If the condition ‘pancreatitis’ was a person, he’d be a grumbly pessimist who makes life a misery. Indeed, when describing pancreatitis this condition has so many different faces and outcomes that it’s hard to know where to start. So let’s begin by understanding what the pancreas does.
What is the Pancreas?
The pancreas is an organ that sits in the front of the abdomen, snuggled up to the loop of gut (the duodenum) that exits the stomach. The pancreas has two main jobs, which are producing digestive enzymes and insulin. These two groups of chemicals are stored by different cells within the same organ, (like keeping orange juice and milk in the same fridge).
When the cat eats a meal the pancreas releases the digestive enzymes, amylase and lipase, into the duodenum where their job is to digest food. Just like stomach acid, lipase and amylase are highly corrosive and need to be stored carefully. If they leak in to the surrounding tissues they will digest that tissue – which is exactly what happens with pancreatitis.
In pancreatitis, the organ becomes inflamed which makes it leaky. This allows the amylase and lipase to ooze out and bathe the pancreas in digestive enzymes. Depending on how severe the inflammation is, the resulting pancreatitis can be mild and grumbly (the commonest form) or so serious that it’s potentially life threatening.
What are the Signs of Pancreatitis?
This is where my analogy to a grumbly pessimist comes in, because the commonest form of pancreatitis is associated with a rumbly, grumbly, tummy ache. The discomfort is worse after the cat eats (because food in the stomach stimulates the production of digestive juices) and so the cat goes off her food.
So what might you notice if your cat has low-grade pancreatitis?
- Quiet and depressed: Cats hide pain so a natural reaction is to seem, “Not quite right,” and withdraw.
- Lack of appetite: She associates eating with pain and goes off her food.
- Sickness: Some cats will vomit or have diarrhoea.
- Weight loss: If her appetite is poor for long enough she’ll lose weight.
What I’m describing above is “chronic” pancreatitis, which is less severe than the “acute” form.
Acute pancreatitis comes on suddenly and the cat may be very ill indeed. Acute pancreatitis is associated with massive inflammation, the release of lots of enzymes, and all sorts of serious complications such as tiny blood clots causing organ damage and failure.
The signs tend to be those of a weak, lethargic or even collapsed cat that shows no interest in food, has a painful abdomen, and may vomit. Of course these signs are quite general and can arise for other reasons other than pancreatitis. But whatever the cause, if you cat is unwell you must seek prompt veterinary attention.
How Common is Pancreatitis?
It’s more common than you might think. Experts believe around 75% (yes, three-quarters!) of all cats suffer at least one episode of pancreatitis during their lifetime. This figure is high, but many times the problem is so mild that the only sign is the cat’s appetite dipping and she then makes a full recovery.
How is Pancreatitis Diagnosed?
Your vet will be suspicious based on the cat’s history of poor appetite and lethargy, especially if the front of the cat’s abdomen is tender or painful. The next step is to run blood tests to check out organ function and the immune system, plus a special test looking at levels of pancreatic hormones in the blood stream.
The latter test gives a Yes / No answer as to whether pancreatitis is likely or not. If the vet wants to know how serious the condition is, he then sends the sample to an outside lab to measure the exact amount of leakage.
Additional tests may be necessary, especially if the cat is very sick. Of these the most useful is an ultrasound scan of the abdomen. This helps the clinician check for underlying issues which might cause a problem such as a pancreatic tumour or bowel inflammation, and assess how inflamed the pancreas is.
How is Pancreatitis Treated?
Here we have a full spectrum of options, depending on the severity of the condition.
Mild cases are often self-limiting and the cat recovers with the aid of a pain-killing injection.
The scenario I most commonly see are cats that are moderately unwell and require supportive care in the hospital for a few days. This involves aggressive pain relief and intravenous fluids to support the cat whilst she’s not eating. Other treatments include anti-nausea drugs and possibly antibiotics, although the role of the latter in treating pancreatitis is controversial.
Does Diet Play a Part?
Forgive me for mentioning our canine cousins, but in this instance they serve as a useful comparison. We know fat in the diet is a major risk factor in triggering canine pancreatitis; however the same does not seem to be true for cats.
Cats are more of a mystery (of course!). The majority of feline cases of pancreatitis don’t seem to be triggered by fat, although it does no harm to feed a low-fat diet especially after a severe episode.
So what causes feline pancreatitis? To be honest, for many cats it’s just “one of those things” and a root cause is never identified. However, in some cats there is a link between inflammatory bowel disease (IBD) and also liver infections (cholangitis or cholangiohepatitis). In these cases the way forward is to address the IBD and/or liver disease so as to reduce the risk of future flare-ups of pancreatitis.
If your cat: “Isn’t quite right”, such as she’s off her food or vomiting, always seek veterinary attention. With our feline friends especially, the sooner they are treated, the sooner they are on the mend.
Dr Pippa Elliott BVMS MRCVS is a veterinarian with 27-years’ experience in practice and a special interest in feline medicine and behaviour. Pippa is housekeeping staff to four highly individual cats that conspire to keep her busy opening doors on demand.