Pancreatitis and Pancreatic Insufficiency
Treatment of feline pancreatitis and pancreatic insufficiency
The most common ailments of the pancreas include:
- Pancreatitis (inflammation of the pancreas) – acute or chronic
- Pancreatic insufficiency, also known as malabsorption
Diseases of the Pancreas
The pancreas’ role is to produce hormones, such as insulin, and digestive enzymes. Pancreatitis is a condition where the pancreas becomes inflamed and digestive enzymes may leak from the pancreas and attack other organs, such as the liver. While it’s unclear whether pancreatitis may cause diabetes mellitus, or vice versa, best estimates are that 30% to 50% of diabetic cats also have chronic pancreatitis. Pancreatitis often occurs along with inflammatory bowel disease and cholangiohepatitis, a condition known as triaditis. Pancreatic insufficiency, also known as malabsorption, is a condition where the enzymes released aren’t enough to digest food properly. The conditions may occur concurrently.
Symptoms and Diagnosis
Causes of pancreatic ailments are largely unknown. They are also typically difficult to diagnose. Some cats suffering from pancreatitis exhibit vomiting or abdominal pain. Abdominal pain may be indicated by the cat crying out when picked up, or frequently lying in what many caregivers refer to as a “meatloaf” position, hunched over with all four legs tucked under the body. Stools from a cat with pancreatic insufficiency may be yellow or gray in color.
A newer blood test, the Pancreatic Lipase Immunoreactivity (PLI) test, can be useful in diagnosing pancreatic ailments, but may produce normal results unless an attack is underway when the test is performed. Ultrasounds are sometimes useful, but the pancreas is so small it’s often difficult to see abnormalities unless the inflammation is very severe. The only definitive way to rule out pancreatic ailments is a necroscopy.
As causes are largely unknown, treatment focuses on managing symptoms. Sub-cutaneous (sub-q) fluids maintain hydration, and may be administered at home. Digestive enzymes may assist the body in digesting food, but they may also exacerbate enzyme leakage from the pancreas. If enzymes are utilized, powdered enzymes seem to work better than other forms. Enzymes are often administered in conjunction with an antacid, such as famotadine (Pepcid AC). Supplementation with B-12 (cobalamin), folate, and other B vitamins may be helpful. In some cases, pain medications or other drugs may be necessary.
Cats with pancreatic insufficiency (malabsorption) generally do best on low-fiber diets. While a low-fat diet seems to work best for dogs and humans with pancreatitis, there’s no scientific evidence to indicate the same for cats. However, some caregivers report that a lower-fat diet seems to benefit their cats. As carnivores, cats are most suited for a low-carbohydrate diet, and tolerate animal fats well. As pancreatitis occurs so often in conjunction with diabetes, and diabetic cats do best with an all-wet low-carbohydrate diet, and cats with pancreatic insufficiency do best on a low-fiber diet, it may be best to feed cats with pancreatitis a highly-digestible all-wet (canned or raw) low-carbohydrate/low-fiber diet. Monitor your cat to see what foods it seems willing to eat and seem to make it most comfortable.
Pancreatic ailments often occur in conjunction with diabetes mellitus, gastro-intestinal disorders such as inflammatory bowel disease (IBD), and liver disorders. Proper nutrition may be the best way to manage these ailments, and perhaps even prevent them.
Brochure (printable version)
Latifah was diagnosed with pancreatitis after she was admitted to the emergency room. She was vomiting and lethargic, and had blood sugar levels much higher than usual (as she'd previously been a diet-controlled diabetic). Gastro-intestinal bloodwork performed shortly thereafter showed low cobalamin (vitamin B12) levels, high pancreatic lipase immunoreactivity (PLI) levels, and elevated TLI levels. These tests indicated Latifah had IBD and pancreatitis. Latifah's treatment included sub-q fluids administered at home (100 cc daily), famotadine (1/4 of a 10 mg Pepcid AC tablet once daily), digestive enzymes administered with food, and vitamin B12 injections weekly.
Cost Saving Ideas
Many over-the-counter supplements marketed for human use are as effective as veterinary brands and are less expensive. Examples include digestive enzymes made from porcine pancreas, famotadine (Pepcid-AC), or S-adenosylmethionine (Sam-E). Check the dose with your vet.
Sub-q fluid sources
For futher information, visit:
Feline Pancreatitis: Underdiagnosed and Overlooked Margie Scherk,
DVM, DABVP (WSAVA 2003)
Update on the Diagnosis and Management of Feline Pancreatic Disease by Stanley L. Marks, BVSc, PhD, DACVIM, DACVN (Waltham Feline Medicine
Pancreatic Lipase Immunoreactivity (PLI)
Dietary Management of Feline Pancreatitis by Stanley Marks, BVSc, PhD
Feline GI Pearls
Diseases of the Exocrine Pancreas at Max's House
Response to insulin treatment and survival in 104 cats with diabetes
Pancreatitis in the cat by Mar Vista Animal
Exocrine Pancreatic Insufficiency by Mar Vista Animal
Exocrine Pancreatic Insufficiency in Dogs and Cats: An Update WSAVA
The Exocrine Pancreas by Merck Veterinary Manual
Feline Pancreatitis-Species Specific Diagnostic and Therapeutic
Approach Caroline Mansfield, BSc, BVMS, MVM, MACVSc, DECVIM-CA
Pancreatitis in Dogs and Cats Texas A&M
Feline Pancreatitis by Jorg Steiner (WSAVA 2001)
Pancreatitis In Cats: Management Of A Complicated Disease by Debra L. Zoran, DVM, PhD, Diplomate ACVIM
last updated: 10/29/2008
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