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Pancreatitis in Cats: a silent killer

Pancreatitis (inflammation of the pancreas) is a gastrointestinal disorder that can affect cats. While it’s reported to occur in only 2% of cats, it may be much more common than we think and a recent veterinary study suggests that more than 40% of all cats may be affected. Symptoms in cats are subtle and can be easily overlooked, making it hard to diagnose this silent killer.

Pancreatitis in cats

We spoke with Dr. Michael Sterns of 4Paws Mobile Veterinary Services in Mountain View, CA about questions that come up frequently when cat parents have a sick cat.

The pancreas is part of the endocrine and digestive system, which is vital for the digestion of foods, producing the enzymes that digest food, and producing insulin. Anatomically, cats are different than dogs in that the pancreatic and hepatic ducts empty together into the small intestine, linking the disease to general inflammatory conditions in the bowel and liver.

Cat stretching

What does the pancreas do in cats?

The pancreas has two functions, the first (endocrine pancreas) involves special cells that produce insulin to control blood sugar. The second function, (exocrine pancreas) is to produce the precursors to the enzymes that help to digest food. It is the exocrine pancreas that is involved in pancreatitis when the enzymes are activated abnormally early within the pancreas, causing digestion of the organ itself.

What symptoms should I watch for in my cat?

There are a variety of symptoms that a cat might present with including: vomiting, anorexia, weight loss, abdominal pain, dehydration.

When should a pet parent contact a veterinarian?

If your cat has vomited multiple times in one day, or several times a day for 2-3 days, he/she should be seen by a veterinarian to treat dehydration, acid reflux and nausea.

Tabby cat laying down outside with pancreatitis

What are the possible causes of pancreatitis?

We don’t know exactly what causes pancreatitis. Most cats vomit or regurgitate periodically with or without a hairball. Perhaps a reflux of gut bacteria into the pancreatic duct triggers a local inflammation. It is known to be linked to inflammatory bowel disease (IBD) in cats, and one of the IBD treatment corticosteroids treats both conditions. Untreated it can lead to EPI or exocrine pancreatic insufficiency, with loose stool or diarrhea and gradual wasting away.

It’s still early for understanding the role that the gut microbiome may play in pancreatic disease. However, a recent study showed that people with chronic pancreatitis and pancreatic cancer differ in the composition of bacteria in saliva samples compared to healthy people. And several studies have found that the microbiome affects the development and expression of pancreatitis in laboratory animals. As microbiome testing has become more widely available and fecal microbiota transplantation (FMT) is now an accepted and effective approach for resolving a range of different gastrointestinal diseases, more research insights are eagerly anticipated.

Cat sleeping

Pancreatitis might be more common in cats than we think

I think pancreatitis is much more common, because I examine many sick cats. The typical affected cat is usually greater than ten years of age and has been losing weight for several months. Many of them have recently begun to vomit and or regurgitate more frequently. In my experience vomiting is a very important indicator, and these cats are generally dehydrated. Without lab work it’s difficult to differentiate these cats from cats with chronic kidney disease (CKD). Pain in the abdomen over the pancreas is variable, and many cats just don’t like being poked and prodded in their belly.

What tests are typically done if pancreatitis is suspected?

The definitive diagnostic tool is a blood test called Spec fPL from IDEXX Labs, one of the largest vet lab services. It is a quantitative measure of a specific enzyme activated in acute pancreatic inflammation. Measuring Vitamin B12 levels has also been recommended, but I don’t find it extremely useful, since I treat them all with B12 anyway.

Cat in tree

How is it usually treated?

The first order of business is to rehydrate with fluids, either IV or under the skin. We give medication to prevent nausea and acid reflux, so that the cat’s appetite can return to normal. Corticosteroid injections help reduce pancreatic inflammation and also treat concurrent IBD, for which there is no direct diagnostic test, other than exploratory surgery and biopsy.  I usually treat cats with pancreatitis for 7-10 days orally, and plan on revisiting their health in 14 days. Some cats become chronic and experience periodic bouts of nausea and vomiting.

If a cat with chronic pancreatitis also has an imbalance in gut bacteria (based on a microbiome testing assessment), then restoration of the gut microbiome via fecal transplant might be advisable.  

Any other tips/suggestions for pet parents to aid in their cat’s recovery or aftercare?

Watch for signs of lack of appetite and treat with anti-nausea medication for several days. Once you  know that your cat has the disease, you can be more vigilant about it. If you treat early and avoid dehydration, the course of the disease is much shorter.

Cats recovering from pancreatitis

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