What is Partial Pancreatectomy?
The pancreas is part of your dog’s endocrine system. It secretes digestive enzymes, insulin that regulates metabolism of carbohydrates, and other hormones. If the pancreas experiences disease or disorder that cannot be resolved with medication, it can be completely removed, which will result in your dog immediately developing type 1 diabetes and experiencing deficiencies in hormone and enzyme production. Alternatively, the diseased tissue can be removed in a partial pancreatomy. In a partial pancreatomy, some of the pancreas is left intact, usually, at least 30%, in order for your dog to be able to produce adequate insulin and enzymes to maintain functioning. Partial pancreatomy may still result in insufficient functioning, requiring an adjusted diet and treatment for type 2 diabetes, but this is more manageable than with a full pancreatectomy. Because the pancreas has some regenerative abilities, pancreatic tissue may grow back and resume production of required substances, eliminating the need for intervention. A veterinary surgeon performs this procedure when required in the treatment of pancreatitis or pancreatic cancer under general anesthetic.
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Partial Pancreatectomy Procedure in Dogs
Medication and special diet may be recommended prior to surgery. Partial pancreatectomy is performed under general anesthetic and will require fasting the night prior to surgery. Once under general anesthesia, your dog's abdomen will be shaved and prepared antiseptically for surgery. An incision will be made in your dog's abdomen and tissues manipulated to reveal the pancreas. During surgery the pancreas will be handled carefully to avoid further disruption and release of enzymes and insulin. Special attention needs to be paid to vascularization to avoid cutting off blood supply to remaining tissues and ensure tissues to be removed have vascularization ligated to avoid hemorrhaging.
Partial pancreatectomy can be performed by suture fracture or blunt dissection and ligation. A suture fracture is performed by passing non absorbing suture material around the area of the pancreas to be removed and tightening it off to close off vascularization and ducts. The tissue on the outside is then removed and the incision closed.
Dissection and ligation is performed with scalpel to remove diseased tissue after vascularization has been addressed with double ligation .
If tumors are present, these will be removed along with adjacent tissue and sent for analysis.
Glucose levels will be monitored during and after surgery.
Efficacy of Partial Pancreatectomy in Dogs
Partial pancreatectomy has a more favorable prognosis and is more effective at resolving diseases of the pancreas then complete pancreatectomy, as remaining pancreatic tissue is able to continue to provide endocrine functioning to your dog. Pancreatic insufficiency and diabetes may still occur, requiring medication and diet, however this is more manageable than with complete removal of the pancreas.
Partial pancreatectomy is the most effective way for treatment of insulinoma, however the tumor usually grows back and hypoglycemia results. A second surgery can be attempted or medication to control hypoglycemic condition provided but success is limited.
Partial Pancreatectomy Recovery in Dogs
After partial pancreatectomy, your dog will require that activity be limited for a few weeks post surgery and that they are not allowed to lick or chew at the abdominal incision. Your pet will need to be closely monitored for signs of complications such as infection or bleeding and these complications will need to be addressed immediately by your veterinarian. In addition, your veterinarian will need to monitor enzymes and glucose concentration in your dog post surgery to determine remaining pancreatic function and prescribe medications to compensate as necessary. A modified diet will be prescribed by your veterinarian to enhance pancreatic functioning. Since the canine pancreas has regenerative capability, functioning may be regained if tissue grows back.
Cost of Partial Pancreatectomy in Dogs
The cost of treatment of pancreatic disorders and associated surgical intervention is high due to the severity of the medical condition precipitating partial pancreatectomy and the complexity of the procedure as well as post-operative monitoring and intervention. Partial pancreatectomy for your dog can cost between $3,000 and $6,000 depending on your location and the degree of medical intervention required.
Dog Partial Pancreatectomy Considerations
Aside from the usual surgical risks of anesthetic, hemorrhaging and infection, partial pancreatectomy carries with it additional risks due to the severe illness pets requiring this procedure are experiencing and the consequences of reduced pancreatic tissue post surgery. Pancreatic insufficiency, hypoglycemia and diabetes are all possibilities post-surgery depending on the ability of remaining pancreatic tissue to function postoperatively. Discussion with your veterinarian to weigh considerations and risks is recommended.
Partial Pancreatectomy Prevention in Dogs
Presenting your dog from becoming obese by providing an appropriate diet and exercise will decrease their risk for pancreatic disease. Ensuring your dog is not exposed to medications, toxins or high fat diets that would result in pancreatic damage will help prevent the need for surgical intervention on the pancreas. When symptoms of illness occurs in your dog prompt medical attention from a veterinarian to address symptoms and illness at an early stage will reduce the need for invasive procedures later on as disease progresses.
Partial Pancreatectomy Questions and Advice from Veterinary Professionals
we live in nagasaki city, japan. our 10 yr-old golden, cecile, is up for a complete removal of her inflamed pancreas.
CAT scan shows swelling of 90.5mm/88.5mm. there are multiple "growths" in her liver, one 11.1mm "growth" in her left kidney, also, a foreign "mass" near her gall bladder in the region of her pylorus. Lungs completely clear of any cancerous or foreign growths.
Gastroscope showed in irregularities inside her stomach or pylorus, however something, likely the foreign mass near the pylorus, seemed to be pushing the stomach inwards, likely causing the vomiting when stomach starts to function especially when full.
blood tests results red blood cells=713, white blood cell=9750, Ht=47.0%, TP=7.8, hemoglobin 15.7, liver and kidney functions normal range, only irregularity is a 3.4 CRP. Blood tested for coagulation normal, cleared for surgery.
Our family vet, and the vet who performed the newest blood test and CAT scan both have recommended it for concerns of the pancreas rupturing and causing sudden death.
From May 11/12 till date:
Cecile vomited her food on the morning of May 11/12. Kept her tummy empty (no food/water) for half a day, and gave her soft meal at night. No diarrhea, good appetite, playful as usual. Vomited her softened food on morning of May 14. Visit to vet in afternoon, no fever, no tenderness in the abdomen, stomach, received meds to help digestion, suggested to stay on soft diet, eat smaller portions. Meds seemed to help but after a couple days, vomiting returns. only symptom is vomiting once every 15~20 hours, occasional big burp. second visit May 20, again, no fever, ultrasound (standing position over her unshaved abdomen) reveals a possible 6cm inflammation of pancreas. May 24 thorough ultrasound while laid down, shows likely 7cm inflammation of pancreas, another fuzzy formation possibly cancerous growth on stomach. Family vet recommends CAT scan for thorough check up and likely complete removal of pancreas in fear of sudden rupture.
Thus the above CAT scan and blood tests by vet who will be operating on Cecile. The intention is to remove the swollen pancreas and hopefully remove the foreign mass near the pylorus which seems to be pressuring her stomach.
The vet will have biopsies done on both the pancreas and foreign mass to determine benign/malignancy.
Cecile is weak because she hasn't eaten properly for the past weeks, but has appetite. Water seems to trigger vomiting, or if given a little too much chicken broth/soft rice porridge. I've been feeding her roughly a cup, divided into several times a day. She barks and happily greats family, even plays with our other dog, Legolas. Her stomach has been making squeaky sounds (rumbling) the past couple of days.
Again, only symptom is vomiting, bowel movement and urination are normal (though not much food to digest....)
Would any vet have their thoughts to share? any opinion would be welcome. It seems as though removing her pancreas is inevitable, and hopefully the mass that's pressuring her stomach from the outside.
Cecile became ours when she was 1 year old, weighing only 12 kg. She was left at a park in the rain with a plastic bag containing a barely legible note to please take care of her, her soggy pedigree from which the rescuers retrieved only the birthdate. She has been our four-legged furry daughter ever since, and sister to her four-legged mixed breed brother, Legolas. Legolas doesnt know what's happening to his sister, but comes to let us know when Cecile is going to throw up, a few minutes before, and even before Cecile herself realizes.
Please, any advice, opinions based on the limited information would be appreciated. I want to know as much as possible.
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