Medical and surgical management of pancreatic fluid accumulations in dogs: a retrospective study of 15 cases

Talbot, Charles; Cheung, Ring; Holmes, Emma; Cook, Simon

Abstract

Background – Limited data exist on the diagnosis and successful medical management of suspected pancreatic abscessation, and the appropriate terminology of this condition.
Hypothesis/Objectives – To describe the diagnosis and management of pancreatic fluid accumulations in dogs where pancreatic fluid cytology results were available, to describe those medically and surgically managed at the same institution, and reconsider the terminology describing acute pancreatitis with pancreatic fluid accumulation.
Animals – 15 dogs treated for suspected pancreatic abscessation at a tertiary referral hospital between January 2010 and March 2020.
Methods – Retrospective descriptive study.
Results – Ultrasonographic findings described pancreatic fluid accumulations as hypoechoic in 10/15 and anechoic in 2/15 cases, ranging between 1.6 and 7 cm in diameter (median, 3.5 cm). No complications were documented after ultrasound guided fine-needle aspiration. Cytologically, all samples revealed a predominantly neutrophilic inflammation. 11/15 samples yielded a negative culture (9/11 received antimicrobials prior to sampling) and in 4 cases culture was positive. 7/15 were initially managed surgically including all 4 infected cases. 4/7 surgically managed cases were discharged, including 2 infected cases. The remaining 3/7 surgically managed cases were euthanized due to quality of life concerns. 8/15 cases were managed medically; 7/8 were discharged, 1 died. 3/7 then re-presented, and underwent successful surgical intervention after resumption of clinical signs, and all were discharged. The remaining 4 medically managed cases did not require further therapeutic invention, with no clinical deterioration on reassessment.
Conclusions and clinical importance – Medical management is a viable treatment option for some cases of canine pancreatic fluid accumulations, or as a prequel to surgical management. Subclassifications of pancreatic fluid accumulations using diagnostic criteria may enable more tailored management approaches and accurate prognostication.

Citation

Talbot, C., Cheung, R., Holmes, E., & Cook, S. (2022). Medical and surgical management of pancreatic fluid accumulations in dogs: a retrospective study of 15 cases. Journal of Veterinary Internal Medicine, https://doi.org/10.1111/jvim.16411

• Journal Article Type: Article
• Acceptance Date: Mar 8, 2022
• Online Publication Date: Mar 23, 2022
• Publication Date: Mar 23, 2022
• Deposit Date: Dec 1, 2022
• Publicly Available Date: Dec 5, 2022
• Print ISSN: 0891-6640
• Publisher: Wiley Open Access
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1111/jvim.16411
• Publisher URL: https://doi.org/10.1111/jvim.16411