Complete Care for Your Aging Cat - Amy Shojai [122]
Pancreatitis has been recognized in cats only in the last decade. Most often, chronic pancreatitis affects middle aged and older cats. “Pancreatitis is a very frustrating disease in cats,” says Debbie Davenport, DVM, an internist with Hill’s Pet Nutrition. The disease is hard to diagnose, and difficult to treat, and there are no good answers about what causes the condition. Since the organ is linked to the intestines and also to the liver, cats suffering from pancreatitis may have concurrent liver or inflammatory bowel disease. “It’s possible that an inflammation can actually move from one organ to the other,” says Dr. Davenport. That makes the disease even more difficult to diagnose and treat.
In dogs, feeding fatty table scraps, obesity, and injury are commonly incriminated. Fatty diets and obesity don’t seem to play a role in the feline disease, although the list of potential causes includes trauma, parasites and toxins, says Susan Little, DVM, a feline specialist in Ottawa, Canada.
Despite these puzzles, more cases are being recognized than ever before. “Part of that is we’re looking for it, and part of it is the advent of abdominal ultrasound,” says Dr. Nelson. “Part of it is that I think for some reason, something has shifted, and it’s causing an increase in the prevalence of pancreatitis in cats. It’s become a significant problem.”
Senior Symptoms
Signs of pancreatitis in cats tend to come and go, and often are quite vague.
Lethargy
Anorexia
Dehydration
Low body temperature
Vomiting
Abdominal pain
Diagnosis
Tests diagnose pancreatitis very well in dogs and people don’t work with cats because the disease reacts differently in the feline body. For example, Dr. Webster says humans with pancreatitis have certain enzyme levels in the blood that consistently go up. “That doesn’t happen in cats,” she says.
Even the symptoms and test results are frustrating. “They’re just tremendously varied. It’s really hard to hang your hat on anything,” says Dr. Little. “The blood work can be highly variable. The signs of illness can be highly variable.”
One of the more recent and promising tests is the feline trypsin-like immunoreactivity (TLI), but most times diagnosis is based on an ultrasound of the cat’s pancreas. Even then, the diagnosis may not be definitive, says Cynthia R. Leveille-Webster, DVM, an internist at Tufts University. “Chronic pancreatitis is an old cat disease that’s really hard to get a handle on without doing surgery and a biopsy of the pancreas.”
Treatment
Currently there is no consensus on the best way to treat feline pancreatitis once it’s diagnosed. Dogs usually have acute disease and are supported with fluid therapy to counteract the dehydration, pain-relieving drugs, medicine to control vomiting, and fasting—withholding food for three or four days. Food stimulates the pancreas to continue releasing enzymes, so fasting helps break the cycle.
But cats with chronic disease have symptoms that come and go. They rarely vomit, and fasting can cause life-threatening hepatic lipidosis. “It’s very difficult to safely fast a cat,” says Dr. Davenport. “Most people feed in the face of pancreatitis.” Other supportive care, such as fluid therapy, or drugs to control vomiting, is offered as needed.
Cats that have a mild form of chronic pancreatitis often benefit from a daily dose of pancreatic enzyme, says Dr. Hoskins. A teaspoon of dried powdered extracts of beef or pig pancreas (Pancrezyme, or Viokase-V) can be mixed in the food given twice daily. If the cat refuses the treated food, the veterinarian may have other alternatives such as raw beef pancreas or a fish-based liquid supplement.
Dr. Webster treats cats on a case-by-case basis. “If the cat’s vomiting every two hours I’m not going to shove food down the throat,” she says. “You can give it some parenteral nutrition through the vein for a couple of days until it calms down a little bit.”
Parenteral nutrition—intravenous nutrition—does not stimulate the pancreas as