Pancreatitis (inflammation of the pancreas) is a gastrointestinal disorder that affects cats. While it’s reported to occur in only 2% of cats, it may be much more common than we realize, and a recent veterinary study suggests that over 40% of all cats could be affected. Symptoms of pancreatitis in cats are subtle and can be easily overlooked, making this silent killer difficult to diagnose.
We spoke with a licensed veterinarian to learn more about what happens when the pancreas stops working as it should.
What does the pancreas do in cats?
The pancreas can be divided into two major components: endocrine and exocrine. Endocrine pancreatic tissue produces insulin and other hormones, then releases them into the bloodstream. Exocrine pancreatic tissue manufactures the chemical precursors that will later become digestive enzymes. These enzyme precursors travel through a special pancreatic duct, or channel, to reach the intestines so that food can be broken down.
Feline pancreatitis usually impacts the exocrine pancreatic tissue, and it occurs when those enzyme precursors are activated too early, causing the pancreas to digest itself.
What symptoms should I watch for in my cat?
There are a variety of symptoms that a cat might display, including vomiting, anorexia, weight loss, abdominal pain, and dehydration.
When should a pet parent contact a veterinarian?
If your cat has vomited more than twice in a single day, or hasn’t eaten for more than 24 hours, they should be seen by a veterinarian for treatment and supportive care.
What are some possible causes of pancreatitis?
Like many complex conditions, pancreatitis in cats often has multiple underlying causes. Conditions like liver disease or inflammatory bowel disease (IBD) lead to inflammation in this area where these three important organs, as well as the small intestine, are all located. This is referred to as “triaditis.”
Another condition that often co-occurs with pancreatitis is diabetes mellitus, which impacts blood sugar regulation. Diabetes, which primarily impacts the endocrine pancreatic tissue, can also damage the exocrine pancreatic tissue, and in this way, the diabetes and pancreatitis amplify each other’s effects, creating a dangerous spiral.
Though certain contributing factors may play a role in a cat’s development of pancreatitis, in many cases, we can’t identify the precise cause. These cases are referred to as “idiopathic.”
Pancreatitis in cats is known to be linked to inflammatory bowel disease (IBD), and for this reason, some IBD treatments (such as corticosteroids like prednisolone or budesonide) are used to treat pancreatitis as well. When clinical signs are left untreated, severe pancreatitis can lead to a condition called exocrine pancreatic insufficiency, or EPI, a chronic illness which often appears as loose stool or diarrhea and gradual weight loss (“wasting away”).
Pancreatitis and the microbiome
Scientists are still early in their understanding of the role that the gut microbiome plays in pancreatic disease. Interestingly, a recent study showed that pancreatic cancer patients have different bacteria in their mouths compared to healthy people. And several studies in laboratory animals have found that the microbiome affects the development and expression of pancreatitis as well.
As microbiome testing and fecal microbiota transplantation (FMT) become more widely available methods of understanding and addressing gastrointestinal diseases, we eagerly await more insights into the connection between the pancreas and the microbiome.
Keep reading for insights from an experienced veterinarian, Dr. Michael Sterns.
Pancreatitis might be more common in cats than we think
“I think there are many more cases of pancreatitis than what’s reported,” says Dr. Michael Sterns. Dr. Sterns notes that advanced age is a major risk factor, with most affected cats being older than ten years of age. In a typical case of chronic pancreatitis, the cat has likely been losing weight for several months. Many felines have recently begun to vomit and/or regurgitate more frequently.
“In my experience, vomiting is a very important indicator, and cats with pancreatitis are generally dehydrated. Without lab work, it’s difficult to differentiate cats with pancreatitis from cats with chronic kidney disease (CKD).”
What tests are typically done if pancreatitis is suspected?
To get a definitive diagnosis of pancreatitis, blood work is generally sufficient. Biopsies, x-rays, and abdominal ultrasounds can be valuable tools, but they are not always definitive. Instead, veterinarians rely on a diagnostic test of the blood called fPLI (Feline Pancreatic Lipase Immunoreactivity), which measures a specific digestive enzyme that is activated when the pancreas is inflamed.
Measuring Vitamin B12 levels with a blood test is also sometimes recommended, but because supplementation is so safe and inexpensive, Dr. Sterns generally administers B12 injections to all cats with potential pancreatitis, without testing.
Pancreatitis Treatment in Cats
In mild cases, support can often occur at home by the pet parent. But Dr. Sterns states that in more severe cases, “The first order of business is to rehydrate, often with intravenous fluids. We also give medications like Cerenia (maropitant) to prevent nausea and acid reflux, so that the cat’s appetite can return to normal. Corticosteroid injections help reduce pancreatic inflammation and, as an added bonus, can also alleviate symptoms of IBD if they are present. I usually treat cats with pancreatitis for 7-10 days orally, and plan on rechecking their health in 14 days.”
He adds that while some cats experience acute pancreatitis, which is sudden and severe, other cats develop chronic pancreatitis, and this latter group may experience periodic bouts of nausea and vomiting.
The data is mixed on whether a low-fat diet is important for cats with pancreatitis. Because pancreatitis frequently causes a loss of appetite, strategic nutritional support is key. In more severe cases, potentially deadly complications like hepatic lipidosis can occur. (This is a life-threatening condition where fat accumulates in the liver.) Some cats may need appetite stimulants or a temporary feeding tube to encourage them to resume their normal eating habits.
If a cat with chronic pancreatitis also has an imbalance in gut bacteria (based on the results of a microbiome testing assessment), then restoration of the gut microbiome via fecal transplant might be advisable as well..
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 noticing clinical signs. Pancreatitis is a treatable condition, and cats do recover with early treatment and sufficient hydration.”
Key Takeaways
Pancreatitis generally impacts the digestive component of the pancreas, and it occurs when the enzymes from the pancreas begin to digest the pancreas itself.
Many different risk factors can result in pancreatitis, including disease or inflammation in other closely located organs like the liver or the small intestine.
Imaging technologies like abdominal x-ray or ultrasound may aid in diagnosis, but ultimately, a blood test provides the definitive answer.
One priority when treating a cat with pancreatitis is restoring normal fluid and electrolyte balance and providing sufficient nutrition.
With early detection and swift treatment, the prognosis for a cat with mild to moderate pancreatitis is typically very good. More chronic, severe cases are often more difficult to manage.
Frequently Asked Questions
What is the red flag for pancreatitis? Lethargy, nausea, and abdominal pain are some of the most common indicators of pancreatitis in cats.
What foods cause pancreatitis in cats? While some believe that diets especially high in fat are more likely to trigger pancreatitis in cats, other researchers have found that dietary fat may not play as significant of a role for feline pancreatitis as it does for the condition in dogs.
Will pancreatitis go away on its own? Very mild cases of pancreatitis may resolve without intervention, but if you suspect that your cat may be dealing with pancreatitis, taking them to the veterinarian is advised.
Can cats live without a pancreas? The pancreas plays key roles in the digestive and endocrine systems, so a cat without a pancreas would struggle in many respects.
Can stress trigger pancreatitis in cats? Pancreatitis in cats is usually multifactorial, meaning that there are a number of different contributing factors. Stress can certainly be one contributing factor.
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