Pancreatitis, Feline - contd.
The pancreas is a small organ that sits in the abdominal cavity adjacent to the stomach and the small intestine. It has two main functions. As an endocrine gland, the pancreas produces insulin, a vital hormone. The pancreas is also an exocrine gland that produces digestive enzymes. Normally these digestive enzymes are not activated until they reach the small intestine via the pancreatic duct. The specific cause of pancreatitis in most cats is never determined. However, all cases of clinically significant pancreatitis involve inappropriate activation of digestive enzymes within the pancreas. This results in their release into pancreatic tissue and triggers a profound inflammatory response that is responsible for the signs and complications that occur with pancreatitis. Pancreatitis in cats may be classified as acute, chronic-active, or chronic in nature.
The most common symptoms of cats with pancreatitis are not specific. Most cats will show variable combinations of lethargy, decreased appetite, vomiting, abdominal pain, and dehydration. Jaundice may be seen if secondary changes in the liver are severe, or if bile duct obstruction secondary to inflammation in the pancreas occurs. Pancreatitis may be so severe that cats develop shock or die suddenly because of the disease.
Diagnostic tests are helpful in assessing overall health status, and for identifying additional complicating factors. However, there are no non-invasive tests that are specific for the diagnosis of pancreatitis in cats. Bloodwork, x-rays, and abdominal ultrasound are the most commonly used non-invasive tests to evaluate cases of suspected feline pancreatitis. Tissue biopsy is required for confirmation of the diagnosis, but this is seldom done unless other factors are present that require surgical attention.
Because the diagnosis is seldom definitive, the treatment for pancreatitis in cats is usually supportive and symptomatic in nature. Intravenous fluids, often with dextrose and potassium supplementation, antibiotics, pain medications, anti-vomiting drugs, and antacids are commonly used. Plasma transfusion may be given as well, but its effect on outcome is unknown. If cats are not eating, and vomiting is limited or absent, then nutritional support may be provided with feeding tubes. Surgery may be indicated to address abscess formation or bile duct obstruction if they occur.
The outlook for cats with pancreatitis depends on the severity of the affected animal's disease. Cats with mild clinical signs recover well with supportive care. Severely affected cats may require prolonged and intensive hospitalization if they are to recover. Hepatic lipidosis, or fatty liver syndrome, is a common sequela to severe pancreatitis, so nutritional support is critical to a good outcome. Even with aggressive diagnostics and supportive care, some cats with pancreatitis are either too ill to survive, or they develop life-threatening complications from their illness. Feline patients with severe or chronic pancreatitis may develop diabetes mellitus as a complication because inflammation of the exocrine pancreas may damage the insulin secreting cells of the endocrine pancreas.
