Pancreatitis, Feline - contd.
There is no established, uniform way to treat pancreatitis, even when tissue biopsy confirmation of the diagnosis is available. Treatment is generally supportive, with attention focused on meeting fluid needs with intravenous support, preventing infection, providing nutritional support, and treating symptoms while waiting for the signs to resolve.
Intravenous fluids are used first to correct shock or dehydration, and then to meet the maintenance fluid needs of cats with pancreatitis. Fluids can be supplemented as needed with dextrose and potassium to correct abnormally low blood sugar readings, and abnormalities in potassium concentrations, respectively. Vitamin B-12 is often added to the fluids. Plasma transfusion may help to support good blood flow to the pancreas.
The use of antibiotics in cats with pancreatitis is controversial. Most veterinarians use antibiotics to treat complications from secondary infections. However, there is no data that either supports or detracts from their use in this disease. Similarly, corticosteroids may be given to animals in shock, but their value in more stable cats with pancreatitis is unknown.
Cats may not show obvious signs of abdominal pain. If abdominal pain appears to be present, analgesic medications are often given. Pain medications can have side effects that complicate the management of seriously ill cats, and should be used cautiously and with close supervision for unexpected changes.
If vomiting is a problem, cats with suspected pancreatitis may be treated with anti-vomiting medications administered by injections under the skin or in the intravenous fluids. Antacid medications are also frequently used in vomiting patients.
Nutritional support is another controversial point for cats with pancreatitis. If vomiting is present, it is generally agreed that cats should not be fed. In dogs with pancreatitis, all oral food and water is usually suspended for several days once the diagnosis is made. However, cats may do better with more aggressive nutritional support early on, as long as vomiting is not present. Since many cats with pancreatitis refuse to eat on their own, nutritional support may be provided through a feeding tube placed into the nose or directly into the stomach. Nutritional support may be provided intravenously to patients that are vomiting, but parenteral nutrition is cumbersome and of limited availability.
Surgery is usually not a primary treatment for pancreatitis. However, abscess formation, bile duct obstruction, and other complications may require surgery. Surgery also enables biopsy confirmation of pancreatitis. In cats with persistent vomiting, feeding tubes may be placed into the small intestine at the time of surgery to allow for nutritional support.
