A 4-kg 8-year-old spayed female domestic long hair cat was referred with a 4-day history of lethargy, anorexia, and vomiting.
History. The cat lives with another cat that does not manifest any systemic abnormalities. She was presented to the primary veterinarian 2 weeks earlier for lethargy and 1 episode of vomiting, but a diagnosis was not determined.
Physical Examination. Physical examination revealed splinting of the abdomen and drooling upon abdominal palpation. The cat was mildly dehydrated and had an unkempt hair coat.
Diagnostics. Complete blood count showed neutrophilia and nonregenerative anemia. Serum biochemical profile revealed elevated liver enzymes (ALT, ALP), azotemia, elevated protein, and mild hyperglycemia (Table). Tests for FeLV and FIV were negative. Abdominal radiographs were normal.
- What conditions might fit these nonspecific signs? How would you begin to differentiate?
- Describe all possible clinical signs of feline pancreatitis. How does it differ from pancreatitis in dogs?
- What diagnostic tests are most useful when diagnosing pancreatitis in cats?
- What is the difference between acute pancreatitis and chronic pancreatitis?
Diagnosing pancreatitis in cats can be frustrating due to lack of specific and overt clinical signs. The combined use of often-subtle history and physical examination findings, routine blood analysis (to rule out other causes), abdominal ultrasound, and ELISA testing specific for feline pancreatic lipase immunoreactivity (fPLI) is the most conclusive way to diagnose the disease.
Thoracic radiography is indicated if dyspnea is present or if the cat presents with evidence of concurrent thoracic disease; outdoor cats should be screened for intestinal parasites and Toxoplasma gondii. Additional tests may include ultrasound-guided needle aspiration or laparoscopy with pancreatic biopsy. Other possibilities for cats include hypercalcemia and organophosphates. Hyperlipidemia has been associated with pancreatitis in humans and has been suggested in dogs but not in cats.1
In this case, the abdominal ultrasound showed pancreatic enlargement and hyperechoic mesenteric fat as well as mild peritoneal effusion (Figure 1). Serum fPLI concentration was increased.