OverviewThe pancreas is an pale pink, lobulated organ located near the liver & behind the stomach. The pancreas performs both exocrine (secretes enzymes via a duct) & endocrine (secretes hormones directly into the bloodstream) functions. Small clusters of cells called Islets of Langerhans are responsible for the production of the hormones insulin & glucagon which regulate blood sugar. The pancreas also produce pancreatic juice, a digestive enzyme rich in sodium bicarbonate which helps break down proteins, fats & carbohydrates. This juice is secreted from the pancreas & collected in the pancreatic duct, where it joins with the bile duct from the liver prior to entering the duodenum. Normally, the pancreas protects itself from the digestive enzymes it manufacturers, stores & secretes. To do this this it secretes them inactivated (known as zymogens), they don't become activated until they reach the duodenum. Pancreatitis is the acute or chronic inflammation of the pancreas as a result of inappropriate activation of the digestive enzymes which begin to break down & digest the pancreas, leading to inflammation. Surrounding tissues such as the liver may become involved. Some causes of pancreatitis include toxoplasmosis, hyperlipidemia (high fat content in the blood), hypercalcemia (high calcium content in the blood), feline herpesvirus I, feline infectious peritonitis, feline parvovirus, obesity, certain drugs, high fat diet, hepatic lipidosis, trauma (car accident, high fall). In most cases (around 90%), the cause cannot be determined (idiopathic). What are the symptoms of pancreatitis in cats?Pancreatitis can be acute (sudden onset) or chronic (persistent/long lasting). Cats with pancreatitis often exhibit vague/non specific signs. Both acute & chronic pancreatitis can range from mild to severe/life threatening. Some signs your cat may display include; - Anorexia
- Lethargy
- Dehydration
The above three are the most common symptoms. Other less common symptoms include;
- Fever
- Abdominal pain
- Vomiting is commonly seen in dogs & humans but not a common symptom in cats.
- Diarrhea
- Ataxia (loss of coordination)
- Weight loss
Pancreatitis may run concurrently with other diseases such as cholangitis/cholangiohepatitis, hepatic lipidosis (fatty liver disease), & inflammatory bowel disease. Pancreatitis, cholangiohepatitis & inflammatory bowel disease running concurrently are collectively known as 'feline triad disease'.
How is pancreatitis diagnosed?Due to the vague symptoms, which are similar to a host of other disorders, diagnosis can be a challenge & many cases of pancreatitis go undiagnosed as a result of these non-specific symptoms. Your veterinarian will perform a complete physical examination of your cat & obtain a medical history. Some tests he may wish to perform include; - Complete blood count & biochemical profile - These often come back non specific. Pancreatic enzymes are often normal. Mild elevations of hepatic enzymes ALT may be seen.
- fTLI (feline Trypsin-Like Immunoreactivity) - This test measures the concentrations of trypsin-like proteins in serum.
- TAP (trypsin activation peptide)
- fPLI (feline Pancreatic Lipase Immunoreactivity) - This test measures feline pancreatic lipase (an enzyme secreted by the pancreas which breaks down fat) immunoreactivity in serum.
- X-ray
- Ultrasound can be useful to check the size, shape & density of the pancreas.
- Laparotomy - Surgical incisions are made in the abdomen to allow your veterinarian to examine the organs. In this case, the pancreas.
- Biopsy of the pancreas, liver or intestines may be of additional help.
How is pancreatitis treated?- If possible, find & treat the underlying cause.
- Analgesics (painkillers) for abdominal pain.
- Antemetics (anti nausea medication) if vomiting is present.
- Supportive care such as intravenous fluids to prevent or treat dehydration.
- If hepatic lipoidosis is also present, nutritional support, otherwise withhold food & water or 24 - 48 hours. Once food is resumed, a bland, low fat food may be recommended.
- Antibiotics may be prescribed if there is infection present.
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