Over on the canine edition of Nutrition Nuggets, I used Thanksgiving as a reason to talk about pancreatitis in dogs. Overindulgence, particularly with regards to fatty foods, is a common cause of this disease in our canine friends. The same is not true for cats, so I can’t really link this post to yesterday’s holiday, other than to say you should be very thankful if you’ve never had to deal with pancreatitis in one of your cats.
Still, I felt I would be remiss not to cover the feline version of this disease at the same time. Pancreatitis in dogs and cats are similar but not identical diseases. Understanding the differences is critical to treating cats effectively for this serious condition.
The pancreas is a small organ that is located between the stomach and the first part of the small intestine. It has two main functions: the production of the hormone insulin and the manufacture of digestive enzymes. The disease pancreatitis develops when the organ becomes inflamed. Potential causes for this inflammation in cats include:
- Concurrent inflammatory bowel disease or liver disease. The combination of inflammatory disease of the liver, pancreas, and intestines is so common in cats that it has its own name — "triaditis." In fact, it is safe to assume that most cats diagnosed with one of these conditions have some degree of the other two as well.
- Diabetes mellitus
- Certain types of infections (e.g., toxoplasmosis or feline distemper)
- Abdominal trauma
- Exposure to organophosphate insecticides
In many cases, however, no underlying cause for pancreatitis is determined.
The classic symptoms of pancreatitis in dogs are abdominal pain, vomiting, and diarrhea. This is not the case in feline patients (studies show that only 35 percent of cats with the disease vomit, while closer to 90 percent of dogs do). Most cats with pancreatitis have very vague symptoms, like loss of appetite and lethargy. Routine lab work (e.g., a blood chemistry profile, complete cell count, urinalysis, and fecal examination) is often non-diagnostic but is still necessary to rule out other causes of the cat’s symptoms. The results of specific tests for pancreatitis (fPLI or SPEC-FPL) in combination with a cat’s history, physical exam, routine lab work, and abdominal X-rays and/or ultrasounds can diagnose many cases of feline pancreatitis, but sometimes exploratory surgery is necessary.
Treatment for pancreatitis is essentially symptomatic and supportive and involves fluid therapy, pain relief, medications to control nausea and vomiting, antibiotics, and sometimes plasma transfusions. If an underlying cause can be identified, that needs be addressed as well. Because of the close association between intestinal inflammation and pancreatitis, veterinarians may also prescribe a short course of corticosteroids until a final diagnosis can be made.
Cats that do not eat are at high risk for a disease called hepatic lipidosis. So contrary to what is typically done with dogs, most feline patients are not held off food and feeding tubes may be placed relatively earlier in the course of the disease. Cats need to be hospitalized until their condition is stable enough for them to continue their recovery at home.
Cats with pancreatitis have a variable prognosis. Some recover uneventfully, particularly if an underlying condition like inflammatory bowel disease is diagnosed and can be adequately managed. On the other hand, severe cases of acute pancreatitis can be fatal, and chronic pancreatitis may result in loss of enough pancreatic tissue that cats can no longer produce adequate amounts of insulin or digestive enzymes, resulting in diabetes mellitus and/or pancreatic enzyme insufficiency respectively.
Because pancreatitis in cats is not related to the fat content of their food, patients do not need to eat low-fat foods either to treat or prevent a relapse of the disease. Thank God for small favors; it’s hard enough to get cats with pancreatitis to eat. At least we have the freedom to offer them any tempting morsel we can think of. (Yes, leftover turkey would be fine.)
Dr. Jennifer Coates