Dear Dr. John,

It seems our nine-year-old terrier is prone to pancreatitis. A few years ago, he became quite ill with all of the classical signs of gall bladder disease. At the time, he had been vomiting and had been lethargic. He also seemed painful when we picked him up and was not eating much so we took him in for an evaluation. The diagnosis was made with an exam, bloodwork, and an abdominal ultrasound. There was some urgency associated with the recommendation to remove his gall bladder and it was done right away.

Now, it seems that he comes down with pancreatitis maybe 2-3 times a year. The signs are similar to what we saw at the time when we had to have his gall bladder removed. Do you have any suggestions on how to avert this repeating itself? C.W.

Dear C.W.,

Clearly you are an attentive dog owner and know when things seem amiss. Gall bladder removal or cholecystectomy usually is needed when one seeks to avoid rupture of the gall bladder mucocele which is filled with sludge. This was probably the case for your dog but only your veterinarian can say for sure. Gall bladder stones sometimes also create an urgent need for action. In either case, this is because if there is any possibility of rupture, which can lead to peritonitis and even death, surgery is required.

As for the occasional recurring pancreatitis, this is likely due to diet or things the dog gets into. Pancreatitis is an inflammatory condition of the organ usually caused by a high fat diet or fatty foods and table scraps. Even in dogs with a gall bladder, this can occur. The clinical signs are all those you described such as vomiting, diarrhea, painful abdomen, lethargy, and dogs assuming the praying position with their rears in the air and their front end down. This is due to abdominal discomfort. While recurring pancreatitis is not typical, the best you can do to avert recurrences are feeding the dog a prescription bland diet, avoiding any fatty foods or table scraps, use of probiotics, and working with your veterinarian on a good dietary program.

Dr. John de Jong owns and operates the Boston Mobile Veterinary Clinic. He can be reached at 781-899-9994.