What is pancreatitis?
The pancreas is a vital organ on the right side of the abdomen adjacent to the stomach. It produces enzymes to assist in food digestion and hormones such as insulin, which regulates blood sugar or glucose metabolism. When the pancreas becomes inflamed, the condition is called pancreatitis. Pancreatitis occasionally occurs in the cat. When it does, it is often accompanied by inflammation of the liver and intestine. This multi-organ inflammatory process is sometimes referred to as 'triaditis'. This occurs because the inflammation associated with acute pancreatitis allows digestive enzymes to spill into the abdominal cavity.
There is no age, sex, or breed predisposition for pancreatitis. Acute pancreatitis may take either a mild, edematous (associated with swelling) form or a more severe hemorrhagic (bleeding within or around the pancreas) form.
A few cats who recover from an acute episode of pancreatitis may continue to have recurrent bouts of pancreatitis. This is termed chronic pancreatitis.
What causes pancreatitis?
Normally, pancreatic enzymes are produced in an inactive state and travel through the pancreatic duct to the duodenum, part of the small intestine. Once they reach the small intestine, they are activated to begin digestion. With pancreatitis, these enzymes are activated prematurely in the pancreas instead of later in the small intestine. Think of this as a time-release capsule that suddenly bursts before it reaches its intended target; in this case, the pancreatic enzymes begin to digest before they should. This results in the digestion of the pancreas itself, and thus, the clinical signs begin. The clinical signs of pancreatitis are often variable, and the intensity of the disease will depend on the extent of organ involvement.
"In the cat, pancreatitis appears spontaneously without any identified trigger or inciting cause."
In the cat, pancreatitis appears spontaneously without any identified trigger or inciting cause. Pancreatitis may also occur secondary to underlying causes such as inflammatory bowel disease or diabetes mellitus. See the handouts “Inflammatory Bowel Disease in Cats” and “Diabetes Mellitus in Cats” for further information on these conditions.
What are the clinical signs of pancreatitis, and how is it diagnosed?
Common clinical signs include decreased appetite, nausea, vomiting, lethargy, diarrhea, and abdominal pain. If the attack is severe, acute shock or death may occur.
Diagnosis is generally made with laboratory testing. Tests may reveal elevations in white blood cells and/or pancreatic enzymes. In recent years, newer pancreatic tests have become available to diagnose pancreatitis more accurately. The SPEC-FPL test, which stands for Specific Feline Pancreatic Lipase test, can be run in the clinic quickly, providing a positive or negative result. See the handout “Pancreatitis in Cats - Pancreas-Specific Lipase” for further details on this test.
Ultrasound studies are more helpful than radiographs as they show inflammation in the pancreas and surrounding area. Unfortunately, many cats with pancreatitis will elude detection with any of these tests. Consequently, the diagnosis of pancreatitis may be tentative or presumptive in many cases, based solely on clinical signs and medical history.
How is pancreatitis treated?
Successful pancreatitis management depends on early diagnosis and prompt medical therapy. With mild, edematous pancreatitis, treatment is supportive. Intravenous fluids will be given to maintain normal fluid and electrolyte balance and perfuse the pancreatic tissues. Analgesics will be given to control the intense pain. Many cases will also require anti-inflammatory drugs or other medication to control vomiting. Antibiotics will be administered if a concurrent infection is suspected. Many cats with pancreatitis are hospitalized for two to four days for intravenous fluids and medication administration.
"Many cats with pancreatitis are hospitalized for two to four days for intravenous fluids and medication administration."
With severe hemorrhagic pancreatitis, or in cats showing signs of systemic shock, intensive care is necessary using aggressive doses of intravenous fluids and medications to counteract shock. If your veterinarian suspects that the underlying cause may be related to inflammatory bowel disease, your cat may need to remain on a diet suitable for dietary sensitivities. Additionally, further treatment may be warranted if your cat is found to have diabetes mellitus concurrently.
What is the prognosis for a cat diagnosed with pancreatitis?
The prognosis depends on the severity of the disease and the response to initial therapy. Cats that present with shock and depression have a very guarded prognosis. Most mild forms of acute pancreatitis have a good prognosis with early intervention and aggressive treatment.
Will there be any long-term problems?
Most cats recover without any long-term consequences. However, with severe or recurrent pancreatitis, one or more of the following problems may develop:
- If a significant number of cells that produce digestive enzymes are destroyed, a lack of proper food digestion may follow. This is known as exocrine pancreatic insufficiency and can be treated with the daily administration of enzyme tablets or powder in the food.
- If a significant number of cells that produce insulin are destroyed, diabetes mellitus can result. This can usually be treated with daily injections of insulin.
- If the chronic form occurs, there may be repeated bouts of illness that are difficult to diagnose. These cats may have several days of poor appetite, fever, and lethargy. In some cases, diabetes mellitus can ultimately develop.