A case study following the diagnosis and treatment of pancreatitis of a cat named Oliver paints a picture of why pancreatic lipase testing is important. Oliver's story is a real-life example of how real-time testing can improve disease detection and patient outcomes.

Presentation and Exam

Oliver is a 7-year-old neutered domestic shorthair who presented with a decreased appetite, weight loss, and intermittent vomiting and diarrhea. According to his owner, these signs had been occurring for several months. Recently, Oliver had become increasingly lethargic, prompting his owner to seek veterinary care.

On exam, Oliver's body condition was notably decreased, with a BCS of 3/9. Guarding and discomfort were noted on palpation of his cranial abdomen, consistent with his intermittent gastrointestinal signs. His heart rate and temperature were mildly elevated, which could have been attributed to stress, and his mucous membranes were slightly tacky. While Oliver was historically inquisitive and social during veterinary visits, his behavior at this visit was markedly quiet and depressed.

Oliver's nonspecific clinical signs and concerning history suggested an underlying problem, necessitating further workup. His veterinarian recommended baseline diagnostics, including a CBC, general chemistry profile, and urinalysis.

Initial Diagnostic Findings

Oliver's diagnostic results included:

• CBC: Leukocytosis, neutrophilia, and suspected bands, indicating an inflammatory response

• General chemistry profile: Mild hyperglycemia, hypernatremia, and an elevated BUN and ALT signal metabolic changes and systemic illness

• Urinalysis: No significant findings

This minimum diagnostic data set suggested a serious underlying problem but not a clear diagnosis. Oliver's differential diagnosis list included pancreatitis and several other inflammatory conditions.

Based on Oliver's presentation, lab work, and clinical signs, his veterinarian ordered a real-time pancreatic lipase test.

Real-Time Pancreatic Lipase Testing

The feline pancreatic lipase test measures the digestive enzyme and pancreatic product lipase in circulation. While small amounts of circulating lipase are normal, the enzyme spikes rapidly when the pancreas is inflamed, making it an effective marker to diagnose recurring or chronic pancreatic inflammation in cats. Oliver's real-time pancreatic lipase was elevated at 8.5 U/L, aligning with his veterinarian's suspicion of pancreatitis.

Confirming Pancreatitis With Advanced Imaging

While real-time pancreatic testing provides definitive evidence for the condition in cats, imaging is still necessary to confirm the diagnosis and rule out other causes. Pancreatic inflammation often occurs alongside other gastrointestinal diseases such as inflammatory bowel disease and GI lymphoma. Abdominal ultrasound aids in diagnostic confidence by visually confirming pancreatic inflammation and the presence or absence of other conditions.

Oliver's abdominal ultrasound results showed a thickened and irregularly contoured pancreas and the presence of hyperechoic peripancreatic fat. These findings are consistent with pancreatitis. Additionally, Oliver's veterinarian also identified a thickened intestinal wall and loss of layering, suggesting chronic enteropathy (i.e., possible GI lymphoma or chronic inflammatory enteropathy).

Oliver's Treatment Plan and Recovery

Without any singular treatment for pancreatic inflammation in cats, Oliver's veterinarian used an individualized approach focusing on symptom management and whole-patient support. By carefully considering Oliver's clinical presentation and health history and regularly evaluating his response to treatment, Oliver's veterinarian could set strategic treatment goals and increase the likelihood of a comfortable and successful recovery.

Key goals of Oliver's treatment included:

• Reducing inflammation
• Resolving discomfort
• Supporting recovery through regular monitoring and follow-up communication to ensure appropriate response and timely adjustments if necessary

Oliver's treatment plan featured:

• Subcutaneous fluids to correct dehydration caused by vomiting
• Prednisone to reduce pancreatic and GI inflammation
• Long-acting buprenorphine administered in-clinic for sustained pain relief
• Capromorelin (Elura) to stimulate Oliver's appetite
• Nutritional therapy focusing on a highly-digestible, palatable diet to encourage eating and support gut healing and health

Once treatment was initiated, Oliver demonstrated a marked improvement over the next several days, including a restored appetite. His body condition also improved as he gradually regained weight.

The Value of Real-Time Pancreatic Lipase Testing for Cats

Oliver's case illustrates how to effectively diagnose feline pancreatitis by supporting clinical suspicion with targeted diagnostics. Using a comprehensive approach that combined blood work, real-time testing, and advanced imaging, Oliver's veterinarian was able to connect his subtle signs to this elusive—yet common—condition and provide accurate diagnosis and treatment.

While Oliver's story ends with a conclusive diagnosis, pancreatic lipase testing is equally valuable as a tool to rule out this often hidden condition, which can often overlap with other diseases that have similar symptoms. By quickly eliminating pancreatitis from the differential diagnosis, veterinarians can focus on other potential causes, ensuring faster, more accurate diagnosis, targeted treatment, and better patient outcomes.

Real-time pancreatic lipase testing provides a fast, reliable assessment of pancreatic inflammation, enabling quicker, more informed clinical decisions and rapid intervention. Early detection and treatment increases diagnostic accuracy, reduces complications, and supports faster patient recovery. By incorporating real-time pancreatic lipase testing into a minimum diagnostic database for cats, veterinary teams can expose or rule out this hidden condition, initiate rapid treatment, and improve outcomes for feline patients.

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