Diagnosing and managing feline pancreatitis (Sponsored by IDEXX Laboratories)

Diagnosing and managing feline pancreatitis (Sponsored by IDEXX Laboratories)

A roundtable discussion

Dr. Jane Robertson
Dr. Jane Robertson: Let's begin our discussion with what sounds like a simple question. How does pancreatitis in cats differ from pancreatitis in dogs?

Dr. Marnin Forman

Dr. Marnin Forman: The clinical presentations differ between species. Many dogs develop acute, severe signs including vomiting, anorexia, fever, and marked abdominal pain. It is a more vague disease with cats presenting lethargic with a decreased appetite. Cats' physical exam findings often don't suggest pancreatitis. For example, detecting abdominal pain is uncommon, but this may be underestimated because it's difficult to assess in cats.

Dr. Jörg Steiner
Dr. Jörg Steiner: There may not be a big difference between the two. Acute pancreatitis has been studied more in dogs and chronic pancreatitis has been studied more in cats. If you look at the histopathology, there are two studies, one in dogs and one in cats.1,2 The frequency of changes suggesting chronic inflammation is almost the same in dogs and cats, which is around 60%. Both species have acute and chronic disease—it's just that we focus on the acute disease in dogs. In cats, the focus has been on chronic disease, and acute cases have been less talked about.

Dr. David Williams
Dr. David Williams: I agree. There probably is more chronic disease in cats than in dogs, but both species can have acute and chronic disease. So when managing a patient, you have to keep an open mind. During the past five years, veterinarians have become more aware of chronic disease in both species.


Robertson: What is the prevalence of pancreatitis? Because it can be difficult to differentiate between acute and chronic disease, do you think we are actually missing cases of pancreatitis?

Forman: One study showed that 67% of cats presented for necropsy irrespective of the cause of death had evidence of pancreatitis on biopsy.1 I think that is too high. We need to agree about what pancreatitis is on a histopathologic level. If you agree with Dr. De Cock's assessment of pancreatitis, then the prevalence is extremely high in the population of cats that she evaluated at a tertiary hospital.1 Earlier studies established the prevalence as 1.3%, but that is very likely too low.3 It is probably much higher than initially thought.

Robertson: So we agree that the prevalence of pancreatitis in cats is unknown but between 1.3% and 67%. This is an extremely wide range, but it's probably much more common than previously believed.