Pancreatitis in Cats

Abstract

Pancreatitis was considered a rare disease in the cat until a couple of decades ago when several retrospective studies of severe acute pancreatitis were published. It was apparent that few of the diagnostic tests of value in the dog were helpful in cats. With increasing clinical suspicion, availability of abdominal ultrasonography, and introduction of pancreas-specific blood tests of increasing utility, it is now accepted that acute pancreatitis is probably almost as common in cats as it is in dogs, although the etiology(s) remain more obscure. Pancreatitis in cats often co-exists with inflammatory bowel disease, less commonly with cholangitis, and sometimes with both. Additionally, pancreatitis may trigger hepatic lipidosis, while other diseases, such as diabetes mellitus, may be complicated by pancreatitis. Therapy is similar to that used in dogs, with added emphasis on early nutritional support to prevent hepatic lipidosis. Less is known about chronic pancreatitis than the acute form, but chronic pancreatitis is more common in cats than it is in dogs and may respond positively to treatment with corticosteroids.

Feline Diabetes Mellitus

“…Similarly, traditional assays of lipase activity are widely described to be unreliable due to poor sensitivity and specificity. During the recent years, assays that specifically measure the pancreatic lipase activity (known as fPLI or Spec fPL) became available and are currently considered to be the most accurate blood tests for diagnosing pancreatitis in cats (Steiner et al, 2004;Forman et al, 2009;Armstrong and Williams, 2012). One study reported an overall sensitivity of fPLI for pancreatitis of 67% (100% for moderate to severe pancreatitis and 54% for mild pancreatitis).…”

“…Palpation may or may not elicit a response of pain. Severe acute or acute on chronic pancreatitis may be associated with dehydration, tachycardia, tachypnea, and icterus; cats may be hypothermic; fever is also possible but less common (Armstrong and Williams, 2012;Caney, 2013). For more details on pancreatitis, see Types of Diabetes in Cats and the discussion on pancreatic enzymes in Clinical Pathology.…”

“…In humans with acute pancreatitis, the use of glucocorticoids is currently under investigation. There are anecdotal reports on clinical improvement when used in cats with chronic or chronic relapsing pancreatitis (Armstrong and Williams, 2012). However, there are currently no criteria that would help the clinician to decide which cat would potentially benefit from a short-term steroid administration and in which cases it would cause harm.…”

“…In a substantial percentage of cats, it seems to be a clinical insignificant bystander; in others, it causes clinical signs and may render diabetic regulation at times very difficult. Pancreatitis may also play a role in the development of diabetic ketoacidosis (DKA) (Goossens et al, 1998;Armstrong and Williams, 2012). Diabetes mellitus may also be seen with pancreatic adenocarcinoma; in humans, there is debate as to which diabetes is due to direct effects of the tumor or induced by diabetogenic substances produced by the cancer cells (Chen et al, 2011).…”

Glucocorticoid Therapy

“…Steroids are no longer included in the list of drugs suspected of being associated with pancreatitis (Armstrong and Williams, 2012;Mansfield, 2012). Steroids are no longer included in the list of drugs suspected of being associated with pancreatitis (Armstrong and Williams, 2012;Mansfield, 2012).…”