Page 740 - Problem-Based Feline Medicine

732 PART 9 CAT WITH SIGNS OF GASTROINTESTINAL TRACT DISEASE

Treatment recognized and appropriately managed, it may be pos-
sible to prevent the consequences of chronic pancreati-
Most cats with EPI can be successfully treated by
tis-EPI.
dietary supplementation with pancreatic enzymes.
The powder products (1 tsp per meal) appear to be
more clinically effective than tablets. TYZZER’S DISEASE (BACILLUS
PILIFORMIS)
If the cat refuses to eat the food with pancreatic extract,
raw pancreas can be offered, but it is essential to use
Classical signs
bovine pancreas to prevent transmission of
Aujeszky’s disease in porcine pancreas in areas ● The disease occurs primarily in kittens at
where the disease occurs. weaning age, but is rare.
● Rapid onset of depression, abdominal
A diet that contains low amounts of insoluble fiber
discomfort.
should be fed, since insoluble fibers may interfere with
● Death within 24–48 hours is common, but
pancreatic enzyme activity.
some may have signs several days before
Some cats will not respond to enzyme supplementation death.
alone, and this may be due to concurrent cobalamin
deficiency or small intestinal disease. Cobalamin Pathogenesis
supplementation should be given parenterally
(100–250 μg SC once weekly for 6–8 weeks, then Disease is caused by Bacillus piliformis, a spore-
monthly or bimonthly as needed). forming, Gram-negative, intracellular bacillus.

In cats with suspected vitamin K deficiency, supple- This is primarily a disease of laboratory rodents,
mentation should also be initiated (vitamin K and is very rare in cats and dogs, but may be seen in
1
1 mg/kg/day PO). kittens and especially weanlings.
Other supplements that should be given include: toco- The source of the infection is believed to be rodent
pherol (30 IU orally, once daily with food for the first feces.
month until levels are normalized), and folate (0.5 mg
The organism proliferates in the intestinal epithe-
orally, once daily).
lium producing enterocolitis and then spreads to the
It is unknown whether or not cats develop small liver and systemic circulation.
intestinal bacterial overgrowth as a complication of
EPI as is common in dogs. However, in cats that do Clinical signs
not respond as anticipated to pancreatic enzyme sup-
plementation, addition of metronidazole or tetracy- The most common signs are an acute onset of depression
cline to the treatment regime is indicated. and abdominal discomfort.
Death usually occurs within 24–48 hours, although
Prognosis weight loss and recurrent or chronic diarrhea can
occur in older cats.
Because EPI is associated with the irreversible loss of
pancreatic acinar tissue, complete recovery is not The diarrhea is typically infrequent, scant and
possible. pasty.
However, with appropriate management, cats with EPI will
gain weight, pass normal feces and can live a normal life. Diagnosis
There is no ante-mortem test for Tyzzer’s disease,
Prevention and most frequently, the diagnosis is made by necropsy.

There is no known way to prevent the development of The lesions are most severe in the ileum, colon and
EPI, however, if cats with chronic pancreatitis can be liver, with the ileum and colon being severely thickened.