatitis in dogs and cats.

Injury: An injury or trauma to the abdominal area can result in injury to the pancreas; this can mean possible pancreatitis.

Dianostics

The current blood test for pancreatitis in cats is the SPEC fPL blood test. If you or you veterinarian suspects pancreatitis, a SPEC fPL (sometime also called a PLI for feline PLI test) is highly recommended. This test is currently only performed by Idexx Laboratories and Texas A&M. The fTLI blood test is an unspecific test for feline pancreatitis and more representative of general inflammation of the cat's organs.

Diagnosis

Pancreatitis is often hard to diagnose^[18]. Tests include the serum TLI (Trypsin-Like Immunoreactivity)^[19], and the feline or canine PLI (Pancreatic Lipase Immunoreactivity)^[20], available from the gastrointestinal laboratory at the College of Veterinary Medicine at Texas A&M University. Turnaround from that lab often takes several days.

A canine-specific PLI test is also commercially available through IDEXX Laboratories as the Spec cPL™ Test^[21].

Dr. Williams, who is the director of the GI Lab mentioned above, gave this presentation before the World Small Animal Veterinary Association in 2004^[22]. He notes no specific signs or symptoms which definitely point to pancreatitis in cats.

Labwork for dogs has more clear-cut signs of abnormal values than the results can for cats. Some cats have normal lab results and also have pancreatitis^[23].

Rare but possible

It doesn't happen frequently, but it is possible for a pancreatitis attack to "jolt" the endocrine portion of the organ back into being capable of producing insulin once again in dogs^[24].

Treatment

It may be very tricky to treat, also. It can cause insulin resistance, dehydration, and also nausea and vomiting, all of which complicate diabetes. Pets can also begin drinking more water. For the most part, they also commonly show a higher than normal temperature when the disease is in its beginning stages. As pancreatitis progresses, the body temperature may go below normal^[25].

Some recommended treatments to ask your vet about include:

Diet may be important to a pancreatic cat. Some people have had excellent results with a diet that's about

10-15% calories from carbohydrate
50-55% calories from protein
35% calories from fat^[26]

Others find that a standard low-carb diet works fine. Some are adamant that fat content is irrelevant to pancreatitis.

"resting" the pancreas by withholding^[27]^[28]all food, water and oral medications for a time frame set by your vet. Subcutaneous fluids bypass the oral route; in avoiding the oral route, the pancreas is also avoided. Medical term for this is "nil per os", or "nothing by mouth".
antioxidants to help reduce the inflammation.
pancreatic enzymes to compensate for pancreatic insufficiency^[29], but only when indicated by the TLI.
Vitamin B12 injections, especially in the case of existing bowel issues
Subcutaneous fluids to combat dehydration. These can be given at home.

Complications of Pancreatitis

Chronic pancreatitis can lead to maldigestion syndrome in which the pancreas fails to produce enough digestive enzymes^[30]. A severe attack is capable of damaging the exocrine pancreas, which produces the digestive enzymes and the endocrine pancreas, which produces insulin. Having a severe attack also puts one at risk for developing chronic pancreatitis^[31].

This FDMB thread link below^[32] and followups^[33] deal with alternatives and treatments.

References

[1] BD Diabetes-Diet & Exercise for the Diabetic Dog

[2] BD Diabetes-Diet & Exercise for the Diabetic Cat

[3] Feline Pancreatitis-North American Veterinary Conference-2006

[4] Hills Pet Products-Owner's Guide to Pet Care-Pancreatitis

[5] Beyond Insulin Therapy: Achieving Optimal Control in Diabetic Dogs Drs. Fleeman & Rand-U-Queensland 2005

[6] Dr. Rand, et. al.-Chronic Subclinical Pancreatitis is Common in Diabetic Dogs-University of Queensland 2004

[7] Image Illustrating Acute Pancreatitis

[8] Image Illustrating Chronic Pancreatitis

[9] Veterinary Clinics of North America-Small Animal Practice-2001-Management of Canine Diabetes-Drs. Fleeman & Rand

[10] Beyond Insulin Therapy:Achieving Optimal Control in Diabetic Dogs Drs. Fleeman & Rand-U. Queensland, 2005

[11] Better Medicine E-Newsletter-June 2006

[12] Pettalk.com-Feline Diabetes

[13] PubMed-Diabetes Care 1989-Pancreatic Diabetes Mellitus

[14] Journal of Clinical Pathology 1984-Exocrine Pancreatic Function in Diabetes Mellitus

[15] Pet Education-Drs. Foster & Smith-Fats:Nutritional Requirements & Obesity in Dogs

[16] Hills Pet Care Products-Owner's Guide to Pet Care-Pancreatitis

[17] Beyond Insulin Therapy: Achieving Optimal Control in Diabetic Dogs Drs. Fleeman & Rand-U-Queensland 2005

[18] Felinediabetes.com-Pancreatitis

[19] Texas A & M University-Gastrointestinal Laboratory-TLI Test Information

[20] Texas A & M University-Gastrointestinal Laboratory-PLI Test Information

[21] IDEXX Laboratories-Canine Pancreas-Specific Lipase Spec cPL™ Test

[22] WSAVA 2004-Pancreatitis in Cats

[23] Hills Pet Products-Owner's Guide to Pet Care-Pancreatitis

[24] Vet Info--see "Diabetes with rebound hyperglycemia" Question

[25] Hills Pet Products-Owner's Guide to Pet Care-Pancreatitis

[26] [1]

[27] Hills Pet Products-Owner's Guide to Pet Care-Pancreatitis

[28] Feline Pancreatitis-Drs. Foster & Smith-Pet Education Library

[29] Peteducation.com (Drs. Foster & Smith)-Pancreatic Insufficiency

[30] Purina ONE Health Library-Diabetes Mellitus

[31] CNN.com Health Library-Pancreatitis Overview

[32] FDMB-Pancreatitis Discussion

[33] FDMB-Pancreatitis Discussion Followups

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

[10]

[11]

[12]

[13]

[14]

[15]

[16]

[17]

[18]

[19]

[20]

[21]

[22]

[23]

[24]

[25]

[26]

[27]

[28]

[29]

[30]

[31]

[32]

[33]

@@ Line 1: / Line 1: @@
-'''Pancreatitis''' is acute or chronic inflammation of the [[pancreas]].  It may be caused by [[:Category:Infections|infection]], or irritation from the pancreas' own production of digestive enzymes.  Pancreatitis, whether chronic or acute, usually requires a lowering of dietary fat levels<ref>[http://www.bddiabetes.com/us/main.aspx?cat=1&id=389 BD Diabetes-Diet & Exercise for the Diabetic Dog]</ref><ref>[http://www.bddiabetes.com/us/main.aspx?cat=1&id=367 BD Diabetes-Diet & Exercise for the Diabetic Cat]</ref>, which can be tricky to combine with the [[low-carb diet]] required by diabetics.  This condition plus diabetes usually requires a custom-designed [[medium-carb diet]].
+'''Pancreatitis''' is acute or chronic inflammation of the [[pancreas]].  It may be caused by [[:Category:Infections|infection]], or irritation from the pancreas' own production of digestive enzymes.  Pancreatitis, whether chronic or acute, usually requires a lowering of dietary fat levels<ref>[http://www.bd.com/us/diabetes/main.aspx?cat=7001&id=7389 BD Diabetes-Diet & Exercise for the Diabetic Dog]</ref><ref>[http://www.bd.com/us/diabetes/main.aspx?cat=7001&id=7367 BD Diabetes-Diet & Exercise for the Diabetic Cat]</ref>, which can be tricky to combine with the [[low-carb diet]] required by diabetics.  This condition plus diabetes usually requires a custom-designed [[medium-carb diet]].
 ==Signs==
-While both dogs and cats can suffer from chronic pancreatitis, the species differ when it comes to signs of it.  Dogs tend to have repeated acute episodes while cats appear to have gradual inflammation with difficult to pinpoint signs of illness<ref>[http://www.cliniciansbrief.com/cms/portals/_default/pdfs/capsules/May_06_Cap01.pdf Feline Pancreatitis-North American Veterinary Conference-2006]</ref>.
+While both dogs and cats can suffer from chronic pancreatitis, the species differ when it comes to signs of it.  Dogs tend to have repeated acute episodes while cats appear to have gradual inflammation with difficult to pinpoint signs of illness<ref>[http://web.archive.org/web/20070808051923/http://www.cliniciansbrief.com/cms/portals/_default/pdfs/capsules/May_06_Cap01.pdf Feline Pancreatitis-North American Veterinary Conference-2006]</ref>.
 Some research indicates that male cats are more prone to be sufferers of chronic pancreatitis than females<ref>[http://www.mscc.ca/pancreatitis.html Hills Pet Products-Owner's Guide to Pet Care-Pancreatitis]</ref>.
 Having diabetes puts dogs at a greater risk of acute pancreatitis<ref>[http://www.uq.edu.au/vetschool/centrecah/index.html?page=43392&pid=41544 Beyond Insulin Therapy: Achieving Optimal Control in Diabetic Dogs Drs. Fleeman & Rand-U-Queensland 2005]</ref>.
-==Dianostics==
-The current blood test for pancreatitis in cats is the SPEC fPL blood test. If you or you veterinarian suspects pancreatitis, a SPEC fPL (sometime also called a PLI for feline PLI test) is highly recommended. This test is currently only performed by Idexx Laboratories and Texas A&M. The fTLI blood test is an unspecific test for feline pancreatitis and more representative of general inflammation of the cat's organs.
 ==Concurrent with Diabetes==
-There is evidence to suggest that chronic, subclinical (unable to be ascertained through present testing methods) pancreatitis is common in canines with diabetes<ref> [http://www.uq.edu.au/vetschool/centrecah/index.html?page=43505&pid=0  Dr. Rand, et. al.-Chronic Subclinical Pancreatitis is Common in Diabetic Dogs-University of Queensland 2004]</ref>.  A study conducted by Drs. Fleeman and Rand puts the estimate of canine diabetics with pancreatitis--either acute<ref>[http://www.petshealth.com/dr_library/images/acutep1.jpg Image Illustrating Acute Pancreatitis]</ref> or chronic<ref>[http://www.petshealth.com/dr_library/images/EPIchr1.jpg Image Illustrating Chronic Pancreatitis]</ref>--at about 40%<ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11570130 Veterinary Clinics of North America-Small Animal Practice-2001-Management of Canine Diabetes-Drs. Fleeman & Rand]</ref>. Dr. Fleeman also states that it is chronic pancreatitis and the damage it causes to the organ that is responsible for 1/3 of canine diabetes cases<ref>[http://www.uq.edu.au/vetschool/centrecah/index.html?page=43392&pid=41544 Beyond Insulin Therapy:Achieving Optimal Control in Diabetic Dogs Drs. Fleeman & Rand-U. Queensland, 2005]</ref>; Dr. Greco echoes this thought<ref>[http://bettermedicine.intervetusa.com/june2006/managing_diabetes.html Better Medicine E-Newsletter-June 2006]</ref>.
+There is evidence to suggest that chronic, subclinical (unable to be ascertained through present testing methods) pancreatitis is common in canines with diabetes<ref> [http://www.uq.edu.au/vetschool/centrecah/index.html?page=43505&pid=0  Dr. Rand, et. al.-Chronic Subclinical Pancreatitis is Common in Diabetic Dogs-University of Queensland 2004]</ref>.  A study conducted by Drs. Fleeman and Rand puts the estimate of canine diabetics with pancreatitis--either acute<ref>[http://www.petshealth.com/dr_library/images/acutep1.jpg Image Illustrating Acute Pancreatitis]</ref> or chronic<ref>[http://www.petshealth.com/dr_library/images/EPIchr1.jpg Image Illustrating Chronic Pancreatitis]</ref>--at about 40%<ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11570130 Veterinary Clinics of North America-Small Animal Practice-2001-Management of Canine Diabetes-Drs. Fleeman & Rand]</ref>. Dr. Fleeman also states that it is chronic pancreatitis and the damage it causes to the organ that is responsible for 1/3 of canine diabetes cases<ref>[http://www.uq.edu.au/vetschool/centrecah/index.html?page=43392&pid=41544 Beyond Insulin Therapy:Achieving Optimal Control in Diabetic Dogs Drs. Fleeman & Rand-U. Queensland, 2005]</ref>; Dr. Greco echoes this thought<ref>[http://web.archive.org/web/20070208103248/http://bettermedicine.intervetusa.com/june2006/managing_diabetes.html Better Medicine E-Newsletter-June 2006]</ref>.
 This 2000 lecture given at the District of Columbia Academy of Veterinary Medicine regarding managing acute pancreatitis in dogs and cats refers to an (uncited) study suggesting that cats with pancreatitis are quite sensitive to insulin<ref> [http://www.petalk.com/feline-diabetes.html Pettalk.com-Feline Diabetes]</ref>.  A 1989 study of persons with pancreatitis-caused diabetes also seems to point to the same effect in humans<ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2693011&dopt=Abstract PubMed-Diabetes Care 1989-Pancreatic Diabetes Mellitus]</ref>, noting that those in the study had low [[glucagon]] levels which did not respond normally.
@@ Line 35: / Line 32: @@
 * Injury:  An injury or trauma to the abdominal area can result in injury to the pancreas; this can mean possible pancreatitis.
+==Dianostics==
+The current blood test for pancreatitis in cats is the SPEC fPL blood test. If you or you veterinarian suspects pancreatitis, a SPEC fPL (sometime also called a PLI for feline PLI test) is highly recommended. This test is currently only performed by Idexx Laboratories and Texas A&M. The fTLI blood test is an unspecific test for feline pancreatitis and more representative of general inflammation of the cat's organs.
 ==Diagnosis==
-Pancreatitis is often hard to diagnose<ref>[http://www.felinediabetes.com/phorum5/read.php?8,224817,225112 Felinediabetes.com-Pancreatitis]</ref>.  Tests include the serum TLI (Trypsin-Like Immunoreactivity)<ref>[http://www.cvm.tamu.edu/gilab/TLI.shtml Texas A & M University-Gastrointestinal Laboratory-TLI Test Information]</ref>, and the feline or canine PLI (Pancreatic Lipase Immunoreactivity)<ref>[http://www.cvm.tamu.edu/gilab/cPLI.shtmlTexas A & M University-Gastrointestinal Laboratory-PLI Test Information]</ref>, available from the gastrointestinal laboratory at the College of Veterinary Medicine at Texas A&M University. Turnaround from that lab often takes several days.
+Pancreatitis is often hard to diagnose<ref>[http://www.felinediabetes.com/phorum5/read.php?8,224817,225112 Felinediabetes.com-Pancreatitis]</ref>.  Tests include the serum TLI (Trypsin-Like Immunoreactivity)<ref>[http://www.cvm.tamu.edu/gilab/TLI.shtml Texas A & M University-Gastrointestinal Laboratory-TLI Test Information]</ref>, and the feline or canine PLI (Pancreatic Lipase Immunoreactivity)<ref>[http://www.cvm.tamu.edu/gilab/assays/cPLI.shtml Texas A & M University-Gastrointestinal Laboratory-PLI Test Information]</ref>, available from the gastrointestinal laboratory at the College of Veterinary Medicine at Texas A&M University. Turnaround from that lab often takes several days.
 A canine-specific PLI test is also commercially available through IDEXX Laboratories as the Spec cPL™ Test<ref>[http://www.idexx.com/animalhealth/laboratory/speccpl/index.jsp IDEXX Laboratories-Canine Pancreas-Specific Lipase Spec cPL™ Test]</ref>.
@@ Line 44: / Line 44: @@
 Labwork for dogs has more clear-cut signs of abnormal values than the results can for cats.  Some cats have normal lab results and also have pancreatitis<ref> [http://www.mscc.ca/pancreatitis.html Hills Pet Products-Owner's Guide to Pet Care-Pancreatitis]</ref>.
+==Rare but possible==
+It doesn't happen frequently, but it is possible for a pancreatitis attack to "jolt" the endocrine portion of the organ back into being capable of producing insulin once again in dogs<ref>[http://www.vetinfo.com/ddiabt.html Vet Info--see "Diabetes with rebound hyperglycemia" Question]</ref>.
 ==Treatment==
@@ Line 62: / Line 65: @@
 ==Complications of Pancreatitis==
-Chronic pancreatitis can lead to [[maldigestion syndrome]] in which the pancreas fails to produce enough digestive enzymes<ref>[http://purinaone.com/catcare_cond_atoz_article.asp?Seed=745&ArticleNumber=65 Purina ONE Health Library-Diabetes Mellitus]</ref>. A severe attack is capable of damaging the exocrine pancreas, which produces the digestive enzymes and the endocrine pancreas, which produces insulin. Having a severe attack also puts one at risk for developing chronic pancreatitis<ref>[http://www.cnn.com/HEALTH/library/DS/00371.html CNN.com Health Library-Pancreatitis Overview]</ref>.
+Chronic pancreatitis can lead to [[maldigestion syndrome]] in which the pancreas fails to produce enough digestive enzymes<ref>[http://web.archive.org/web/20071104040917/http://www.purinaone.com/catcare_cond_atoz_article.asp?Seed=745&ArticleNumber=65 Purina ONE Health Library-Diabetes Mellitus]</ref>. A severe attack is capable of damaging the exocrine pancreas, which produces the digestive enzymes and the endocrine pancreas, which produces insulin. Having a severe attack also puts one at risk for developing chronic pancreatitis<ref>[http://web.archive.org/web/20080315113521/http://www.cnn.com/HEALTH/library/DS/00371.html CNN.com Health Library-Pancreatitis Overview]</ref>.
 This FDMB thread link below<ref>[http://www.felinediabetes.com/phorum5/read.php?8,226951 FDMB-Pancreatitis Discussion]</ref> and followups<ref> [http://www.felinediabetes.com/phorum5/read.php?8,228902 FDMB-Pancreatitis Discussion Followups]</ref> deal with alternatives and treatments.
 ==Further Reading==
@@ Line 74: / Line 75: @@
 *[http://www.jaaha.org/cgi/content/abstract/42/1/1?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=diabetes&searchid=1&FIRSTINDEX=20&sortspec=relevance&resourcetype=HWCIT Pancreatitis in Cats-Diagnosis & Management of a Challenging Disease-JAAHA-2006]
 *[http://www.vin.com/VINDBPub/SearchPB/Proceedings/PR05000/PR00114.htm WSAVA 2001-Feline GI Pearls-Pancreatitis]
-*[http://groups.msn.com/FDLibrary/offtopic.msnw?action=get_message&mview=0&ID_Message=104 Dr. Stanley Marks' update on Feline Pancreatitis]
 *[http://www.sniksnak.com/cathealth/pancreatitis.html Sniksnak on Pancreatitis (but W/D food not recommended!)]
 *[http://www.vetinfo4dogs.com/dpancrea.html Pancreatitis and dogs]
@@ Line 84: / Line 84: @@
 *[http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2004&PID=8669&Category=1261&O=Generic Pancreatitis in Cats--WSAVA 2004]
 *[http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2003&PID=6623&Category=1004&O=Generic Feline Pancreatitis--Underdiagnosed & Overlooked-WSAVA 2003]
-*[http://maxshouse.com/diseases_of_the_exocrine_pancrea.htm Explaining the Differences in Pancreatitis in Dogs & Cats]<br>More on both-how Chronic Pancreatitis May Affect Cats' Insulin Needs.
+*[http://maxshouse.com/diseases_of_the_exocrine_pancrea.htm Explaining the Differences in Pancreatitis in Dogs & Cats]<br />More on both-how Chronic Pancreatitis May Affect Cats' Insulin Needs.
 * [http://www.marvistavet.com/html/pancreatitis__feline_.html Primer information on pancreatitis]
 *[http://www.vin.com/VINDBPub/SearchPB/Proceedings/PR05000/PR00120.htm Feline Pancreatitis-WSAVA 2001]
 *[http://www.southpaws.com/news/Newsletter-Fall%202000/page4.html Feline Pancreatitis-Southpaws-Fall, 2000]
 *[http://www.petplace.com/cats/acute-pancreatitis-in-cats/page1.aspx Acute Pancreatitis in Cats-Petplace.com]
+*[http://ftp.amvq.qc.ca/Notes/A-Ogg-04-03.htm Acute Pancreatitis in the Cat-Anthony Abrams-Ogg]
@@ Line 98: / Line 100: @@
 *[http://www.peteducation.com/article.cfm?cls=2&cat=1580&articleid=335 Pet Education.com-Drs. Foster & Smith-Pancreatitis in Dogs]
 *[http://www.petplace.com/dogs/acute-pancreatitis-in-dogs/page1.aspx Acute Pancreatitis in Dogs]
+*[http://images2.wikia.nocookie.net/petdiabetes/images/6/63/08Abstracts_Posters.pdf Subclinical Pancreatitis is More Common in Overweight and Obese Dogs if Peak Postprandial Triglyceridemia is >445 mg/dl ACVIM 2008, Posters, Page 51, Abstract #336]
+*[http://images1.wikia.nocookie.net/petdiabetes/images/7/71/Abstracts2006_acvim.pdf Continuing Pancreatic Inflammation or Reduced Exocrine Function Are Common in Dogs After Acute Pancreatitis-Abstract #143, Page51, ACVIM Abstracts, 2006]
+*[http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2007&Category=2986&PID=18128&O=Generic Canine Pancreatitis From Clinical Suspicion to Diagnosis and Treatment-WSAVA 2007]
+*[http://ivermectinfordogs.org/dog-ear-infection Dog ear infection]
+*[http://ivermectinfordogs.org/pancreatitis-in-dogs Pancreatitis in dogs]
+*[http://ivermectinfordogs.org Ivermectin for dogs]
+*[http://ivermectinfordogs.org/how-long-are-dogs-pregnant-before-they-giving-birth How long are dogs pregnant ]
+*[http://ivermectinfordogs.org/why-do-dogs-eat-grass Why do dogs eat grass ]
+*[http://ivermectinfordogs.org/save-5-off-with-purina-dog-chow-coupons Purina dog chow coupons ]
@@ Line 105: / Line 115: @@
 * [http://www.antechdiagnostics.com/clients/antechNews/2004/may04_01.htm Discussion about the PLI tests from Antech]
 * [http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=12889722 Discussion about the PLI tests in the Canadian Journal of Veterinary Research]
 *[http://maxshouse.com/diseases_of_the_exocrine_pancrea.htm Explaining the Differences in Pancreatitis in Dogs & Cats]
 *[http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2002&PID=2583&Category=414 Pancreatitis in Dogs & Cats-WSAVA 2002]
 *[http://www.provet.co.uk/health/diseases/pancreatitisrisks.htm Risk Factors for Pancreatitis in Dogs & Cats-Provet UK]
 *[http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2005&PID=10904&Category=1545&O=Generic The Perils of Acute Pancreatitis in the Dog and Cat WSAVA 2005]
-*[http://groups.msn.com/ValleySugarcats/pancreatitis.msnw Lots of good pancreatitis links for cats and dogs]
+*[http://web.archive.org/web/20080114042156/http://groups.msn.com/ValleySugarcats/pancreatitis.msnw Lots of good pancreatitis links for cats and dogs]
+[[Category:Infections]]
+[[Category:Complications]]
+[[Category:Other conditions and procedures]]
+[[Category:Gastrointestinal Disorders]]
 ==References==