Pancreatitis

Pancreatitis

This is the pancreatitis section, designed to help you look at living examples of this disease and other GI
conditions. Each cat has different dietary needs, medications, treatments, etc. As you will see, it's not an easy
road, some thrive and some have a much harder time. But the purpose of this section is to help you shed some
light as to what possibly could have started your kitty's pancreatitis and maybe help you find some answers and
support so that your kitty can live a long, happy and healthier life from this day forward. If you are a veterinarian
or are currently working on research for feline pancreatitis, please take some time to examine each case study.
This section is here to provide you with knowledge outside of your practice or research center and eventually
give you some statistics as to how prevalent this disease is and the complications from it really are.

We're looking for more cats to document on this site as a way of letting researchers, universities, veterinarians
and the public know what kind of treatments, foods, age group, etc., that these cats are falling into. If you would
like to contribute information on your cat for this sections, please follow instructions provided here:
www.ibdkitties.net/caseinstruct ions .html

*A special note on this article. Although pancreatitis is a very serious and scary disease, the information provided
here is in no way meant to panic or frighten anyone. In trying to provide the correct information and the
importance of testing and treating this condition, I’ve tried to be very thorough in explaining the inner workings of
the pancreas. I’ve also used some of the kitties from this site, both living and passed, in certain examples.
Although many frightening things can and sometimes do happen with disease of the pancreas, cats that are
treated early and properly enough can lead a full and healthy life.

The pancreas is a tricky organ to keep tabs on. Because of its position in both humans and animals (just under
the stomach), it’s very difficult to diagnose any problems and often disguises any inflammation viewed through x-
rays, endoscopic surgery or ultrasound. Its two main functions include the production of metabolic hormones
(insulin and glucagon which regulate blood sugar) and the production of digestive enzymes. Those enzymes are
secreted through a special duct into the intestine to digest our food. In cats, the pancreatic duct joins with the
common bile duct from the liver, so both bile and pancreatic fluid, which is rich in digestive enzymes enter the
intestine from the same location.

X-rays can be inconclusive in the diagnosis of pancreatitis and sometimes isn’t worth the money or stress on the
cat. Ultrasound is a better tool and often shows an enlarged pancreas surrounded by fluid, which confirms the
diagnosis. When doing ultrasound, make sure to have a board certified, licensed and experienced
ultrasonographer performing the tests. They’ll know what to look for and how to spot any inconsistencies in the
size and texture of the pancreas.

I highly recommend getting both an ultrasound and a Spec PLI (pancreatic lipase) run. Lipase is one of the
pancreatic digestive enzymes with small traces that are normally present in the circulation. These levels jump
dramatically in pancreatitis, giving a clear diagnosis without invasive tests. Alex’s two ultrasounds showed no
inflammation in the pancreas, only the liver. But months later, her PLI showed a positive result and a bacterial
overgrowth. Another cat was the opposite. His PLI showed no disease yet when his parent insisted on running
an ultrasound, the results were positive and he was hospitalized, which saved his life. That insistence was due
in part to the sudden downturn and death of my Alex and sparked many to get their cats tested again and with
both tests run. Although I lost my girl, thankfully because of her, some lives were saved. I also recommend re-
testing every two to three months and staying hyper vigilant in regards to this issue.

Because Alex was found to have bacterial overgrowth with the results of her PLI serum tests, her vet has stated
that she most likely died of a massive viral infection. The theory is that these bacteria are able to crawl up the
pancreatic duct and cause infection in the pancreas. When the pancreas gets inflamed, the enzymes escape and
begin digesting the pancreas itself. The living tissue becomes further inflamed and the tissue damage quickly
involves the adjacent liver. Toxins released from this tissue destruction are released into the circulation and can
cause a body-wide inflammatory response resulting in infection. For this reason, digestive enzymes should only
be given under the care of a veterinarian and closely monitored as it can quite frequently exacerbate the
digestive process. Even the vet won’t know for sure how it will affect your cat’s pancreas, but they can monitor
your kitty closely and know which changes warrant either continuing the enzymes or halting their use.

Pancreatitis is a chief risk factors for developing what’s called disseminated intravascular coagulation or DIC.
DIC is a massive uncoupling of normal blood clotting and clot dissolving mechanisms. This leads to simultaneous
bleeding and clotting of blood throughout the body, which can eventually lead to heart failure. After speaking with
several vets, we think this may be what caused Purr Panther’s untimely passing. Again, its just guesswork but
many vets have seen this before and can make an educated guess about the circumstances. Plasma
transfusions can sometimes be helpful to replace the clotting factors needed to prevent DIC as well as natural
blood factors to deactivate pancreatic enzymes.

Pancreatitis can be acute or chronic. Acute cases can reverse completely but tend to be much more severe than
chronic. Lethargy, depression, appetite loss, abdominal pain, nausea and vomiting are consistent signs.
Crouching in a meatloaf position is indicative of abdominal pain and lip smacking almost always suggests severe
nausea and that the cat will vomit shortly thereafter. Pancreatitis is painful and your vet should prescribe pain
medications for you to administer at home along with subcutaneous fluids to avoid dehydration.

Approximately 40% of cats with hepatic lipidosis have pancreatitis as the underlying cause. Hepatic lipidosis,
(fatty liver disease), is liver failure that develops from appetite loss/inadequate calorie intake and complicates
pancreatitis tremendously. The treatments usually recommended for pancreatitis involve withholding food for 48
hours but with fatty liver disease, you risk severe liver failure, infection and even death.

Exocrine pancreatic insufficiency is the insufficient secretion of digestive enzymes, usually due to loss of the
exocrine tissue from idiopathic atrophy (unknown cause of muscle mass). It can lead to acute or chronic
inflammation and causes maldigestion and malabsorption with diarrhea, steatorrhea and weight loss.
Steatorrhea is excess fat in the feces due to malabsorption caused by disease of the intestines. The feces are
bulky, greasy, foul smelling and pale in color. It was never diagnosed, but I now know this is what Alex had in the
last week or two of her life. I thought she was going to the bathroom very well, because she never had diarrhea
or constipation. But her stools became more and more pale and large, which means that she wasn’t absorbing
any nutrients at all.

Alex’s case was extreme as she suffered from triaditis. Those with triaditis have a much poorer prognosis.
Because we don’t know which disease really occurred first, it’s hard to tell if she could have really ever
recovered. A biopsy was a huge risk because of bleeding in the liver and probably would have killed her early
on. And a necropsy won’t always tell an exact cause of death with these diseases.

Learning the signs of distress from your cat can help to facilitate that early treatment. Pacing around the room,
crying, huddling and rapid breathing. Putting what’s called their third eyelid up, the coated film on their eyes
beginning to close. Those are signs of extreme pain and disorientation. Fever, accompanied by a quick
temperature drop are usually a sign that organ failure has started and the body is shutting down. Get your cat to
a vet or an ER immediately if they exhibit any of these signs. Cats are the smartest animals at hiding their
illnesses and are notorious for not showing any symptoms at all, even if they’re very sick. Learning to recognize
different behavior patterns and any changes in their diet, stools, coloring, etc. is the best way to tell if they need
to be seen by a vet. Please see Alex's medical history page for more information on pancreatitis and her other
conditions: http://ibdkitties.net/Alexmedicalhistory.html.

Some materials used in this article were written and provided by:
Dr. Wendy C. Brooks, DVM, DipABVP
www.marvistavet.com/html/pancreatitis.html
www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=577

Although this website is based on information about pancreatitis for humans, it’s got an enormous amount of
information on just how the pancreas works, what exactly each enzyme does, different levels of enzymes, etc.
www.medical-dictionary.thefreedictionary.com/pancreatic+hypertrophy

Here are some links on feline pancreatitis, some are from medical journals and veterinary articles:
www.vetinfo.com/cpancrea
www.manhattancats.com/Articles/pancreatitis_test
www.idexx.com/pubwebresources/pdf/en_us/smallanimal/reference-laboratories/spec-fpl-treatment-for-feline-
pancreatitis.pdf
www.idexx.com/animalhealth/laboratory/specfpl/0969115.pdf
www.vetcentric.com/reference/encycEntry.cfm
w ww.veterinarymedicine.dvm360.com/vetmed/article/articleDetail.jsp?id=313764&pageID=1&sk=&date=
www.ncbi.nlm.nih.gov/pmc/articles/PMC1111363/
www.felineoutreach.org/Education/Pancreas.html
www.vin.com/proceedings/Proceedings.plx?CID=WALTHAMTNAVC2003&PID=3670
www.peteducation.com/article.cfm?c=1+1329&aid=334
www.vin.com/VINDBPub/SearchPB/Proceedings/PR05000/PR00114.htm
www.vet.uga.edu/vpp/clerk/west/index.php
www.tddslab.co.uk/tddsexeter/downloads/PLI_TLI_pancreatic%20disease.pdf
vetmed.tamu.edu/gilab/research/pancreatitis-information
Pancreatitis in Cats
www.petmd.com/blogs/nutritionnuggets/cat/jcoates/2012/nov/pancreatitis_in_cats?
utm_source=Newsletter&utm_medium=Email&utm_content=20121123&utm_campaign=NutritionNuggets-
pancreatitis-in-cats#.ULfQeKzAfEt

These are fantastic sites as they have pictures to show the normal pancreas and the inflamed pancreas:
www.soundvet.com/academy-of-imaging/case-studies/feline-pancreatitis
www.all-about-cats.com/pancreatitis.htm
www.felipedia.org/~felipedi/wiki/index.php?title=Pancreatitis
Great article written by a vet:
Real reason not to give begging pet those table scraps: Pancreatitis
www.kearneyhub.com/life/article_2af82982-0d0a-11e1-8265-001cc4c002e0.html

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