Pancreatitis in cats

Pancreatitis in cats

When I first became a Veterinarian in 1980, it was thought that pancreatitis was mostly a canine disease (and of course affected people too). It is now widely recognized that pancreatits is actually quite common in cats.  It is, however, not to be confused with the disease in dogs and  people.  Dr. Google will not tell you this fact, but in cats pancreatits rarely presents in the acute fulminating form. Instead it appears as a more chronic, smoldering and recurrent illness characterized by as we vets say, the ADR (ain't doing right) syndrome. 

So what exactly does the pancreas do  you might ask?  The pancreas is a powerhouse of a digestive system gland that produces enzymes to help break down starches, proteins and fats in the small intestine.  It also produces insulin, a hormone that is absolutely necessary for processing sugar absorbed during digestion of the food we eat.  

Together with bile stored in the gall bladder, the 2 organs (pancreas and gall bladder) literally squirt their juices via a single duct into the first part of the small bowel.  This efficient system is also a potential cause of involving other organs when the pancreas becomes inflamed; because there is only 1 common duct, pathology of the pancreas can easily spread down to the small intestine, up to the gall bladder and by extension, to the liver and even stomach. Conversely, pathology with any of these organs can also involve the pancreas. 

So why, you as, is cat pancreatitis different from the disease in dogs, and people? 

In people and dogs, and probably other species, the most common cause of pancreatits is an ascending infection of bacteria that migrate up the ducts from the bowel to the pancreas.  This happens less frequently in cats because of the bacteriostatic (helps to kill or control bacteria) action of the bile in the shared common duct in cats.  

In cats, however, pancreatitis is more often due to inflammation than infection. The inflammation is due to the migration of lymphocytes, and plasmacells to the pancreas where they release chemicals   that effectively damage the pancreatic tissue. To date, no research has determined the exact cause of why this process occurs. It appears to fall into a group of diseases called auto-immune diseases. There are syndromes where our body is stimulated to actually reject our own tissue. Examples of these are Rheumatoid arthritis, Lupus, Spastic colon and Irritable bowel disease.  

In cats, other inflammatory disease are often present at the same time as pancreatitis. Feline Inflammatory bowel disease (IBD) is the most common process diagnosed at the same time as pancreatitis. 

The most common 3 symptoms of both pancreatitis and IBD are vomiting, vomiting and vomiting. Other symptoms are vomiting, (even hair balls) decreased appetite, either diarrhea or constipation, often with the presence of fresh blood or mucus on or mixed in with the feces and abdominal pain. 

Diagnosis is made by careful history taking (most cats with IBD have a long term history of intermittent or frequent vomiting or other gastro intestinal symptoms), stool analysis, lab testing, radiographs and most importantly, an abdominal ultrasound study with or without tissue sampling. 

The gold standard for accurate diagnosis is surgery with multiple biopsies. In an attempt to avoid this aggressive stressful procedure, we utilize all possible non invasive procedure before resorting to surgery. Because of the possible similarity between IBD and Feline Lymphoma, we do occasionally need to proceed with surgery to ensure an accurate differentiation between these 2 diseases. 

Identifying possible food allergies is also part of the history taking; some cats are sensitive to one or more ingredient in their diet, and may benefit from limited ingredient diets.  To date, no evidence exists that "grain free" diets benefit IBD or pancreatitis kitties; we are just exchanging one carbohydrate (wheat, rice, soy) for another (potatoes, lentils). 

Treatment usually consists of either a change to a limited ingredient diet, and / or anti inflammatory agents such as prednisolone, budesonide, or leukeran. These medications moderate but do not cure the inflammation. Because they have potential side effects accurate diagnosis is important. 

Follow up care involves periodic rechecks (exam and lab tests) to ensure there is no adverse reaction to the medication and that it is effectively working. 

At the Scaredy Cat Hospital, our in house diagnostic tools provide our patients with the most expedient and reasonable opportunity for a rapid resolution to these chronic debilitating problems.