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  • Dr. Carsen, DVM
    17 Organs of the Abdomen Diseases of the Pancreas Diagnosis by Kathleen M Carson D V M Last month I wrote about pancreatitis inflammation of the pancreas which is the most common disease of the exocrine digestive enzyme producing part of the pancreas I told about how in acute pancreatitis the digestive enzymes made by the pancreas are activated while they re still in the pancreas and start digesting pancreatic tissue In some cases the activated enzymes escape into the blood stream and cause all kinds of damage throughout the body How would you know if your geriatric dog or cat had acute coming on suddenly pancreatitis For dogs the most common signs are vomiting not eating hunched stance rapid shallow breathing depression occasional diarrhea occasional jaundice or icterus yellowing of the eyeballs gums and skin and more rarely shock collapse As is typical with cats signs of acute pancreatitis are often subtle he she may stop eating and be lethargic Sometimes there s vomiting and less commonly diarrhea but these are much less frequent than in the dog In more severe cases there is dehydration and shock in which case your cat would have a dry mouth pale gums and would feel cold to the touch If you ve read my earlier columns on other diseases you ll note that these signs especially those of cats are common to a lot of different conditions You should bring your animal to your veterinarian if he she is showing these signs especially if they are severe or have gone on for more than a day or two Right away if they re very pronounced How about the signs for chronic pancreatitis in which the inflammation in the pancreas has been going on at a low boil for a long time Over time more and more pancreatic tissue is replaced by scar tissue When the scarring is extensive enough not enough digestive enzymes are formed The result is chronic diarrhea On physical exam by your veterinarian there are things he she may find in your animal with acute pancreatitis depending on the severity of the condition In dogs more than half will show signs of pain when the forward cranial part of their abdomens are felt palpated these dogs will probably be panting from the pain Frequently they will be dehydrated and show signs of weakness Some will have the jaundice mentioned above In severe cases they ll be collapsed with subnormal temperatures pale gums and other signs of shock Severe pancreatitis can also cause cardiac arrhythmias irregularities of the heartbeat In cats the signs will be less specific in most cases The most common physical findings of a cat with pancreatitis are weakness dehydration and subnormal temperature Cranial abdominal pain is only found in 25 of cats with pancreatitis As with dogs cats with severe pancreatitis will show signs of collapse shock and or cardiac arrhythmias Your veterinarian will want to do some diagnostic tests First on the list will be

    Original URL path: http://www.themetaarts.com/2006march/drcarson.html (2016-02-13)
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  • Dr. Carsen, DVM
    the most forward part of your animal s abdominal cavity on the right side The pancreas has two very different functions first it produces digestive enzymes trypsin and other proteases which break down proteins amylase which breaks down carbohydrates and lipase which breaks down fats This is called its exocrine function Second it makes the hormone insulin which allows sugar in the blood to enter the cells of the body where it is used for fuel This is called its endocrine function The exocrine part composed of acinar cells makes up approximately 98 99 of the pancreas The endocrine part composed of tissue called the Islets of Langerhans makes up only 1 2 The cells comprising the Islets of Langerhans are scattered among the acinar cells The most common disease of the exocrine part of the pancreas is a condition called pancreatitis inflammation of the pancreas The most common disease of the endocrine part is called diabetes mellitus Diabetes mellitus is such a complex disease that it won t be discussed here I ll write about it in future columns The pancreas also plays a role in vitamin B12 and zinc absorption as well as helping prevent bacterial overgrowth in the small intestine The acinar cells in the pancreas secrete a fluid rich in bicarbonate and digestive enzymes When your dog or cat sees or even smells food the pancreas starts to releases this fluid into the pancreatic duct which empties into the duodenum In dogs the pancreatic ducts they have two enter the duodenum near where the common bile duct from the liver does In cats the one pancreatic duct joins with the common bile duct before it enters the duodenum When the food and acid mixture from your animal s stomach enters the duodenum even more of this enzyme bicarbonate fluid is released from the pancreas where the enzymes start the process of breaking down the food so it can be absorbed and used by the body The bicarbonate in the fluid facilitates optimal activity of digestive enzymes within the duodenum Within the pancreas the enzymes are held in their inactive forms Once they leave the pancreas and enter the duodenum substances in the duodenum activate the enzymes so they can break down food Small amounts of the pancreatic enzymes are also released into the bloodstream in normal animals these enzymes are bound and neutralized by circulating inhibitory factors in the blood Unfortunately under certain circumstances the enzymes are activated while they re still within the pancreas Once activated they start to digest the pancreatic tissue causing the pancreatitis mentioned above From there the activated enzymes start damaging surrounding organs They also enter the bloodstream In large amounts they overwhelm the blood s inhibitory factors causing shock and wreaking havoc throughout the body If the damage is severe enough death occurs Pancreatitis has an acute form and a chronic form In acute pancreatitis the condition comes about suddenly Generally speaking acute pancreatitis can be mild moderate or severe

    Original URL path: http://www.themetaarts.com/2006february/drcarson.html (2016-02-13)
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  • Dr. Carsen, DVM
    Permanently Stop the Endless Cycle of Dieting Rena Greenberg Practitioner of Neuro Linguistic Programming Hypnotherapist The Directory The Book Nook Archives Past Issues Healing Alternative Health Dr Carson s Holistic Animal Care Signs of the Aging Dog and Cat Part 15 Organs of the Abdomen Diseases of the Liver Treatment by Kathleen M Carson D V M How would your geriatric dog or cat be treated if he she is diagnosed with liver disease The treatment of liver disease consists of specific treatments and supportive symptomatic treatments Examples of the specific treatments are 1 antibiotics if infection is found 2 anti inflammatory immunosuppressive drugs if inflammation autoimmune disease is found 3 chemotherapy if cancer is found In addition to the specific treatments listed above there are many treatments fitting under the category of supportive symptomatic treatments for the patient with liver disease How many are used in any given situation depends on how sick the patient is and what symptoms he she has If your cat or dog with liver disease is eating and keeping food down as well as more or less maintaining his weight then home care will probably be enough On the other hand if she is not eating vomiting frequently losing weight and or is dehydrated and weak then a hospital stay is in order at least until stability is achieved If your dog or cat with liver disease has to be hospitalized he will probably be put on intravenous fluids I V which serve the purpose of rehydrating him Other things can also be added to the I V fluids such as dextrose for energy and B vitamins If your animal is vomiting then injections of an anti emetic anti vomiting drug will be given An oral anti emetic drug probably would be vomited right back up If your cat has hepatic lipidosis the liver condition I mentioned last month where the liver becomes infiltrated by fat then a feeding tube will be installed while your cat is in the hospital This is an essential part of the treatment for this condition Without it your cat will die for cats with hepatic lipidosis completely quit eating for weeks or months With the feeding tube cats can be saved who would have died 20 years ago The tube can be inserted through the nose and thence down to the esophagus or stomach NE or NG tube However the NE NG tubes are uncomfortable for longterm use and if your cat is vomiting the tube probably won t stay in place Most commonly the tube is placed in the esophagus and thence into the stomach esophagostomy tube The esophagus lies close under the skin on the left hand side of your cat s neck It is usually placed under shortterm general anesthesia In some cases a tube is inserted through the abdominal wall into the stomach gastrostomy tube or into the small intestine jejunostomy tube Obviously a more complex procedure is necessary to insert these latter tubes

    Original URL path: http://www.themetaarts.com/2006january/drcarson.html (2016-02-13)
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  • Dr. Carsen, DVM
    some animals these conditions first appear in their geriatric years If a geriatric animal has had liver disease before he reaches old age when he does so the disease is more advanced and more likely to cause serious problems If there is cancer in the liver it can either be primary where the cancer originates in the liver or secondary where the cancer starts elsewhere and then spreads metastasizes to the liver The latter is especially likely since as I wrote last month all the body s blood is filtered through the liver What signs would you see if your geriatric dog or cat has liver disease You may see none at all More than one geriatric animal s liver disease has only been diagnosed on routine geriatric labwork and or pre dental labwork However most animals at some point do show signs Most commonly there are the generalized signs of lethargy decreased appetite and weight loss Other common signs are vomiting and or diarrhea Less commonly an animal with liver disease may be excessively thirsty and urinate large quantities However as you ve read in my previous columns these signs are seen in the diseases of many other organs they aren t exclusive to liver disease There are signs of liver disease which are less common and which are more likely to be caused by liver disease though they can be seen in a narrow range of other diseases as well These are 1 jaundice called icterus in medical terms it is a yellowing of certain tissues the skin the gums and the eyes a jaundiced animal also usually has deep golden urine 2 petechiae or ecchymoses which refer to bruises seen on the skin or gums and 3 fluid in the abdomen called ascites if your animal has ascites her belly will become larger than normal Icterus comes about in liver disease when there is backup of the bile in the bile ducts of the liver cholestasis Instead of flowing out of the liver into the gall bladder or small intestine its movement is impeded usually by a swelling of the bile ducts from inflammation or infection It eventually gets into the bloodstream and from there to the skin gums eyes and the kidneys The petechiae ecchymoses or bruising bleeding under the skin comes about when the sick liver doesn t make enough clotting factors The ascites results from the sick liver not producing enough of the protein albumin Last month I wrote about how albumin helps regulate the movement of water from the bloodstream into the body s tissues When there s a deficiency of albumin fluids leak out into the abdominal cavity How is liver disease diagnosed A thorough history including whether your animal is taking drugs which could potentially damage the liver a non steroidal antiinflammatory drug like Rimadyl is one example or whether your animal has been exposed to hepatotoxic harmful to the liver chemicals would be the first step The next step is

    Original URL path: http://www.themetaarts.com/2005december/drcarson.html (2016-02-13)
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  • Dr. Carsen, DVM
    which separates the chest from the abdomen on the right hand side It lies on top of the stomach right kidney and intestines It is rich in blood which comes from two sources unlike other organs which have one 1 oxygenated blood which flows in from the aorta the large artery coming from the heart through the hepatic artery and 2 nutrient rich blood which flows in from the intestines through the hepatic portal vein Note hepatic referring to the liver It has multiple functions All the nutrients which enter through the hepatic portal vein from the intestines are processed by the liver In this processing the liver breaks down fats proteins and carbohydrates into forms that are easier for the rest of the body to use The liver is the major site for converting the carbohydrates and proteins which the body doesn t need immediately into fat which is then stored in adipose fatty tissues in the body The liver produces bile which flows from the liver into the duodenum upper small intestine though the common bile duct There it acts as an emulsifier allowing fats and fat soluble nutrients in the ingested food to dissolve and be absorbed They enter into the blood vessels which surround the intestines ultimately ending up in the hepatic portal vein and thence into the liver See above under blood supply Until it is needed the bile is stored in the gall bladder a sac like organ which nestles against the bottom side of the liver The bile also helps the intestines carry away waste such as detoxified substances see immediately below It also is what causes the stools feces or bowel movements to be brownish in color It breaks down toxic substances rendering them harmless to the body The damaging substances it detoxifies come both from inside the body such as byproducts of metabolism like ammonia and from outside the body such as pesticides herbicides food preservatives food colorings and drugs After being broken down these substances are blended with the bile which then exits the body through the intestines The liver makes certain proteins which are an important part of blood plasma the solid part of the blood Albumin the major plasma protein is synthesized almost exclusively by the liver Among other things albumin helps regulate the movement of water from the bloodstream into the body s tissues Another blood protein made by the liver is globin one of the two components that form hemoglobin the oxygen carrying part of red blood cells RBCs Lastly it makes proteins called globulins an important component of which are antibodies a crucial part of the immune system It helps the body to resist infections by not only producing the immunoglobulins referred to above but by removing bacteria from the blood stream It converts excess glucose a type of sugar into a substance called glycogen This process is called glycogenesis As glycogen it can be stored in the liver until the body needs it Then

    Original URL path: http://www.themetaarts.com/2005november/drcarson.html (2016-02-13)
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  • Dr. Carsen, DVM
    any of these signs in your older cat a trip to your veterinarian is in order the sooner the better By the time a cat s human family members are aware there s a problem often their kitty is badly constipated full of a large volume of hard dry stool He usually needs an enema sometimes several enemas to get rid of all the backed up stool Sometimes she has crossed the line from constipation into what s called obstipation An obstipated cat s intestines are grossly overloaded with huge very hard stools To help him her a procedure called de obstipation is necessary in which he she actually has to be anesthetized to be thoroughly cleaned out What causes constipation in the older cat There are a variety of contributing factors Some cats have merely one factor others have many The most common contributing factors are dehydration poor muscle tone in the large intestine called megacolon and lack of bulk to the stool the latter caused by a low fiber diet Because constipation can have more than one cause the treatment of constipation has to be tailored to each individual constipated cat I can t emphasize this enough There s not just one treatment or medication which works for all You and your veterinarian need to work together closely to discover the causes of constipation in your individual cat and to work out a treatment plan which is effective for him or her If you re lucky you ll hit on the right combination of things right away If not it may take a while to find what works for your cat Try not to get discouraged if you persist usually a solution can be found Another fact to remember is that in most cats if he she has had one episode of constipation there will be more in the future Constipation rarely is a condition which has to dealt with once and never again In fact unfortunately it tends to worsen with time especially if treated inconsistently or inadequately You can help your veterinarian discern the causes of your cat s constipation by observing some things about your cat If dehydration is a factor your cat s stools will be dry hard crumbly His coat may also look dull or dry and his skin may be flaky When you pick up a fold of her skin it may take several seconds for it to flatten out again If this is the case for your cat add extra water to her food and stay away from dry foods kibble as much as possible If these changes are not enough ask your veterinarian about putting your cat on subcutaneous under the skin injections of fluids at home They can make a significant difference not only in helping constipation but in making your cat feel better overall There also are stool softeners your veterinarian can prescribe for the dry stools If your cat s stools are very small you will need

    Original URL path: http://www.themetaarts.com/2005october/drcarson.html (2016-02-13)
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  • Dr. Carsen, DVM
    signals the dog or cat that he she needs to defecate or evacuate the feces from his her body through the sphincter like opening called the anus If there are problems with your dog or cat s large intestine your animal will have diarrhea and or constipation Less commonly there will be bloating nausea vomiting and or abdominal pain the latter evidenced by an arched back reluctance to move groaning and or pacing Diarrhea comes about when a diseased irritated colon moves the feces through much faster than normal not leaving enough time for water to be absorbed This excess water in the stool causes it to be anything from formed but soft to pudding like or watery with no form Last month I described diarrhea caused by small intestinal problems to be loose large in volume and passed slightly more frequent than normal stools If chronic it can lead to weight loss Diarrhea due to large intestinal problems on the other hand is loose small in volume and of a frequency much greater than normal It also is not unusual to see straining continuing to try to defecate even when nothing more comes mucus slimy material and fresh red blood in large intestinal LI diarrhea Weight loss is much less common with LI diarrhea Of course some geriatric animals have both large and small intestinal diarrhea which makes diagnosis and treatment more complex than if it were one or the other Constipation is the opposite of diarrhea Instead of the feces being rushed through and out it sits in the large intestine for a longer time than normal Of course the longer the feces sits in the colon the more water is taken from it making it drier and harder and thus even more difficult to pass Problems originating in the large intestine alone can cause constipation An example would be megacolon in which the muscles in the wall of the colon become flabby and ineffective not doing their job of moving the feces along and out On the other hand problems from outside of the large intestine can contribute to constipation or even be the main cause These would be things like dehydration or a low fiber diet For some reason older cats seem more prone to constipation than dogs Some of these cats with constipation will go to their boxes and strain and strain in their efforts to pass stool Other constipated cats will show no outward signs just not visit the box for two or more days This can be tricky to detect in a multiple cat household Constipation is such a complex subject that I will devote an entire column to it in the future Chronic LI diarrhea is another one of those geriatric problems which often starts earlier in life and worsens with time The causes of chronic LI diarrhea in geriatric patients are most commonly one or more of the following parasites infection from bacteria or fungi dietary intolerances allergic and non allergic

    Original URL path: http://www.themetaarts.com/2005august/drcarson.html (2016-02-13)
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  • Dr. Carsen, DVM
    by vomiting the main symptom associated with stomach upsets In vomiting the food reverses its direction hurling back up out of the stomach through the esophagus then through and out the mouth Problems with your animal s small intestine show up as diarrhea ie his her stool will be less formed because there will be more liquid in it Diarrhea occurs when the bowel moves the food along faster than it normally goes not allowing for the full absorption of water and nutrients from the digesting food Sometimes even more liquid is poured into the irritated diseased intestines from the body leading to a very watery stool Diarrhea from small intestinal disease results in stools that are large in volume these large volume loose stools are passed more frequently than normal stools are but usually not more than 2 3 times per day Problems with the upper small intestine sometimes causes vomiting not diarrhea In this case bile is vomited either alone causing bright yellow vomitus or mixed with food Conditions causing vomiting and or diarrhea in your geriatric dog or cat which primarily involve the stomach and or upper small intestines include food allergies sensitivities autoimmune diseases such as Inflammatory Bowel Disease IBD hairballs and unfortunately cancer As with other conditions discussed in this column not all the illnesses which cause these symptoms in the older dog or cat are exclusively illnesses of the geriatric patient Some of them can show up first in earlier years and worsen with time An example of this is food allergies or sensitivities Your animal can start developing allergies or sensitivities to various ingredients in his her diet early in life By the time your animal is in his her geriatric years the allergic reaction to a given ingredient has intensified and he she has probably developed multiple dietary allergies sensitivities If your animal has a severe enough problem with food allergies it may turn into a disease called lymphoplasmacytic gastritis or gastroenteritis gastritis inflammation of the stomach gastroenteritis inflammation of the stomach and intestines It is commonly called Inflammatory Bowel Disease or IBD It is one of a family of diseases called autoimmune disease In autoimmune disease the body starts attacking parts of itself as if they were foreign In the case of IBD the parts attacked are the stomach and or intestines Food allergies are a major trigger of IBD but there are genetic and other factors involved as well As stated above IBD usually doesn t wait to show up until the geriatric years but certainly by that time the symptoms have progressed from occasional vomiting and or diarrhea to more frequent severe vomiting and or diarrhea This is often accompanied by reduced appetite and weight loss Interestingly the tendency in some cats to vomit hairballs is associated with IBD It isn t known if irritation from the hairballs is one of the factors which triggers IBD or whether animals with IBD are more likely to form hairballs Your older

    Original URL path: http://www.themetaarts.com/2005july/drcarson.html (2016-02-13)
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