A pancreatitis primer for cat owners
Pancreatitis is an increasingly important pancreatic disorder in cats, but what exactly is it? What happens when a cat becomes ill due to pancreatitis?
By Robyn Thrasher
The pancreas is glandular organ has two main functions: to produce metabolic hormones that control blood sugar and to produce enzymes that aid in food digestion.
Normally, due to their destructive nature, the protein-digesting enzymes trypsin and chymotrypsin are stored in the pancreas in an inactive form. Once undigested food moves from the stomach to the intestine, the pancreas is stimulated to release these enzymes, which only become activated once they reach the intestinal tract.
When the enzymes are inappropriately activated within the pancreas, inflammation occurs causing a disorder known as pancreatitis.
Cats and pancreatitis
Feline pancreatitis is a fairly complex disease that is likely more prevalent than previously thought. According to a 2007 study published in The Journal of Veterinary Pathology, 67 per cent of cats had evidence of pancreatitis based on tissue analysis and almost half of these cats were considered clinically healthy.
In cats, the cause of pancreatitis is often unknown and reaching a definitive diagnosis is difficult.
"In dogs, pancreatitis is often thought to be secondary to a high fat meal or dietary indiscretion, whereas in cats this association doesn't exist," says Dr. Melissa Meachem, a graduate student in veterinary pathology at the Western College of Veterinary Medicine (WCVM).
Typically, cats with pancreatitis have vague and non-specific symptoms such as anorexia and lethargy, which makes determining the cause of the illness challenging.
While vomiting and abdominal pain are classical signs of this disease in dogs, these symptoms are rarely seen in cats.
Affected cats may develop concurrent diseases such as hepatic lipidosis (also known as "fatty liver" – a type of liver disease that stems from inadequate food intake) that further complicate diagnosis and treatment.
Due to the anatomy of the pancreatic duct system, the cat is more susceptible to developing inflammation of the intestine and bile duct in addition to the pancreas..
"Dogs usually have two pancreatic ducts while cats only have one," explains Meachem. "This single pancreatic duct opens to the intestine in conjunction with the bile duct. If a cat has pancreatitis, there's a high likelihood that it also has inflammatory bowel disease (IBD) and cholangitis (inflammation of the liver and bile duct)."
Diagnosis
Along with physical examination, appropriate history and clinical signs, there are a number of blood tests that can be performed to aid in diagnosing feline pancreatitis.
One such test, the feline pancreas-specific lipase assay (Spec fPL), is fairly good at identifying moderate to severe cases. It does have limited ability to detect mild forms of the disease, which can result in these cases being overlooked. This test may also be positive in patients that have diseases other than pancreatitis, making it an imperfect tool in the diagnosis of pancreatitis.
Abdominal ultrasound is useful in recognizing pancreatitis. Specific changes in the appearance of the pancreas and the tissue surrounding the organ can signal inflammation and disease. Ultrasound-guided fine needle aspiration (FNA) can be done to collect a sample of cellular material from the pancreas for microscopic evaluation, but this isn't a commonly performed procedure in most cases.
"None of these tests are 100 per cent specific or sensitive," Meachem points out. "But they can help narrow down the list of potential diagnoses."
Treatment
The major treatment strategy for feline pancreatitis is to provide good supportive care.
"This centres on intravenous fluid therapy to maintain the patient's hydration status and adequate nutrition to maintain normal metabolism," says Dr. Casey Gaunt, a WCVM small animal internal medicine specialist.
Providing the required nutrients typically involves placement of a feeding tube until the cat is feeling well enough to resume eating on its own.
"As well, we often provide medication to control pain in those that demonstrate discomfort," adds Gaunt.
Prevention
No specific preventive measures exist for feline pancreatitis. With dogs, a common solution is to switch to lower fat diets to reduce the risk of recurrence of the disease. This approach doesn't work for cats: abrupt dietary changes can result in decreased food intake and severe liver disease in some cats.
"The best thing an owner can do is recognize when their cat stops eating and seek prompt veterinary care," says Gaunt. "This allows us to identify the problem and provide treatment early in the course of the disease before the cat becomes severely ill."
Robyn Thrasher of Edmonton, Alta., is a third-year veterinary student at the WCVM. Robyn is a WCVM research communications intern as well as a summer student in the WCVM Veterinary Medical Centre during the summer of 2012.
Normally, due to their destructive nature, the protein-digesting enzymes trypsin and chymotrypsin are stored in the pancreas in an inactive form. Once undigested food moves from the stomach to the intestine, the pancreas is stimulated to release these enzymes, which only become activated once they reach the intestinal tract.
When the enzymes are inappropriately activated within the pancreas, inflammation occurs causing a disorder known as pancreatitis.
Cats and pancreatitis
Feline pancreatitis is a fairly complex disease that is likely more prevalent than previously thought. According to a 2007 study published in The Journal of Veterinary Pathology, 67 per cent of cats had evidence of pancreatitis based on tissue analysis and almost half of these cats were considered clinically healthy.
In cats, the cause of pancreatitis is often unknown and reaching a definitive diagnosis is difficult.
"In dogs, pancreatitis is often thought to be secondary to a high fat meal or dietary indiscretion, whereas in cats this association doesn't exist," says Dr. Melissa Meachem, a graduate student in veterinary pathology at the Western College of Veterinary Medicine (WCVM).
Typically, cats with pancreatitis have vague and non-specific symptoms such as anorexia and lethargy, which makes determining the cause of the illness challenging.
While vomiting and abdominal pain are classical signs of this disease in dogs, these symptoms are rarely seen in cats.
Affected cats may develop concurrent diseases such as hepatic lipidosis (also known as "fatty liver" – a type of liver disease that stems from inadequate food intake) that further complicate diagnosis and treatment.
Due to the anatomy of the pancreatic duct system, the cat is more susceptible to developing inflammation of the intestine and bile duct in addition to the pancreas..
"Dogs usually have two pancreatic ducts while cats only have one," explains Meachem. "This single pancreatic duct opens to the intestine in conjunction with the bile duct. If a cat has pancreatitis, there's a high likelihood that it also has inflammatory bowel disease (IBD) and cholangitis (inflammation of the liver and bile duct)."
Diagnosis
Along with physical examination, appropriate history and clinical signs, there are a number of blood tests that can be performed to aid in diagnosing feline pancreatitis.
One such test, the feline pancreas-specific lipase assay (Spec fPL), is fairly good at identifying moderate to severe cases. It does have limited ability to detect mild forms of the disease, which can result in these cases being overlooked. This test may also be positive in patients that have diseases other than pancreatitis, making it an imperfect tool in the diagnosis of pancreatitis.
Abdominal ultrasound is useful in recognizing pancreatitis. Specific changes in the appearance of the pancreas and the tissue surrounding the organ can signal inflammation and disease. Ultrasound-guided fine needle aspiration (FNA) can be done to collect a sample of cellular material from the pancreas for microscopic evaluation, but this isn't a commonly performed procedure in most cases.
"None of these tests are 100 per cent specific or sensitive," Meachem points out. "But they can help narrow down the list of potential diagnoses."
Treatment
The major treatment strategy for feline pancreatitis is to provide good supportive care.
"This centres on intravenous fluid therapy to maintain the patient's hydration status and adequate nutrition to maintain normal metabolism," says Dr. Casey Gaunt, a WCVM small animal internal medicine specialist.
Providing the required nutrients typically involves placement of a feeding tube until the cat is feeling well enough to resume eating on its own.
"As well, we often provide medication to control pain in those that demonstrate discomfort," adds Gaunt.
Prevention
No specific preventive measures exist for feline pancreatitis. With dogs, a common solution is to switch to lower fat diets to reduce the risk of recurrence of the disease. This approach doesn't work for cats: abrupt dietary changes can result in decreased food intake and severe liver disease in some cats.
"The best thing an owner can do is recognize when their cat stops eating and seek prompt veterinary care," says Gaunt. "This allows us to identify the problem and provide treatment early in the course of the disease before the cat becomes severely ill."
Robyn Thrasher of Edmonton, Alta., is a third-year veterinary student at the WCVM. Robyn is a WCVM research communications intern as well as a summer student in the WCVM Veterinary Medical Centre during the summer of 2012.