ISSN 2398-2950      

Pancreatitis

ffelis

Introduction

  • Signs: often vague (lethargy, anorexia); vomiting, abdominal pain, diarrhea or asymptomatic.
  • Diagnosis: elevated feline pancreatic lipase, ultrasonography, histopathology.
  • Treatment: intravenous fluid support, dietary modification, enteral/parenteral nutrition, pain relief, anti-nauseous medications.
  • Prognosis: variable.
    Print off the owner factsheet on Pancreatitis Pancreatitis to give to your client.

Pathogenesis

Etiology

Predisposing factors

General

  • Hyperstimulation of pancreas.
  • Blocked pancreatic ducts.

Pathophysiology

  • Hyperstimulation of pancreas or blocked pancreatic duct  →  fusion of zymogen granules and lysozymes  →  activation of intrapancreatic trypsin and pancreatic autodigestion.
  • Oxygen-derived free radicals  →  damage to cell membranes  →  increased capillary permeability  →  edema.
  • Increased levels of proteases and phospholipase in pancreas and blood stream  →  necrosis  →  multisystem involvement including pulmonary edema and vasculitis. Trypsin activates coagulation cascade and fibrinolytic system can  →  disseminated intravascular coagulation.
  • Serum antiproteases and alpha-2 macroglobulin bind trypsin and are removed from circulation. Manifestations of pancreatitis are only seen when compensatory mechanisms are overwhelmed.
  • Pancreatitis is often found concurrently with other diseases, such as cholangiohepatitis Liver: cholangitis, and inflammatory bowel disease Inflammatory bowel disease: overview. The concurrent occurrence of these three disorders in cats is termed "triaditis". Chronic pancreatitis can also be associated with exocrine pancreatic insufficiency Exocrine pancreatic insufficiency and diabetes mellitus Diabetes mellitus

Timecourse

  • Acute progression: 24-48 hours, but many cats appear to have chronic relapsing pancreatitis.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Forman M A, Steiner J M,  Armstrong P J, Camus M S, Gaschen L,  Hill S L, Mansfield C S, Steiger K (2021) ACVIM consensus statement on pancreatitis in cats. JVIM 35(2), 703-723 PubMed onlinelibrary.wiley.com/doi/10.1111/jvim.16053.
  • Marolf A J, Kraft S L, Dunphy T R et al (2013) Magnetic resonance (MR) imaging and MR cholangiopancreatography findings in cats with cholangitis and pancreatitis. J Feline Med Surg 15 (4), 285-294 PubMed.
  • Oppliger S, Hartnack S, Riond B et al (2013) Agreement of the serum Spec fPL" and 1,2 -omega-dilauryl-rac-glycero-3-glutaric acid-(5'-methylresorufin) ester lipase assay for the determination of serum lipase in cats with suspicion of pancreatitis. JVIM 27 (5), 1077-1082 PubMed.
  • Boscan P, Monnet E, Mama K et al (2011) Effect of maropitant, a neurokinin 1 receptor antagonist, on anesthetic requirements during noxious visceral stimulation of the ovary in dogs. Am J Vet Res 72 (12), 1576-1579 PubMed.
  • Giorano T, Steagall P V, Ferreira T H et al (2010) Postoperative analgesic effects of intravenous, intramuscular, subcutaneous or oral transmucosal buprenorphine administered to cats undergoing ovariohysterectomy. Vet Anaesth Analg 37 (4), 357-366 PubMed.
  • Trepanier L (2010) Acute vomiting in cats: rational treatment selection. J Feline Med Surg 12 (3), 225-230 PubMed.
  • Chan D L (2009) The inappetent hospitalized cat: clinical approach to maximising nutritional support. J Feline Med Surg 11 (11), 925-933 PubMed.
  • Schweighauser A, Gaschen F, Steiner J et al (2009) Evaluation of endosonography as a new diagnostic tool for feline pancreatitis. J Fel Med Surg 11 (6), 492-498 PubMed.
  • De Cock H E, Forman M A, Farver T B et al (2007) Prevalence and histopathologic characteristics of pancreatitis in cats. Vet Pathol 44 (1), 39-49 PubMed.
  • Forman M A, Marks S L, De Cock H E et al (2004) Evaluation of serum feline pancreatic lipase immunoreactivity and helical computed tomography versus conventional testing for the diagnosis of feline pancreatitis. JVIM 18 (6), 807-815 PubMed.
  • Steiner J M (2003) Diagnosis of pancreatitis. Vet Clin North Am Small Anim Pract 33 (5), 1181-1195 PubMed.
  • Simpson K W (2002) Feline pancreatitis. J Feline Med Surg (3), 183-184 PubMed.
  • Mansfield C S & Jones B R (2001) Review of feline pancreatitis part 1 - the normal feline pancreas, the pathophysiology, classification, prevalence and aetiologies of pancreatitis. J Feline Med Surg​ (3), 117-124 PubMed.
  • Mansfield C S & Jones B R (2001) Review of feline pancreatitis part 2 - clinical signs, diagnosis and treatment. J Feline Med Surg (3), 125-132 PubMed.
  • Gerhardt A, Steiner J M, Williams D A et al (2001) Comparison of the sensitivity of different diagnostic tests for pancreatitis in cats. JVIM 15 (4), 329-333 PubMed.
  • Simpson K W (2001) The emergence of feline pancreatitis. JVIM 15 (4), 327-328 PubMed.
  • Washabau R J (2001) Feline acute pancreatitis - important species differences. J Feline Med Surg (2), 95-98 PubMed.
  • Swift N C, Marks S L, MacLachlan N J et al (2000) Evaluation of serum feline trypsin-like immunoreactivity for the diagnosis of pancreatitis in cats. JAVMA 217 (1), 37-42 PubMed.
  • Zhao P, Tu J, Martens A et al (1998) Radiologic investigations and pathologic results of experimental chronic pancreatitis in cats. Acad Radiol (12), 850-856 PubMed.
  • Bruner J M, Steiner J M, Williams D A et al (1997) High feline trypsin-like immunoreactivity in a cat with pancreatitis and hepatic lipidosis. JAVMA 210 (12), 1757-1760 PubMed.
  • Steiner J M & Williams D A (1997) Feline pancreatitis. Cont Educ Pract Vet 19, 590-602.
  • Hines B L, Salisbury S K, Jakovljevic S et al (1996) Pancreatic pseudocyst associated with chronic-active necrotising pancreatitis in a cat. JAAHA 32 (2), 147-152 PubMed.
  • Weiss D J, Gagne J M & Armstrong P J (1996) Relationship between inflammatory hepatic disease and inflammatory bowel disease, pancreatitis and nephritis in cats. JAVMA 209 (6), 1114-1116 PubMed.
  • Akol K G, Washabau R J, Saunders H M et al (1993) Acute pancreatitis in cats with hepatic lipidosis. J Vet Intern Med (4), 205-209 PubMed.
  • Hill R C & Van Winkle T J (1992) Acute necrotising pancreatitis and acute suppurative pancreatitis in the cat; a retrospective study of 40 cases (1976-1989). JVIM (1), 25-33 PubMed.

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