The pancreas is an enzyme-producing gland that is located on the right side of a cat’s abdomen next to the first part of the small intestine. It makes many enzymes that are important to digestion. These enzymes travel to the intestine through a duct that also carries bile from the liver. Pancreatitis is the inflammation of this organ and is the result of many factors, some of which are known and others that have not yet been recognized. It is an important and relatively common disorder in cats.  It may present as an acute, recurrent acute or chronic clinical disease. The recognized conditions that have been associated with pancreatitis include viral and parasitic infections, liver disease, intestinal disease, kidney disease, elevated blood calcium and some insecticides. Some factors that do not seem to be related to this condition in cats are obesity, sex, or a particular diet. Because the pancreas is so closely associated with the intestine and the liver, many times all three organs are involved.

The clinical signs of pancreatitis are extremely variable. The most common signs are lethargy, weight loss, and loss of appetite. Less commonly, vomiting, low body temperature, abdominal pain, and diarrhea may be seen. Chronic or acute pancreatitis may be associated with transient or permanent diabetes. All of these signs may be seen in other feline illnesses and are not diagnostic of pancreatitis.

Diagnosis is difficult. Mild non-specific changes are seen in the CBC and the serum biochemistry profile.  In the past the only way to confirm this diagnosis was by biopsy. Recently a new blood test, fPLI, has been developed, and it is the most sensitive test to date. It is very sensitive for acute severe disease but may not be as sensitive for the recognition of mild, chronic disease. Ultrasound may also be helpful in diagnosis in 50-80% of cases. Final confirmation by biopsy is still considered to be the gold standard of diagnosis.

Treatment protocols are adjusted to the needs of each individual patient and are largely supportive. The following medications may be included in the treatment protocol.

1.      Intravenous fluids

2.      Inhibition of gastric acid secretions (famotidine, aka Pepcid)

3.      Anti-nausea medication (maropitant)

4.      Pain medication (buprenorphine)

5.      Nutritional support (feeding tube placement if needed)

6.      Prednisolone  5 mg daily for 2 to 4 weeks and then tapered

7.      Cobalamin (vit. B12)  250 ug weekly then tapered

8.      SAMe

9.      Antimicrobials (not indicated in all cats)

Generally the cause of pancreatitis is obscure. There are few effective and lasting remedies, and the outcome is unpredictable. It may be a continuous inflammatory disease that may cause permanent impairment of function, or the cat may recover after a single episode. Pancreatic lesions have been seen in apparently healthy cats. Chronic rather than acute disease is most often seen in cats. The prognosis is related to the severity of the disease, the occurrence of systemic signs and the presence of concurrent disease.