| Abstract | U ovom radu obrađene su bolesti egzokrine gušterače kod pasa i mačaka: akutni i kronični pankreatitis, egzokrina insuficijencija gušterače te tumori, ciste, pseudociste, nekroze i apscesi gušterače. Posebna pažnja je usmjerena na njihovo dijagnosticiranje i liječenje. Ovisno o kojoj se bolesti gušterače radi simptomi mogu varirati od blagih samoograničavajućih do teških životno ugrožavajućih simptoma. Također simptomi variraju od nejasnih nespecifičnih gastrointestinalnih simptoma do teških koji uključuju ozbiljno nekontrolirano povraćanje i/ili proljev, bolan abdomen te kombinacije sistemskih i/ili metaboličkih komplikacija. Postavljanje definitivne dijagnoze je težak i izazovan zadatak, jer simptomi bolesti, klinički nalaz te laboratorijske abnormalnosti nisu specifični. Metode koje se koriste u dijagnostici ovise o bolesti gušterače, a osim navedenog kombiniraju se ultrazvučna pretraga, specifične laboratorijske pretrage (imunoreaktivnost tripsina i tripsinogena - TLI, imnoreaktivnost pankreasne lipaze -PLI), citologija i patohistologija. Tako se npr. dijagnoza akutne upale gušterače bazira na kombinaciji 4 faktora: prisutnost tipičnih kliničkih simptoma, eliminaciji mogućih diferencijalnih dijagnoza, povišenog PLI te tipičnim ultrazvučnim promjenama, dok se dijagnoza tumora gušterače bazira na kombinaciji ultrazvučne, citološke i patohistološke pretrage. Izbor i način liječenja ovisi o osnovnoj bolesti gušterače, a uključuje tekućinsku terapiju, analgeziju, potpornu terapiju (antiemetici, antacidi), specijalnu prehranu, nadoknadu probavnih enzima te moguću kiruršku intervenciju i kemoterapiju. Prognoza kod egzokrine insuficijencije gušterače te blagog i umjerenog oblika akutne upale gušterače je povoljna, kod izrazite upale gušterače, posebno ako je došlo do nastanka apscesa, nekroze ili sistemskih komplikacija, je nepovoljna (visoki mortalitet), dok je kod kronične upale gušterače nepredvidljiva jer ovisi o kontroli boli koja, ako nije adekvatan odgovor na terapiju, najčešće bude razlog da se vlasnici odluče na eutanaziju. U slučaju neoplazija mortalitet je iznimno visok. |
| Abstract (english) | This thesis addresses diseases of the exocrine pancreas in dogs and cats: acute and chronic pancreatitis, exocrine pancreas insufficiency, tumors, cysts, pseudocysts, necrosis and pancreas abscess. Particular attention has been given to their diagnosis and treatment. Depending on the type of pancreas disease, symptoms can range from being mild and self-limited to difficult, life threatening. Furthermore, they may be vague, nonspecific gastrointestinal symptoms but also severe, including uncontrolled vomiting and/or diarrhea, abdominal pain and a combination of systemic and/or metabolic complications.
Making a definitive diagnosis is a difficult and challenging task because the symptoms of the disease, clinical findings and laboratory abnormalities are not specific. The methods used in diagnostics depend on the type of pancreas disease. In addition to those previously mentioned, we should combine methods such as ultrasound imaging, specific laboratory tests (trypsin-like immunoreactivity-TLI, pancreatic lipase immunoreactivity-PLI), cytology and histopathology. Hence, the diagnosis, for example, of an acute pancreas inflammation is based on a combination of 4 factors: presence of typical clinical symptoms, elimination of possible differential diagnosis, elevated PLI and typical ultrasound changes, while the diagnosis of a pancreas tumor is based on a combination of ultrasound, cytology and histopathology tests.
Choice and type of treatment depends on the underlying pancreatic disease and includes fluid therapy, analgesia, supportive therapy (antiemetics, antacids), special nutrition, digestive enzyme supplementation, and possible surgical intervention and chemotherapy.
The prognosis is favorable for the exocrine pancreatic insufficiency and mild/moderate acute pancreatic inflammation, while it is unfavorable (high mortality rate) for severe pancreatic inflammation, particularly if abscess, necrosis or other systemic complications occur. In chronic pancreatic inflammation, the prognosis is unpredictable because it depends on managing the pain, which, if it is not adequately controlled, is the most common reason for the owners to decide to euthanize their animal. In case of neoplasia, mortality is extremely high. |
