Kari-Anne Bjørnkjær-Nielsen

Master Student: Kari-Anne Bjørnkjær- Nielsen
Specialisation: Internal Medicine
Project: "Corticosteroid treatment for acute/acute-on-chronic canine pancreatitis"

Abstract

Background:

Acute pancreatitis in dogs is a prevalent and known inflammatory disease. Treatment with anti-inflammatory corticosteroids has been much debated, but not generally recommended in veterinary medicine.

Objective:

To present the current evidence of corticosteroid treatment effect on acute/acute-onchronic pancreatitis, and to evaluate how treatment with corticosteroids in the acute/acute-onchronic stage of canine pancreatitis could influence disease outcome.

Methods:

A scoping review was performed searching Agricola, CAB Abstracts, Medline and Embase to identify relevant articles published before August 28, 2019. Selection criteria were English language, original research published in peer-reviewed journal, and study investigating corticosteroid treatment effect of acute/acute-on-chronic pancreatitis by the following outcome parameters: Clinical score, circulating CRP-levels, duration of hospitalisation, mortality and histopathology of the pancreas. Research concerning any species was considered. Studies were rated based on level of evidence and methodological quality was evaluated by similarities between groups at baseline, risk of bias and study group size. The method of reporting was according to The PRISMA extension for scoping Reviews.

Results:

One thousand nine hundred and fifty-four studies were identified, of which 31 met the inclusion criteria: Five were canine studies, of which 4 regarded experimentally induced pancreatitis, 5 were human studies and 21 were rodent studies of experimentally induced pancreatitis. Level of evidence ranged between randomised controlled trials and case series, estimated risk of bias was low to high and sample sizes were very small to moderate.

Conclusions and clinical importance:

Evidence points in the direction that treatment with corticosteroids in addition to symptomatic treatment in the acute/acute-on-chronic phase of canine pancreatitis can have a positive influence on disease outcome. However, as evidence was gathered among several species and as some of it reflected the effect in experimentally induced pancreatitis, the author encourages the performance of large randomised controlled studies on dogs with spontaneously occurring acute/acute-on-chronic pancreatitis to elucidate the potential benefit of corticosteroid treatment.