Feline Pancreatitis

Question 1

How is pancreatitis diagnosed in cats?

Answer 1

biopsy!
- signs of acute pancreatitis = interstitial edema, neutrophilic infiltration, possible mesenteric fat necrosis
- signs of chronic pancreatitis = lymphocytic infiltration, cystic acinar degeneration, fibrosis
- can have mixed pattern

Question 2

What are the common clinical signs of pancreatitis in cats?

Answer 2

lethargy, anorexia, vomiting, dehydration
- abdominal pain is no well recognized

Question 3

How is acute vs chronic differentiated based on clinical signs?

Answer 3

it can’t be!

Question 4

How valuable is fTLI in diagnosis of pancreatitis?

Answer 4

Not that great
- the sensitivity of fTLI is about 60% at the best, and the specificity is questionable
- normal fTLI does not rule out pancreatitis

Question 5

How valuable is serum lipase and amylase in diagnosis of feline pancreatitis?

Answer 5

poor to no diagnostic value

Question 6

Which diagnostic parameter has the highest sensitivity/ specificity?

Answer 6

spec PLI! 79% sensitivity and 82% specificity
serum fPLI sensitivity/ specificity = 67%

Question 7

How valuable is AUS in feline pancreatitis?

Answer 7

okay specificity, but the sensitivity is quite variable
- cannot rule out pancreatitis

Question 8

How useful is biopsy in feline pancreatitis?

Answer 8

probably most useful in chronic pancreatitis
- while the procedure itself comes with low complications, anesthesia can worsen pancreatiis
- also has patchy distribution like the dog, so multiple samples are required and normal biopsy cannot rule out pancreatitis

Question 9

What the treatment approach to feline pancreatitis?

Answer 9

all based on severity of clinical signs
Severe = hypoalbuminemia, hypocalcemia; circulatory shock
mild = weight loss, poor appetite, intermittent vomiting

Question 10

How is severe feline pancreatitis treated?

Answer 10

Aggressive fluid therapy/ colloids for pressure support
- supplement electrolyte (potassium, calcium)
- fresh frozen plasma may be beneficial
- nutritional plan –> want to minimize risk of hepatolipidosis
- analgesia
- antiemetics

Question 11

How is chronic feline pancreatitis managed?

Answer 11

same principle as IBD
- diet: novel protein, hypoallergenic
- not need to fat restrict (unlike dogs)
- anti-inflammatories/ immunomodulatory drugs