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Pancreatitis in the Cat

Craig Ruaux, BVSc (Hons), PhD, MACVSc, DACVIM (SAIM)

School of Veterinary Science, Massey University, Palmerston North, New Zealand

In the veterinary profession, attitudes to pancreatitis in cats with either suspected or actually confirmed pancreatic
have undergone a massive shift in relatively recent times. disease is uncommon in the veterinary literature, aggre­
From an earlier perspective that pancreatitis was an uncom­ gation of results from several studies has provided data
mon disease in the cat, recent findings and the introduction on clinical signs and owner complaints in 136 cats; these
of new diagnostic testing modalities have led to the under­ findings are summarized in Table 56.1.
standing that pancreatitis is actually common in the feline One remarkable observation from the aggregated data
patient. Pancreatitis may actually be one of the most com­ in Table 56.1 is that the most common clinical sign in
mon diseases of the domestic cat, and is often an important cats with pancreatitis, across a variety of studies span­
co‐morbidity with other diseases. This is particularly true of ning several decades, is decreased appetite, followed
diseases of the gastrointestinal tract and liver. The actual closely by lethargy. Vomiting and abdominal pain, both
importance of pancreatitis in the overall health of the frequent clinical signs of pancreatitis in dogs, were
domestic cat remains somewhat unclear, in part due to the reported in less than 50% of feline patients. The actual
very different pathology of most cases of pancreatitis in this case outcomes and severities of clinical presentations in
species and the markedly different way in which cats tend to the cats aggregated for Table 56.1 range from mild dis­
manifest this disease when compared to dogs. ease with “incidental” findings of pancreatic disease
In large part, this relatively recent change in attitudes to through to objectively severe, life‐threatening or termi­
feline pancreatitis has arisen with the development and nal disease. Based on clinical signs alone, there is no way
ready availability of much more sensitive and specific diag­ to distinguish the severity of pancreatic disease or pre­
nostic tests for this disease. Advances in the resolution and dict the histopathologic findings if biopsies are to be
availability of ultrasound imaging, new noninvasive diag­ taken. While some authors have suggested that chronic
nostic tests for specific markers of pancreatic tissue integ­ pancreatitis in the cat is a less severe disease, this is prob­
rity and increased willingness to obtain pancreatic biopsies ably an unfounded belief; cats with chronic pancreatitis
and histopathologic assessment have all been extremely can present with objectively severe presenting signs
valuable in advancing our knowledge of this disease. (most likely associated with an acute worsening of their
The purpose of this chapter is to provide an overview disease, or an “acute on chronic” disease presentation).
of the presenting signs and histories, diagnostic approach Given that both decreased appetite and lethargy are
to, and current recommendations for the management of nonspecific signs, and are also common reasons for pres­
pancreatitis in the domestic cat. entations of feline patients for veterinary care, it is not
surprising that pancreatitis is becoming a much more
common diagnosis in feline medicine. In light of these
Clinical Signs and Symptoms data, pancreatitis should be considered a reasonable and
of Pancreatitis in Cats important differential diagnosis for any cat presenting
with vague, nonspecific clinical signs.
History and Physical Examination Findings Physical examination findings in cats with pancreatitis
A quite remarkable difference between companion ani­ are also often unrewarding. Clinical signs such as cranial
mal species is seen in the way that pancreatitis manifests. abdominal pain and guarding, commonly encountered
While specific reporting of clinical signs seen in cats in canine patients, are uncommon in cats with diagnoses

Clinical Small Animal Internal Medicine Volume I, First Edition. Edited by David S. Bruyette.
© 2020 John Wiley & Sons, Inc. Published 2020 by John Wiley & Sons, Inc.
Companion website: www.wiley.com/go/bruyette/clinical