Exocrine Pancreatic Neoplasia

Question 1

What are some clinical signs of pancreatic neoplasia?

Answer 1

• can have signs similar to acute pancreatitis: nausea, vomiting, anorexia, abdominal pain
• typically vague: reduced appetite, weight loss, diarrhea, abdominal pain
• compression of the extrahepatic bile duct can lead to icterus
• adenoma = no clinical signs, unless ascites noted
• may have palpable mass

Question 2

What paraneoplastic signs can be seen in cats with exocrine pancreatic neoplasia?

Answer 2

alopecia - along the ventrum, can extend down the limbs

Question 3

What biochemistry changes is consistent with pancreatic or hepatic neoplasia?

Answer 3

elevation in lipase with minimal changes to amylase

Question 4

How is exocrine pancreatic neoplasia diagnosed?

Answer 4

• lesion (primary and metastatic) can be noted on ultrasound
• cytology has high positive predictive value but low negative predictive value
• biopsy = gold standard

Question 5

How is exocrine pancreatic neoplasia treated?

Answer 5

Surgery!
- not very responsive to chemo, but can try gemcitabine and carboplatin
- Palladia?
- Cox 2 inhibitors = limited value

Question 6

What’s the prognosis of exocrine pancreatic neoplasia?

Answer 6

very poor in cats – overall MST 3m, can be around 5m with Sx and Chemo