Signs of acute pancreatitis in the cat include anorexia, depression, lethargy, and abdominal discomfort. Vomiting in cats is notably less common than in dogs. Diagnosis is made with a combination of history, physical examination, abdominal imaging (ie, ultrasound), and clinical pathology. Laboratory findings include leukocytosis with or without left shift, azotemia, various serum electrolyte abnormalities, and abnormal liver tests, which often show an increase in total bilirubin concentration (mimicking primary cholestatic liver disease). Specific feline pancreatic lipase level tests have added significantly to the diagnostic acumen. Exploratory surgery should be avoided unless there is ultrasound evidence of an abscess that requires drainage (rare).