Dr. Harry Cridge highlights chronic pancreatitis in dogs: full analysis

Clinician’s Brief is putting a spotlight on a problem many general practitioners may already be seeing without naming: chronic pancreatitis in dogs. In a newly updated podcast episode tied to his January 2026 peer-reviewed article, Michigan State University internist Harry Cridge says chronic pancreatitis often looks very different from the classic acute case, showing up instead as intermittent vomiting, picky eating, hyporexia, lethargy, and subtle abdominal discomfort that can be easy to attribute to other chronic gastrointestinal disease. (cliniciansbrief.com)

That framing matters because chronic pancreatitis has long been harder to define, diagnose, and study than acute disease. In his Clinician’s Brief review, Cridge describes it as an inflammatory condition that can cause irreversible injury to both the exocrine and endocrine pancreas. He notes that histopathology is rarely pursued in clinical practice because biopsy is invasive, costly, and can miss multifocal disease, leaving veterinarians to make a practical diagnosis based on history, clinical signs, imaging, pancreatic lipase testing, and exclusion of other causes. (cliniciansbrief.com)

The background literature supports the idea that the condition may be more common than day-to-day case recognition suggests. Cridge’s review cites necropsy studies reporting microscopic evidence of pancreatitis in 34% to 64% of dogs, while cautioning that those figures likely overestimate true clinical prevalence. Even so, they reinforce the concern that chronic pancreatic inflammation is underdiagnosed. The article also notes that about 40% of dogs diagnosed with fatal acute pancreatitis had histopathologic features of chronicity, suggesting that acute-on-chronic disease may be missed in practice. (cliniciansbrief.com)

Cridge’s key clinical points are pragmatic. A normal-looking pancreas on ultrasound does not rule out chronic pancreatitis, because ultrasonography has high specificity but low sensitivity for chronic disease. When abnormalities are present, they may reflect fibrosis and ongoing inflammation rather than the edema more typical of acute pancreatitis. Likewise, pancreatic lipase remains useful, but mild or persistent elevations may be more relevant than dramatic spikes, especially after other gastrointestinal, renal, or systemic explanations have been considered. Treatment remains largely supportive: pain control, antiemetics, hydration support, and typically a low-fat, highly digestible diet, with screening over time for exocrine pancreatic insufficiency and diabetes mellitus. (cliniciansbrief.com)

There’s also growing interest in whether chronic pancreatitis in some dogs may represent distinct disease subtypes. A 2024 Journal of Veterinary Internal Medicine paper described a form of chronic pancreatitis in English cocker spaniels with histologic and clinical features resembling human IgG4-related disease, including possible involvement beyond the pancreas. Cridge’s Clinician’s Brief article reflects that evolving understanding, noting that English cocker spaniels with suspected IgG4-related disease may also show keratoconjunctivitis sicca, protein-losing nephropathy, or anal sac disease, and may sometimes warrant consideration of immunosuppressive therapy if supportive care is not enough. (academic.oup.com)

Industry and academic interest in this area appears to be growing. Michigan State University highlighted in March 2025 that Cridge’s pancreatitis and exocrine pancreatic disease publications were among the most-read and most-cited papers in major veterinary journals, underscoring how much demand there is for clearer diagnostic and treatment guidance. In that announcement, Cridge said the goal is to make pancreatitis easier to detect and treat in everyday practice, while improving awareness of secondary complications such as EPI. (cvm.msu.edu)

Why it matters: For veterinarians, this is a reminder that chronic pancreatitis is often a longitudinal case-management problem, not just an emergency presentation. Dogs with vague, recurring GI signs, postprandial discomfort, or repeated “nonspecific” flare-ups may warrant a more deliberate pancreatic workup, even when bloodwork is unrevealing and ultrasound changes are modest. Earlier recognition could help clinicians intervene before irreversible pancreatic damage leads to chronic pain, EPI, diabetes, or repeated acute-on-chronic episodes. It also has communication implications with pet parents, who may need help understanding why a dog with intermittent signs still requires monitoring and long-term management. (cliniciansbrief.com)

What to watch: The next developments are likely to center on better validation of diagnostic combinations, including pancreatic lipase assays, ultrasound, and possibly cytology, as well as more evidence on nutrition, pain control, and whether targeted immunosuppression has a role in select chronic pancreatitis phenotypes. For now, the practical takeaway is that chronic pancreatitis is moving from an underappreciated concept to a more explicit part of canine internal medicine decision-making. (cliniciansbrief.com)