Abdominal ultrasound and clinicopathologic findings in 22 cats with exocrine pancreatic insufficiency

Abstract

Background Awareness of exocrine pancreatic insufficiency (EPI) in cats has increased since the development of an assay for feline trypsin‐like immunoreactivity (fTLI). Ultrasound findings in cats with EPI have only been reported rarely and described as nonspecific. Hypothesis/Objectives To describe the ultrasonographic findings, clinical signs, and concurrent diseases in cats with EPI. Animals Twenty‐two client‐owned cats with EPI. Methods Multicenter retrospective descriptive study including cats with serum fTLI concentration ≤8 μg/L and an abdominal ultrasound examination performed within 6 weeks of fTLI measurement. Sonographic measurements of maximal pancreatic thickness and maximal pancreatic duct diameter as well as ratios of pancreatic duct diameter to pancreatic thickness were obtained. Additional sonographic findings, concurrent conditions, and clinical signs were recorded. Results The most common clinical sign was weight loss (15/22 cats). Chronic enteropathy was the most common concurrent disease (13/22 cats). In 39% of cats, the pancreas had minimal or no sonographic alterations. Pancreatic duct dilatation (>2.5 mm), pancreatic duct tortuosity with variable diameter, or both were seen in 6/13 cats. The pancreatic parenchyma was subjectively thin in 6 cats. A significant relationship was found between subjectively thin pancreatic parenchyma and increased pancreatic duct size : pancreatic thickness ratio (P = .004). Diffuse gastrointestinal dilatation with echogenic content was observed in 8/22 cats. Conclusion Exocrine pancreatic insufficiency often causes minimal to no sonographic pancreatic changes. Nonetheless, the findings of thin pancreatic parenchyma, pancreatic duct dilatation, or diffuse small intestinal dilatation with echogenic contents in cats with unexplained weight loss or unformed feces should raise clinical suspicion for EPI.

Influences of exocrine pancreatic insufficiency on nutrient digestibility, growth parameters as well as anatomical and histological morphology of the intestine in a juvenile pig model

“…90 g/m in both groups, which indicates that the intestinal wall thickness did not differ between the groups and that an actual growth of the intestine in the PL animals can be assumed. Previous studies found by histological or ultrasonographic examination either no effect on intestinal wall thickness due to EPI or an increase in intestinal wall thickness in EPI patients (56)(57)(58)(59).…”

ACVIMconsensus statement guidelines on diagnosing and distinguishing low‐grade neoplastic from inflammatory lymphocytic chronic enteropathies in cats

“…Few retrospective studies have investigated signalment, clinical signs, and concurrent diseases in cats with exocrine pancreatic insufficiency (EPI) 74,82 . They highlight EPI as an important differential diagnosis of CE in cats.…”

Ultrasonographic Findings of Exocrine Pancreatic Insufficiency in Dogs

“…From an epidemiological point of view, our data confirm what is reported in the literature: German Shepherds were the most affected breed (35%), but no other breed predisposition was identified in this study. Associations with EPI and dog breed were found in German Shepherds, rough-coated collies, Chow Chows, and Cavalier King Charles Spaniels [4][5][6][7][8][9]. PAA is the most common cause of severe EPI in German Shepherds [4,9,24], rough-coated collie [25,26], and English setter [27].…”

“…The first is an autoimmune disorder, called pancreatic acinar atrophy (PAA), and it is caused by lymphocytic infiltration of the pancreatic acinar tissue, which leads to active tissue destruction [2,3]; the second is rarer and can be caused by chronic pancreatitis (CP) or pancreatic neoplasia [4]. The most common cause of EPI in dogs is PAA [1], while CP is reported to be an uncommon cause [5], in contrast to humans and cats [6][7][8].…”

“…The most common clinical signs of EPI, present in more than 90% of affected dogs, have been reported to be polyphagia, increased fecal volume and defecation frequency, weight loss, flatulence, poor digestion, loose, pulpy feces, and diarrhea. Other reported clinical signs are skin disorders, such as poor coat and eczema, and nervousness or aggressiveness that was also reported in one third of dogs with EPI [1][2][3][4][5][6][7][8][9].…”