Lying just under the stomach and along the beginning of the small intestine, known as the duodenum, the pancreas is a small pink glandular organ. Its main responsibilities include digestion of fats and starches through secretion of enzymes called amylase and lipase and also the regulation of blood sugar levels through secretion of hormones known as insulin and glucagon.
Whatever the inciting cause, the inflammation in the pancreas causes the digestive and metabolic enzymes that are usually stored inside to be released too early. Then they actually start digesting the organ itself. They can get out into circulation and cause inflammation in neighboring organs like the liver. In acute cases, the pancreas can recover and repair. In chronic cases, scar tissue replaces the cells and the pancreas loses the ability to function normally, which can lead to other diseases like diabetes. In cats, there is also a condition called triaditis, which includes concurrent chronic pancreatitis, inflammatory bowel disease and cholangiohepatitis, which is inflammation of both the liver and the biliary system.
Most commonly cats with pancreatitis lose their appetite and become lethargic. In some cases, these signs are accompanied by vomiting, abdominal pain and a change in body temperature. The diagnosis comes from combining the clinical signs together with blood tests. Historically the levels of amylase and lipase (the digestive enzymes of the pancreas) have been the mainstay but they can be elevated for other reasons so other tests such as the PLI (pancreatic lipase immunoreactivity) and the SPEC fPL (Specific Feline Pancreatic Lipase) have been developed. The veterinarian will decide which tests would rule out other causes for the clinical signs. Often, cats with pancreatitis are also affected by a condition called hepatic lipidosis or fatty liver disease, which stems from a large drop in caloric intake. If this occurs, it can significantly make it more difficult for the cat to recover.
The patient is usually placed on supportive care, such as intravenous fluids, anti-nausea medications and pain medicine, to control the clinical signs. Nutritionally, cats with pancreatitis do not appear to be as fat-sensitive as dogs; and they are often placed on a highly digestible, moderate fat diet. If inflammatory bowel disease is suspected as a contributing factor, a hypoallergenic diet may be recommended. If the case is chronic, the patient may be on the special diet long term. Other possible interventions include antibiotics and plasma transfusions depending on the severity of the inflammation.