Pancreatitis, Feline - contd.
Because the signs are not specific, pancreatitis is seldom diagnosed unless it is suspected to be present. Bloodwork test results may range from normal to profoundly abnormal. On the complete blood count, possible abnormalities include an elevated white blood cell count, low red blood cell count, and reduced platelet count. Biochemistry profile abnormalities may include unusually high or unusually low blood glucose levels, elevated liver enzymes, elevated kidney values, and abnormal sodium, potassium, chloride, and calcium concentrations. The two most commonly measured pancreatic enzymes, amylase and lipase, which are helpful in diagnosing pancreatitis in the dog, have been shown to be of minimal value in diagnosing the disease in cats. Another blood test called trypsin-like immunoreactivity, or TLI, may be sensitive for diagnosing feline pancreatitis. However, studies have shown that it is not always reliable in predicting the severity of the disease. Furthermore, obtaining TLI results requires several days; therefore this test can seldom be useful in the initial evaluation of a cat with possible pancreatitis. Additionally, serum TLI can be abnormally elevated in conditions other than clinically significant pancreatitis.
Abdominal x-rays and ultrasound may help to rule out other causes for symptoms in cats with pancreatitis. However, results of these tests are seldom specific for the diagnosis. X-rays may show reduced structural detail in the abdomen or a mass effect in the area of the pancreas. Abdominal ultrasound studies may reveal unremarkable findings, non-specific changes in the area where the pancreas is normally seem, mass lesions in the area of the pancreas, or abdominal fluid accumulation. Yet none of the positive findings are specific to the diagnosis of pancreatitis in cats. If abdominal fluid is present, measurement of amylase and lipase concentrations in the fluid may help in the diagnosis.
Ultimately, tissue biopsy is the most definitive way to diagnose pancreatitis in cats. However, many cats are so ill that surgical biopsy is too high-risk for diagnostic purposes alone. If other tests suggest the presence of abnormalities that are best addressed surgically, the diagnosis can be confirmed during exploratory abdominal surgery. Surgery may also allow for feeding tube placement into the small intestine for nutritional support in cats with severe pancreatitis.
