Cats Are Unique

You might have heard the saying "Cats are not small dogs," and the adage certainly rings true when it comes to how these two species present when affected by pancreatitis. For example, in feline patients, the disease tends to be more recurrent or chronic vs. a singular acute episode. The disease is not associated with dietary factors like it is in dogs.

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In chronic pancreatitis, signs can be subtle or difficult to discern from those that indicate other metabolic, endocrine, or gastrointestinal pathology. In cats, the disease is often accompanied by concurrent conditions such as diabetes mellitus, inflammatory bowel disease, or hepatopathy. In fact, multiple organ involvement is so common in cats that we use the term "triaditis" to describe and refer to inflammation of three specific organs—the pancreas, the small intestine, and the liver. Pancreatitis is a multifactorial disease and without specific tests such as pancreatic lipase, it can be very challenging to determine whether the pancreas is involved and should be included in the treatment plan.

Pancreatitis Symptoms in Cats

Clinical signs of pancreatitis in cats can be more subtle and trickier to detect than in dogs. The more obvious symptoms include lethargy, anorexia, vomiting, weight loss, abdominal pain, and dehydration. Less obvious signs include over-grooming on the abdomen, anxiety, and behavior changes. With feline recurrent or chronic pancreatitis, any one of these symptoms may occur—often only intermittently—making it difficult to diagnose the disease with exam, history, and clinical signs.

Because symptoms come and go, cat owners often have difficulty deciding or recognizing when to bring their cat for a veterinary exam, and by the time they do, the cat may no longer be symptomatic. Since the symptoms in these cats are inconsistent and often subclinical, having a way to test for pancreatitis is critical to making the diagnosis and improving their quality of life.

Reaching a Diagnosis

The sooner this problematic disease is diagnosed, the earlier we can institute treatment, providing the best chance to reduce the severity and escalation to fatal disease or chronicity. Diagnosis of pancreatitis is based on clinical suspicion (from exam and history details), information from a minimum data base, and more specific testing to evaluate pancreatic lipase. In some cases, if lab results do not yield a definitive diagnosis, abdominal imaging such as an ultrasound or radiographs are important to provide a look at the abdominal organs and help rule out other diseases such as a GI foreign body. Laparoscopy or an exploratory laparotomy may be warranted to evaluate for concurrent disease of the small intestines or liver.

Pancreatitis is an unpredictable disease in cats and carries a guarded prognosis because we can't be certain how or when it will escalate. Pancreatic lipase testing helps veterinarians confirm pancreatitis is present in order to take the necessary steps to prevent escalation. Treatment is geared at maintaining pancreatic perfusion, reducing inflammatory mediators, preventing bacterial translocation, providing enteral nutritional support, and managing the patient's pain. Individual treatment will vary based on the severity of the disease and whether the patient is consuming adequate food. Once treatments are instituted, pancreatic lipase testing can be used to assess progress, guiding veterinarians on how to adjust the patient's medications and overall treatment plan.

CBC and Chemistry

It's important first to establish a minimum database when beginning testing—that's where a complete blood count (CBC) and chemistry come in. Some cats may experience changes in the CBC indicating dehydration or inflammation. The other values included in the chemistry of a minimum database can help to detect concurrent disease involving the liver or endocrine system.

Abdominal Imaging

Imaging such as an abdominal ultrasound or radiographs are also necessary to diagnose pancreatitis. This allows veterinarians to visualize the pancreas and look for changes that indicate inflammation, such as swelling or evidence of peripancreatic fluid accumulation. However, changes are typically more obvious in cases of acute and severe pancreatitis vs. the more chronic type that commonly affects cats. Abdominal imaging is also important to rule out other causes of the clinical signs such as foreign body or other abdominal disease.

Pancreatic Lipase

Pancreatic lipase testing detects lipase released from the pancreas, which is elevated in cases of pancreatic inflammation and disease. In the past, testing options often necesitated a waiting period for results when having them sooner would be better. The good news is that expanded in-house analyzers now include a pancreatic lipase test. This test is efficient and convenient (and done at the practice)—meaning cats who are clinical for pancreatitis or exhibiting nonspecific signs, can now be evaluated in less than 10 minutes with a single slide added to your chemistry panel. New testing provides quantitative results allowing veterinarians to confidently confirm diagnosis and begin treatment as quickly as possible.

Educating Pet Owners

Pancreatitis is a common yet complicated condition that detracts from the quality of life and longevity of our feline patients. In many cases, cat owners are unaware their furry family member is experiencing this inflammatory disease. But, educating and engaging clients in what to look for can aid in early detection and diagnosis and improve prognosis. Consider sharing helpful data and background information about pancreatitis to encourage pet owners to look for symptoms and seek testing right away if they notice anything unusual.

Sources:

Forman MA, Steiner JM, Armstrong PJ, et al. ACVIM consensus statement on pancreatitis in cats. J Vet Intern Med. 2021;35(2):703-723. doi:10.1111/jvim.16053

Forman MA. Pancreatitis in cats. In: Textbook of Veterinary Internal Medicine Expert Consult. Vol 2. 9th ed. Elsevier; 2024:1869-1874.

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