Pancreatitis in Diabetic Cats

Diabetes mellitus (DM) is a common endocrinopathy of cats. Pancreatitis can be a complicating factor, but studies on the association have yielded mixed results. Diagnosing feline pancreatitis can be difficult, especially in subclinical cases. Use of the serum markers feline pancreatic lipase immunoreactivity (fPLI) or feline pancreas-specific lipase (Spec fPL) combined with abdominal ultrasonography is most useful. An additional diagnostic serum marker, 1, 2-o-dilauryl-rac-glycero-3-glutaric acid-(6’-methylresorufin) ester (DGGR)-lipase, has recently been shown to correlate well with Spec fPL concentration.

In this study, 30 cats newly diagnosed with DM underwent abdominal ultrasonography and had serum Spec fPL and DGGR-lipase activities measured at admission, then 2 and 6 months postdiagnosis. All cats were treated with insulin glargine and fed a high-protein, low-carbohydrate diet. At diagnosis, subclinical pancreatitis was suspected in 33%, 50%, and 31% of cats based on Spec fPL, DGGR-lipase, and ultrasound, respectively. When diagnostic criteria were combined, 60% of cats were diagnosed with subclinical pancreatitis. Most suspected subclinical pancreatitis cats did not demonstrate clinically relevant signs at diagnosis or during follow-up. Serum concentrations of Spec fPL and DGGR-lipase remained high in ≈80% and 86.7%, respectively, of cats with suspected pancreatitis; abnormal ultrasonography findings endured in 44.4%. Seventeen of 30 cats achieved diabetic remission; these had significantly lower Spec fPL at the 2-month follow-up. Although there was a trend toward cats with abnormal pancreatic tests being less likely to achieve remission, the results did not reach significance.

Commentary

Based on necropsy studies, histopathologic evidence of pancreatitis is common in cats. Although the authors presented interesting findings, this study may not change how some clinicians would approach diabetic management in a cat. The principles of achieving diabetic remission remain appropriate diet, good glycemic control, and addressing underlying clinical disease. Clinically, there is not a way to influence pancreatitis resolution. Until that occurs, this information is interesting, and it may influence discussions with clients on achieving diabetic remission; ultimately, though, it does not change treatment, and further research is needed.—Natashia Evans, BVSc (Hons), BSc (Vet), MACVSc (Small Animal Medicine)