26 May Feline Pancreatitis- Chronic and Acute- Signs and Treatment
Pancreatitis is an inflammation of the Pancreas. Pancreatitis can be mild and intermittent (the cat who vomits “hairballs”, food or fluid sometimes), to mild and chronic (the cat who vomits hairballs, food or fluid routinely) to Severe and Life Threatening (persistent vomiting, lack of appetite, inactivity) . In a recent study, 80% of older cats who died of causes unrelated to their pancreas had some degree of pancreatic inflammation– it’s THAT Common!
The primary jobs of the pancreas are 1) to secrete insulin into the bloodstream to regulate glucose metabolism and 2) to secrete digestive enzymes into the digestive tract. The pancreas in the cat is intimately associated, physically, with the liver, gall bladder, and small intestine. Consequently, if any of those organs becomes inflamed, the pancreas can, and often does, become secondarily involved. Add to that the fact that many cats develop all kinds of inflammatory conditions for reasons that we veterinarians mostly don’t understand (likely owing to the cat’s very unique nervous system– it’s hard to be both a predator and prey species!). So, there are lots of opportunities for the pancreas to become inflamed!
What happens when the Pancreas becomes inflamed?
1) Insulin secreting cells become over run by inflammatory cells that secrete damaging enzymes, killing the Insulin secretors. Less insulin means a cat can become diabetic. This diabetic condition may be transient– persisting only as long as the pancreas is inflammed- if only a few of the insulin cells get killed off. Or diabetes can become permanent if too many cells were killed off and can’t regenerate due to ongoing inflammation.
2) The digestive enzyme secreting cells get damaged by the inflammatory enzymes. Their cell walls become leaky, releasing digestive enzymes into the surrounding tissues, destroying (digesting) the cat’s own tissues! This is part of the process of “Acute, necrotizing pancreatitis”. This is the life threatening form.
Since the process is on going, waxing and waning, there can be any degree of either of those processes going on at any one time.
Signs of chronic pancreatitis:
- Intermittent Vomiting (of anything)
- Occasional diarrhea
- Weight loss related to intermittent poor (“finicky?”) appetite
- Abdomenal pain- which may look like intermittent crankiness, vocalization when picked up, or hiding more
- Signs of Diabetes: increase drinking and urinating, ravenous appetite, sometimes with weight loss
- Freqent vomiting, depression and complete lack of eating and drinking
Diagnosis can be tricky
The best test for pancreatitis in cats called a Feline Pancreatic Lipase test. It’s run on a blood sample. There is a screening test that your veterinarian can run in house. A more detailed test can be run at the lab. That’s the easy part. The tricky part is that any inflammatory condition related to the small intestines, liver, gall bladder OR pancreas can cause the pancreas to excrete excessive amounts of Pancreatic Lipase. So, yes, the test may tell you that the pancreas is upset, it doesn’t tell you that the pancreas is the primary problem. Your veterinarian will have to put all of your cat’s symptoms and history together to determine the best way to manage your cat’s level of pancreatitis– and any other coexisting conditions!
Treatment for Mild, Chronic Pancreatits is still being perfected
Reducing inflammation, long term is the objective.
Special Diet: Some cats respond well to a High Protein, low carbohydrate diet– this is the most natural for cats, anyway
Some cats respond better to a hypoallergenic diet – maybe there is an allergic component to their inflammation?
Antioxidants: Nutritional supplements that reduce the oxidative aspect of the ongoing inflammatory process may be helpful:
High potency Omega 3 EPA, Sam-e, silymarin, Vitamin C, Vitamin E, Cobalamin
Which products your veterinarian recommends for your kitty depend on safety (Vitamin E can be toxic) , cost (the most effective brands are more expensive in Sam-E and silymarin), practicality (some are by injection), and simply what the cat will tolerate!
Intermediate Pancreatitis- when diet/ supplements aren’t enough
Anti-inflammatory medications may be indicated. Prednisolone is the most commonly used anti-inflammatory for cats. However, it is not the best choice for diabetics because steroids cause insulin resistance. This is not good in a patient that is already borderline diabetic or may be diabetic, receiving insulin therapy. Fortunately, there is another anti-inflammatory, Atopica, specifically formulated for cats, that has been showing great promise in pancreatitis kitties! (Ask your vet about this, if they haven’t mentioned it yet! Not all vets are used to using this medication for this condition!)
Treatment for Severe Pancreatitis needs to be in the Hospital
Intravenous fluids, anti-inflammatories and pain medications are important to start the recovery process. Vomiting often needs to be treated with injectable medciations. Cats often need feeding tubes placed via a short surgical procedure to ensure theyget enough calories to heal when they are not feeling like eating on their own. Medications are given either by injection or feeding tube to help stimulate the return of normal eating as quickly as possible.
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