Title DIFERENCIJALNA DIJAGNOSTIKA BOLESTI GUŠTERAČE PASA I MAČAKA Title (english) Differential diagnostics of pancreatic diseases in dogs and cats Author Lana Zovko Mentor Mirna Brkljačić (mentor)Mentor Ivana Kiš (mentor)Committee member Dalibor Potočnjak (predsjednik povjerenstva)Committee member Ivana Kiš (član povjerenstva)Committee member Mirna Brkljačić (član povjerenstva)Committee member Vesna Matijatko (član povjerenstva)Granter University of Zagreb Defense date and country 2022, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Gušterača je žlijezda povezana s probavnim sustavom koja ima endokrinu i egzokrinu
ulogu. Poremećaji u funkciji gušterače relativno su česti u pasa i mačaka. Klinička slika i
anamnestički podatci često su nespecifični te variraju od suptilnih
do izrazitih, a dijagnoza se postavlja uporabom više različitih dijagnostičkih metoda.
Pankreatitis je upala gušterače koja po svome tijeku može biti akutna i kronična. U pasa s
akutnim pankreatitisom najčešće se uočavaju nagla pojava povraćanja uz abdominalnu bol,
letargiju i dehidraciju. Simptomi kroničnog pankreatitisa uglavnom su blaži od akutnoga.
Klinički simptomi u mačaka s pankreatitisom su blaži i još manje specifični nego u pasa
(inapetenca, letargija i dehidracija te rjeđe ikterus). Testovi imunoreaktivnosti gušteračne
lipaze (kvantitativni testovi Spec cPL i Spec fPL te semi-kvantitativni testovi SNAP cPL i
SNAP fPL) imaju najveću osjetljivost i specifičnost u dijagnostici pankreatitisa.
Histopatološka pretraga se smatra zlatnim standardom za dijagnostiku pankreatitisa te za
razlikovanje akutnog i kroničnog pankreatitisa. Liječenje pankreatitisa pasa i mačaka je
simptomatsko i potporno te ovisi o težini kliničke slike. Sastoji se od primjene tekućinske
terapije, analgetika, antiemetika i antacida, promjene prehrane te po potrebi antibiotika.
Prognoza je varijabilna, pri čemu je akutni pankreatitis povezan s većim mortalitetom, a
kronični pankreatitis s dugoročnim komplikacijama koje smanjuju kvalitetu života. Egzokrina
insuficijencija gušterače pasa i mačaka je sindrom uzrokovan nedovoljnim izlučivanjem
probavnih enzima gušterače u tanko crijevo što rezultira maldigestijom i malapsorpcijom
hranjivih tvari, a očituje se proljevom, polifagijom i gubitkom tjelesne mase. Serumski test
imunoreaktivnosti slične tripsinu (fTLI u mačaka, tj. cTLI u pasa) ima najveću osjetljivost i
specifičnost za dijagnostiku egzokrine insuficijencije gušterače. Oboljeli psi i mačke
zahtijevaju doživotnu peroralnu terapiju enzimima gušterače te je potrebna suplementacija
vitamina B12 i promjena prehrane. Prognoza je uz redovito davanje enzima gušterače
povoljna. Šećerna bolest (diabetes mellitus) je endokrinološka bolest pasa i mačaka gdje zbog
potpunog ili relativnog nedostatka inzulina ili smanjene aktivnosti inzulina dolazi do razvoja
hiperglikemije te posljedične poliurije, polidipsije i polifagije. Dijagnosticira se dokazom
perzistentne hiperglikemije uz glukozuriju. Liječenje se sastoji od davanja inzulina, promjene prehrane i aktivnosti oboljelih životinja, a prognoza je uz pridržavanje terapije povoljna.
Maligni tumori gušterače se dijele na tumore egzokrinog (adenokarcinom gušterače) i
endokrinog (inzulinom, gastrinom, glukagonom) dijela gušterače. Izrazito su rijetki u pasa i
mačaka te agresivnog ponašanja zbog čega do kliničkih simptoma dolazi kada je već došlo do
metastaziranja. Liječenje se ponajprije sastoji od kirurške ekscizije tumora, a prognoza je
oprezna do nepovoljna.
Abstract (english) 60
The pancreas is an endocrine and exocrine gland associated with the gastrointestinal
tract. Functional disorders of the pancreas are fairly common in dogs and cats. The clinical
signs and history are often unspecific and can vary from mild to severe. The diagnosis is made
using several diagnostic methods. Pancreatitis is an inflammation of the pancreas that can be
acute or chronic. Dogs with acute pancreatitis have an acute onset of vomiting followed by
abdominal pain, lethargy and dehydration. Clinical signs of chronic pancreatitis are less
severe than those of acute. Cats with pancreatitis have milder and even more unspecific
clinical signs than dogs (inappetence, lethargy, dehydration and rarely icterus). Pancreatic
lipase immunoreactivity assays (quantitative tests Spec cPL and Spec fPL, semiquantitative
test SNAP cPL and SNAP fPL) are most sensitive and specific for the diagnosis of
pancreatitis. The histopathological examination is considered as the gold standard of the
diagnostics of pancreatitis as well as for differentiating between acute and chronic
pancreatitis. The treatment of pancreatitis in dogs and cats consists of symptomatic and
supportive care. Fluid therapy, analgetics, antiemetics and antacides, change of diet and if
needed, antibiotics, are used. The prognosis is variable. Acute pancreatitis is linked to a
higher mortility rate, while chronic pancreatitis has long-term complications that make the
quality of life worse. Exocrine pancreatic insufficiency of dogs and cats is a syndrome caused
by inefficient secretion of pancreatic digestive enzymes to the small intestine, which leads to
maldigestion and malabsorption of nutritients. The accompanying clinical signs are diarrhea,
polyphagia and loss of weight. The serum trypsin-like immunoreactivity test (fTLI in cats and
cTLI in dogs) is the most specific and sensitive test for the diagnosis of exocrine pancreatic
insufficiency. The treatment of exocrine pancreatic insufficiency in dogs and cats consists of
peroral intake of pancreatic enzymes, cobalamine supplementation and change of diet. The
prognosis is favourable when the pancreatic enzymes are given daily. Diabetes mellitus is an
endocrine disorder of dogs and cats. Due to the absolute or relative insulin deficiency or
decreased insulin activity hyperglycemia occurs and leads to the clinical signs of polyuria,
polydipsia and polyphagia. The diagnosis is made when there is persistent hyperglycemia
with glucosuria. The treatment consists of insulin supplementation, change of diet and activity levels of dogs and cats. The prognosis is favourable when the treatment protocol is followed.
Malignant pancreatic neoplasms are divided into neoplasms of exocrine (pancreatic
adenocaricnoma) and endocrine (inuslinoma, gastrinoma, glucagonoma) part of pancreas.
They are extremely rare in cats and dogs. Due to their aggressive behaviour, the clinical signs
are observed when they have already metastased. The treatment of choice is surgical excision
of the neoplasm. The prognosis is poor.
Keywords
gušterača
pankreatitis
egzokrina insuficijencija gušterače
maligni tumori gušterače
dijagnostika
Keywords (english)
pancreas
pancreatitis
exocrine pancreatic insufficinecy
malignant pancreatic neoplasms
diagnostics
Language croatian URN:NBN urn:nbn:hr:178:636714 Study programme Title: Veterinary Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2022-07-20 07:33:02
