Feline Pancreatitis: Serious

Although the feline pancreas is a relatively small internal organ, typically weighing no more than six or eight ounces, it plays a demanding and multifaceted role in maintaining a cats robust health. Indeed, a disease or injury that results in the inflammation of this vital organ – a condition called pancreatitis – could prove fatal unless the animal receives prompt, and potentially quite expensive, medical care.

The pancreas is a slender, pink, v-shaped strip of tissue resting snugly within the cats abdomen between its left kidney and its duodenum. It is a glandular organ that performs two life-sustaining functions-endocrine and exocrine.

• Endocrine function – A minute but crucially important portion of total pancreatic mass is made up of tissue containing small clusters of cells called islets of Langerhans. These cells produce two hormones: glucagon, which stimulates the production of blood sugar; and insulin, which maintains the proper levels of circulating blood sugar. The most common disorder of the endocrine pancreas is diabetes mellitus, a condition resulting in the abnormal metabolism of fats, proteins, and carbohydrates.
  
  
• Exocrine function – The major activity of the exocrine pancreas is the production and secretion of a liquid that normally passes out of the pancreas and into the small intestine, where it is activated to enable the digestion of fats, proteins and carbohydrates. Insufficient production of the enzymes in this liquid can interfere with an animals digestive processes – a disorder known as exocrine pancreatic insufficiency. If, on the other hand, these harsh digestive enzymes are prematurely activated, they can seep not into the intestines but into the pancreas itself and surrounding tissue. This process can lead to severe inflammation of the organ – the condition known as pancreatitis.

While still in the pancreas, explains Richard Goldstein, DVM, an associate professor of small animal medicine at Cornell Universitys College of Veterinary Medicine, these digestive enzymes are normally sequestered in tiny droplets that prevent their coming into direct contact with pancreatic tissue. Moreover, he says, the enzymes are biologically programmed to remain inactive until after they have been secreted and have traveled via the pancreatic duct into the small intestine.

The process of enzyme secretion has several stimuli, says Dr. Goldstein. “It may begin with the cats hunger – merely thinking of food. Or it can start when the animal begins eating and swallowing food and its stomach starts to fill. But if these digestive enzymes start working while still inside the pancreas, they can begin feeding on the organ itself, since it is made up of fat, protein and carbohydrate.”

In general, Dr. Goldstein remarks, the feline pancreas is an amazing phenomenon, and things usually dont go wrong. “But when things do go wrong and the enzymes start digesting the pancreatic tissue,” he says, “youve got pancreatitis.”

Although it is the most common disorder of the feline exocrine pancreas, studies have indicated that pancreatitis occurs in fewer than two percent of the general cat population. Cats of both sexes and of all ages and breeds appear to be similarly vulnerable.

The specific causes of pancreatitis remain unknown. “Something, perhaps a defect in an animals natural defense mechanisms, triggers the disease and results in digestion of the pancreatic tissue,” says Dr. Goldstein. “Some people believe it can be caused by too much fat in the diet or by ingestion of insecticides or other toxins.” In some cases, physical trauma – being struck by a car, for example – has been associated with cases of the disease. And various infectious disorders, such as toxoplasmosis and feline infectious peritonitis, have been cited as possible causes of pancreatitis, as have such factors as adverse drug reactions, inflammatory bowel disease, liver disease and parasitic infection.

The progression of feline pancreatitis can take various paths. Says Dr. Goldstein: “Your cat can have a perfectly normal pancreas but then develop – for no apparent reason – a sudden, very acute, and very severe case of the disease. And the cat may die as a result of that single acute attack. Or it may recover and never experience a problem with its pancreas again. But what often happens is that a cat will recover from the initial acute attack and then develop chronic pancreatitis. The animal will tend to have intermittent little bouts of the disease over time. With each occurrence, there will be less inflammation, but there will be gradual scarring of the pancreatic tissue, which could eventually take its toll on the organs ability to function.”

The clinical signs associated with feline pancreatitis, says Dr. Goldstein, are quite nonspecific: inappetence and lethargy, for example. The standard diagnostic procedure will involve a medical history of the animal, a thorough physical examination, bloodwork and ultrasound. Radiography tends to be of little value, he notes, since pancreatic abnormalities – indeed, the organ itself – are not readily perceptible on x-rays. They are sometimes useful, however, in ruling out other disorders, such as an intestinal obstruction, which can have symptoms resembling those of pancreatitis. The only way a definitive diagnosis can be made is through a biopsy, he notes, but this involves a surgical or laproscopic procedure that may not be advisable for a seriously ailing, physically debilitated animal.

“So in a lot of cases,” he explains, “you just have to make the assumption of pancreatitis based on the physical examination of the cat, the presence of any concurrent diseases, bloodwork and ultrasound – and then you begin treatment.”

Although no uniformly effective cure for feline pancreatitis has yet been developed, an affected cat will typically be hospitalized for several days while supportive treatment proceeds. This treatment will entail feeding the patient – through a tube leading directly into its stomach, if necessary – to make sure that it is getting adequate nutrition. This must continue until the animals spirits pick up and it resumes its normal eating habits.

Prognosis in all cases is guarded, says Dr. Goldstein, and pancreatitis can be a fatal disease. “The outcome,” he notes, “will depend not only on the severity of the disorder but also, unfortunately, on the owners ability to pay for treatment. Theres often no way to treat a severe case of the disorder on an outpatient basis, and 24-hour care can run into thousands of dollars.”