Wednesday, August 18, 2010

Feline Pancreatitis

Cats can be affected by inflammation of the pancreas known as pancreatitis. The pancreas is an organ in the abdomen located very close to the stomach, intestines and liver. The pancreas has multiple jobs that are very important to every day life. It produces insulin which is necessary for keeping the body’s blood sugar stable and it also produces important products necessary to properly digest food. When the pancreas becomes inflamed, the products that it makes to help digest food in the intestines are activated within the pancreas and the pancreas basically begins to “eat/dissolve” itself.

Usually the cause of pancreatitis in cats is not found. Some causes are believed to include trauma, infection and some medications. In cats chronic pancreatitis is more common in cats, where the acute form occurs more commonly in dogs. Signs of pancreatitis are very nonspecific and can be hard to notice. 80-100% of cats have decreased energy/actvity, 87-97% stop eating and 54% are dehydrated. In contrast to dogs and humans, vomiting (35%) and abdominal pain (25%) are not common signs in cats. Other conditions that occur with pancreatitis include hepatic lipidosis (fatty liver disease), inflammatory bowel disease (IBD-inflammation of the intestines), diabetes and inflammation/infection of the bile tract and liver.

Abdominal ultrasound is considered more useful that x-rays for the diagnosis of pancreatitis and should be the next test performed if x-rays of the abdomen do not provide a definitive diagnosis. A recently new blood test (fPLI-feline serum pancreatic lipase immunoreactivity) is being used to identify cats with pancreatitis. The only way to definitively diagnose pancreatitis is via biopsy, but this procedure is expensive and requires general anesthesia in patients that may be at higher risk complications. Using a combination of clinical signs, blood tests and ultrasound a strong suspicion that pancreatitis is affecting your cat can be attained.

If a cause for the pancreatitis is found, that cause must be treated. Other treatments are not directly targeted at the pancreatitis but more at helping the cat feel more comfortable and assist in balancing any secondary complications. This consists of providing intravenous fluids via a catheter to provide adequate hydration, electrolytes and blood flow to the pancreas. Medications that provide relief of nausea and vomiting as well as pain medications are given. In severe cases, protein levels drop and blood clots may form which require transfusions of plasma. Cats that have not been eating for a few days and do not begin to eat shortly after treatment is started may require a temporary feeding tube to be able to provide adequate nutrition. Cats that have inflammatory conditions of the liver/gallbladder (cholangiohepatitis) or intestines (IBD) require steroids to decrease the inflammation. If infection of the liver or gallbladder is suspected antibiotics may b administered.

The prognosis is very variable as some cases are more severe than others. Because the pancreatitis in cats is usually chronic, other bouts of pancreatitis will most likely occur at some point in time. If enough pancreatic tissues are damaged secondary complications can occur. One is diabetes as the insulin producing cells are damaged and the second is exocrine pancreatic insufficiency as the cells that make products that assist in digesting food are damaged. Sometimes the inflammation of the pancreas is so severe that the bile duct becomes obstructed.

Because cats hide disease so well, by the time they are showing signs they may already be very sick. It is important to remember that if you notice any non-specific signs such as lethargy or loss of appetite which do not improve after a day or two make sure you see your veterinarian. Pancreatitis may be only one of many possible diseases making your cat sick.