--- title: "Pancreatic Imaging Made Easy: Why the Pancreas Deserves a Closer Look" description: Targeted GI Ultrasound Insights for Veterinary Practices --- [![Oncura logo High Res](https://blog.oncurapartners.com/hs-fs/hubfs/Oncura%20logo%20High%20Res.png?width=6191&height=1721&name=Oncura%20logo%20High%20Res.png "Oncura logo High Res")](https://www.oncurapartners.com/) - [Products](https://www.oncurapartners.com/product) - [Testimonials](https://www.oncurapartners.com/testimonials) - [Training Videos](https://www.oncurapartners.com/educational-videos) - [Sonographers](https://www.oncurapartners.com/sonographers) - [Education](https://blog.oncurapartners.com/blog) - [Telehealth Portal](http://telehealth.oncurapartners.com/) - [Contact](https://www.oncurapartners.com/contact) - [Products](https://www.oncurapartners.com/product) - [Testimonials](https://www.oncurapartners.com/testimonials) - [Training Videos](https://www.oncurapartners.com/educational-videos) - [Sonographers](https://www.oncurapartners.com/sonographers) - [Education](https://blog.oncurapartners.com/blog) - [Telehealth Portal](http://telehealth.oncurapartners.com/) - [Contact](https://www.oncurapartners.com/contact) ## Post Sign Up - [All Posts](https://blog.oncurapartners.com/blog) All Posts Log in / Sign up [Oncura Partners](https://blog.oncurapartners.com/blog/author/oncura-partners) - Nov 4 - 4 min Share Post ## Share Post ## Share Link Cancel Copy Link # Pancreatic Imaging Made Easy: Why the Pancreas Deserves a Closer Look When a patient presents with vomiting, decreased appetite, diarrhea, lethargy, abdominal discomfort, or unexplained weight loss, one organ is often involved but easy to overlook: the pancreas. Pancreatic disease is difficult to diagnose on clinical signs alone. The signs are vague and overlap with gastrointestinal, hepatic, renal, endocrine, and systemic disease. In cats especially, pancreatitis may show up as little more than a quiet, thin, inappetent patient. This month, we’re highlighting our **Pancreas System Focus Exam: Endocrine & Exocrine**, a targeted ultrasound examination designed to make pancreatic imaging easier and more accessible whenever the pancreas is on your differential list. ## The Pancreas Plays a Bigger Role Than Many Realize The pancreas serves two critical functions, and disease in either can affect the whole patient. Exocrine Function The exocrine pancreas produces the digestive enzymes that break down food and support nutrient absorption. Conditions affecting the exocrine pancreas include: ●    Acute pancreatitis ●    Chronic pancreatitis ●    Pancreatic nodular hyperplasia ●    Pancreatic masses and neoplasia ●    Pancreatic cysts and pseudocysts ●    Exocrine pancreatic insufficiency (EPI) Endocrine Function The endocrine pancreas produces the hormones that regulate blood glucose. Conditions that may affect endocrine function include: ●    Diabetes mellitus, including diabetes complicated or destabilized by concurrent                       pancreatitis ●    Insulinoma ●    Other endocrine-related pancreatic abnormalities Because exocrine and endocrine disease can occur together, a patient with one pancreatic problem deserves a look for the other. ## When Should Pancreatic Disease Be Suspected? Common presenting concerns include: ●    Vomiting, whether acute or chronic and intermittent ●    Decreased appetite or anorexia ●    Weight loss, sometimes despite a good appetite ●    Lethargy ●    Diarrhea ●    Abdominal pain ●    Elevated pancreatic lipase ●    Diabetic patients, especially those that are newly diagnosed or difficult to regulate ●    Recurrent gastrointestinal episodes ●    Chronic gastrointestinal disease Many of these patients receive symptomatic treatment first, because the signs mimic so many other conditions. The question becomes: Are we treating a gastrointestinal upset, or are we missing an underlying pancreatic condition? ## Cats Are Different Feline pancreatitis is common, frequently chronic, and often subtle. Many cats never show the classic abdominal pain or dramatic vomiting seen in dogs. Instead, they present with lethargy, reduced appetite, and gradual weight loss. Cats also tend to have pancreatic disease alongside other problems. Pancreatitis in cats frequently occurs with chronic enteropathy and cholangitis, a combination often called triaditis. Older cats may have concurrent kidney disease or hyperthyroidism muddying the picture. That makes it especially valuable to image the pancreas in context, together with the intestines, liver, biliary tract, and regional lymph nodes. ## Case Spotlight: A Senior Cat with Chronic Vomiting A recent case submitted to our team shows how much information an ultrasound can add to a routine-looking GI workup. ### The Presentation A 16-year-old neutered male domestic cat presented with daily vomiting for about two months and gradual weight loss, despite a good appetite. Bloodwork showed a neutrophilia, hyperglobulinemia, an SDMA of 19, a high-normal T4, and an elevated pancreatic lipase. On paper, this patient could fit several stories: chronic enteropathy, early kidney disease, hyperthyroidism, pancreatitis, or even lymphoma. ### What the Ultrasound Showed Our board-certified internal medicine specialist reviewed the images and identified: - A mildly enlarged, hypoechoic pancreas, consistent with mild or chronic pancreatitis - Mild, variable thickening of the duodenum and jejunum with normal wall layering, raising chronic inflammatory enteropathy and small cell lymphoma as differentials - Prominent mesenteric lymph nodes, most likely reactive - Moderate splenomegaly - Bilateral renal changes, including decreased corticomedullary definition and mild pyelectasia, supporting the elevated SDMA ``` { "embed_field": { "source_type": "oembed", "supported_oembed_types": [ "video" ] }, "hubspot_video": { "height": 528, "player_id": 226336382498, "player_type": "hsvideo2", "width": 816 }, "style_options": { "play_button_color": { "color": "#568fcb", "css": "#568fcb", "hex": "#568fcb", "opacity": 100, "rgb": "rgb(86, 143, 203)", "rgba": "rgba(86, 143, 203, 1)" } }, "video_type": "hubspot_video", "dataQueryResult": {}, "fieldValues": { "embed_field": { "source_type": "oembed", "supported_oembed_types": [ "video" ] }, "hubspot_video": { "height": 528, "player_id": 226336382498, "player_type": "hsvideo2", "width": 816 }, "style_options": { "play_button_color": { "color": "#568fcb", "css": "#568fcb", "hex": "#568fcb", "opacity": 100, "rgb": "rgb(86, 143, 203)", "rgba": "rgba(86, 143, 203, 1)" } }, "video_type": "hubspot_video" }, "hublParameters": { "field_types": { "embed_field": "embed", "hubspot_video": "videoplayer", "style_options": "group", "video_type": "choice" }, "isJsModule": true, "is_widget_block": true, "module_id": 136619187592, "org_tag": "module_block", "path": "@hubspot/video_prototype", "schema_version": 2, "smart_objects": [], "smart_type": "NOT_SMART", "tag": "module", "widget_type": "module", "wrap_field_tag": "div" }, "hublData": null, "experimentalHublData": null, "moduleName": "widget_81fc51b3-a2d9-4aef-8870-8fd22c62c2bb", "supplementalFieldValues": { "embed_field": {}, "hubspot_video": {}, "style_options": { "play_button_color": {} }, "video_type": {} } } ``` ### Why It Mattered The elevated lipase alone suggested the pancreas was involved. The ultrasound confirmed the pancreatic changes and showed that the pancreas was only part of the story. This cat had concurrent intestinal and renal changes that called for their own workup. Instead of another round of antiemetics and a recheck, the clinic left with a clear, prioritized plan: a GI panel (cobalamin, folate, TLI, and pancreatic lipase), urinalysis and urine culture, a free T4 to address the high-normal thyroid value, a dietary trial with a highly digestible or hypoallergenic diet, supportive care for pancreatitis, and serial ultrasound to monitor the lymph nodes, with GI biopsies if signs persist. That is the difference imaging makes. The conversation shifted from “let’s see if this resolves” to “here is what we found, and here is what we do next.” ## The Cost of Treating Symptoms Without Answers Supportive care and monitoring is a common first approach. It may seem like the most affordable path, but it can lead to: - Multiple recheck appointments - Additional medications - Repeat laboratory testing - Ongoing clinical signs - Delayed diagnosis - Progression of underlying disease For pet owners, the lowest upfront cost does not always mean the lowest overall cost. A targeted ultrasound early in the diagnostic process helps you move beyond symptom management and toward real answers. ## Why Ultrasound? The pancreas is notoriously difficult to evaluate on physical examination. Ultrasound allows you to assess: - Pancreatic size and shape - Pancreatic echogenicity and echotexture - Changes in the surrounding mesenteric fat - Peripancreatic fluid - Pancreatic ductal dilation - Adjacent gastrointestinal structures, including wall thickness and layering - The liver, gallbladder, and common bile duct - Regional lymph nodes This information supports clinical decision-making and helps guide treatment, monitoring, and next steps. ## Better Together: Ultrasound and Pancreatic Lipase No single test diagnoses pancreatitis on its own. Pancreatic lipase testing (such as Spec fPL or Spec cPL) is sensitive, but it doesn’t show you the organ, its surroundings, or the other diseases that may be driving the signs. Ultrasound shows you the anatomy, but a normal-appearing pancreas does not completely rule out pancreatitis, particularly mild or chronic disease in cats. Used together, and interpreted alongside the history and clinical signs, they give you a much more confident diagnosis than either one alone. When findings are equivocal, repeat imaging and lipase trends over time can be just as informative as a single snapshot. ## Why Not Just Take Radiographs? Radiographs remain valuable, particularly for ruling out obstruction, foreign material, and other causes of vomiting. However, they are generally insensitive for pancreatic disease. At best, they may show a loss of detail in the cranial right abdomen, and many patients with pancreatitis have normal radiographs. Ultrasound allows direct evaluation of the pancreas and the tissues around it, providing information radiographs cannot. For clinics looking to identify disease earlier, ultrasound offers a significant advantage. ## Seeing the Problem Changes the Conversation Owners often struggle to understand why more diagnostics are recommended. A lab value or a list of differentials can feel abstract. An ultrasound image showing an enlarged pancreas, thickened intestines, or surrounding fluid creates a very different conversation. Instead of discussing possibilities, you are discussing findings. When owners see abnormalities firsthand, they are often more confident moving forward with diagnostics, monitoring, and treatment. ## Keep More Cases in Your Practice Pancreatic disease frequently leads to referral because additional diagnostics are needed to reach a diagnosis. With a specialist reviewing your images, your team can: - Improve diagnostic confidence - Provide answers sooner - Strengthen client trust - Increase ultrasound utilization - Maintain continuity of care - Keep more diagnostic workups within your practice - Vomiting patients - Decreased appetite - Weight loss - Abdominal discomfort - Elevated pancreatic lipase - Chronic gastrointestinal cases - Diabetic patients, especially newly diagnosed or unstable diabetics - Suspected pancreatitis - Recurrent gastrointestinal signs - Senior cats with vague signs or unexplained lethargy The result is a better experience for patients, owners, and your team. ## November Promotion: Pancreas System Focus Exam ### Endocrine & Exocrine: Pancreatic Imaging Made Easy This month, take advantage of our discounted **Pancreas System Focus Exam** whenever pancreatic disease is suspected. ### Ideal Candidates Include: A focused pancreatic ultrasound provides valuable information while offering owners a targeted, cost-conscious diagnostic approach. ## Practice Challenge for November Review every patient presenting with gastrointestinal signs, and ask: **Could the pancreas be part of the story?** Many patients with pancreatic disease look like routine GI cases until imaging reveals otherwise. By making the Pancreas System Focus Exam part of your diagnostic process, your team can uncover hidden disease, improve patient outcomes, and give owners answers earlier in the course of care. **This November, make pancreatic imaging part of the conversation, and discover how a focused ultrasound exam can turn uncertainty into action.** Recent Posts [See All](https://blog.oncurapartners.com/blog) #### [Elevated Liver Enzymes: Could Ultrasound Help This Patient?](https://blog.oncurapartners.com/blog/elevated-liver-enzymes-could-ultrasound-help-this-patient) --- [Write a comment](https://blog.oncurapartners.com/blog/elevated-liver-enzymes-could-ultrasound-help-this-patient#comments-listing) #### [GLOBAL FAST®: Ultrasound for Every Patient](https://blog.oncurapartners.com/blog/global-fast-ultrasound-for-every-patient) --- [Write a comment](https://blog.oncurapartners.com/blog/global-fast-ultrasound-for-every-patient#comments-listing) #### [Gut Reactions: Ultrasound & Allergy Insights](https://blog.oncurapartners.com/blog/gut-reactions-ultrasound-allergy-insights) --- [Write a comment](https://blog.oncurapartners.com/blog/gut-reactions-ultrasound-allergy-insights#comments-listing) ### [Employment](https://go.oncurapartners.com/jobapplication)  |  [Contact Us](https://www.oncurapartners.com/contact)  |  [Privacy Policy](https://www.oncurapartners.com/privacy-policy) - ![Facebook](https://blog.oncurapartners.com/hs-fs/hubfs/raw_assets/public/Oncurapartners_Nov2020/images/facebook.png?width=31&name=facebook.png) 512-220-1400 6628 Bryant Irvin Rd Fort Worth, TX 76132 ### About Oncura Partners The solution to your ultrasound needs by providing training, support, and positive patient outcomes. 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