Skip to main content
Journal of Feline Medicine and Surgery logoLink to Journal of Feline Medicine and Surgery
. 2009 Dec 1;11(12):935–940. doi: 10.1016/j.jfms.2009.04.004

Feline exocrine pancreatic insufficiency: 16 cases (1992–2007)⋆

Kelley A Thompson 1, Nolie K Parnell 2, Ann E Hohenhaus 3, George E Moore 4, Mark P Rondeau 5
PMCID: PMC11318768  PMID: 19553151

Abstract

Medical records of 16 cats diagnosed with exocrine pancreatic insufficiency (EPI) were reviewed. The diagnosis was confirmed with either a serum feline trypsin-like immunoreactivity (fTLI) concentration ≤12 μg/l or a fecal proteolytic activity (FPA) <6 mm for three consecutive days. The majority of cats were castrated male domestic shorthairs. The median age of cats affected was 7 years. The most common clinical sign was weight loss followed by diarrhea, polyphagia and vomiting. Concurrent disease was present in 10/16 (63%) cats. The most common laboratory abnormalities were normocytic normochromic anemia, lymphopenia, neutrophilia, increased alanine transferase activity, hyperglycemia and increased bilirubin concentrations. All 10 cats that were tested for serum cobalamin levels were found to be deficient. All 10 cats that were tested for serum folate concentrations had normal or increased levels. Ten out of 11 cats had at least a partial response to treatment. All cats were discharged from the hospital alive. Results suggest that EPI should be considered a differential diagnosis in any cat with weight loss or poor growth after more common diseases have been ruled out. Concurrent disease is common in feline EPI. Cobalamin deficiency is common in cats with EPI and cats should receive cobalamin supplementation to improve response to treatment. Cats in this study had a good prognosis.

Contributor Information

Kelley A. Thompson, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907–2026, USA  thompska@purdue.edu

Nolie K. Parnell, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907–2026, USA

Ann E. Hohenhaus, Department of Medicine, The Bobst Hospital, The Animal Medical Center, 510 E 62nd Street, New York, NY 10021–8302, USA

George E. Moore, Comparative Pathobiology, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907–2026, USA

Mark P. Rondeau, Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104–6010, USA

References

  1. Steiner J.M.,Williams D.A..Serum feline trypsin-like immunoreactivity in cats with exocrine pancreatic insufficiency.J Vet Intern Med. 2000;14:627-629 [DOI] [PubMed] [Google Scholar]
  2. Williams D.A.Current veterinary therapy xii: small animal practice. Kirk R.W., Bonagura J.D., ed. Philadelphia: WB Saunders; 1995:732-735. [Google Scholar]
  3. Westermarck E.,Wiberg M.,Steiner J.M.,Williams D.A.Textbook of veterinary internal medicine. 6th ednEttinger S.J., Feldman E.C., ed. Philadelphia: WB Saunders; 2005:1364-1495. [Google Scholar]
  4. Steiner J.M.,Williams D.A..Feline exocrine pancreatic disorders: Insufficiency, neoplasia, and uncommon conditions.Compend Contin Educ Pract Vet. 1997;19:836-849 [Google Scholar]
  5. Perry L.A.,Williams D.A.,Pidgeon G.,Boosinger T..Exocrine pancreatic insufficiency with associated coagulopathy in a cat.J Am Anim Hosp Assoc. 1991;27:109-114 [Google Scholar]
  6. Steiner J.M.,Williams D.A.,Moeller E.M..Development and validation of an enzyme-linked immunosorbent assay for feline trypsin-like immunoreactivity.Am J Vet Res. 2000;61:620-623 [DOI] [PubMed] [Google Scholar]
  7. Williams D.A.,Reed S.D.,Perry L..Fecal proteolytic activity in clinically normal cats and in a cat with exocrine pancreatic insufficiency.J Am Vet Med Assoc. 1990;197:210-212 [PubMed] [Google Scholar]
  8. Packer R.A.,Cohn D.R.,Wohlstadter G., et al.D-lactic acidosis secondary to exocrine pancreatic insufficiency in a cat.J Vet Intern Med. 2005;19:106-110 [DOI] [PubMed] [Google Scholar]
  9. Hoskins J.D.,Turk J.R.,Turk M.A..Feline pancreatic insufficiency.Vet Med Small Anim Clin. 1982;77:1745-1748 [Google Scholar]
  10. Browning T..Exocrine pancreatic insufficiency in a cat.Aust Vet J. 1998;76:104-106 [DOI] [PubMed] [Google Scholar]
  11. Anderson W.I.,Georgi M.E.,Car B.D..Pancreatic atrophy and fibrosis associated with Eurytema procyonis in a domestic cat.Vet Rec. 1987;120:235-236 [DOI] [PubMed] [Google Scholar]
  12. Sheridan V..Pancreatic deficiency in the cat.Vet Rec. 1975;96:229. [DOI] [PubMed] [Google Scholar]
  13. Austin J.L.,Roberts C.,Rosenholtz M.S., et al.The effect of pancreatic duct obstruction and subsequent drainage on pancreatic function in cats.J Surg Res. 1980;28:426-433 [DOI] [PubMed] [Google Scholar]
  14. Batchelor D.J.,Noble P.M.,Taylor R.H.,Cripps P.J.,German A.J..Prognostic factors in canine exocrine pancreatic insufficiency: Prolonged survival is likely if clinical remission is achieved.J Vet Intern Med. 2007;21:54-60 [DOI] [PubMed] [Google Scholar]
  15. Steiner J.M.,Williams D.A..Validation of radioimmunoassay for feline trypsin-like immunoreactivity (fTLI) and serum cobalamin and folate concentrations in cats with exocrine pancreatic insufficiency (EPI) [abstract].J Vet Intern Med. 1995;9:193 [Google Scholar]
  16. RuauxC.G.SteinerJ.M.WilliamsD.A.Early biochemical and clinical responses to cobalamin supplementation in cats with signs of gastrointestinal disease and severe hypocobalaminemia, J Vet Intern Med, 2005, 155–160. [DOI] [PubMed] [Google Scholar]
  17. Fyfe J.C..Feline intrinsic factor (IF) is pancreatic in origin and mediates ileal cobalamin (CBL) absorption.J Vet Intern Med. 1993;7:133 [Google Scholar]
  18. Williams D.A.Small animal gastroenterology. 3rd ednStrombeck D.R., Guilford W.G., Center S.A., ed. Philadelphia: WB Saunders; 1996:381-410. [Google Scholar]
  19. German A.J.,Day M.J.,Ruaux C.G., et al.Comparison of direct and indirect tests for small intestinal bacterial overgrowth and antibiotic-responsive diarrhea in dogs.J Vet Intern Med. 2003;17:33-43 [DOI] [PubMed] [Google Scholar]
  20. Reed N.,Gunn-Moore D.,Simpson K..Cobalamin, folate and inorganic phosphate abnormalities in ill cats.J Small Anim Feline Med Surg. 2007;9:278-288 [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Johnston K.L.,Swift N.,van Hijfte Forster M., et al.Comparison of the bacterial flora of the duodenum in healthy cats and cats with signs of gastrointestinal tract disease.J Am Vet Med Assoc. 2001;218:48-51 [DOI] [PubMed] [Google Scholar]
  22. Simpson K.W.,Fyfe J.,Cornetta A., et al.Subnormal concentrations of serum cobalamin (vitamin B12) in cats with gastrointestinal disease.J Vet Intern Med. 2000;15:26-32 [DOI] [PubMed] [Google Scholar]
  23. Ruaux C.G.,Steiner J.M.,Williams D.A..Metabolism of amino acids in cats with severe cobalamin deficiency.Am J Vet Res. 2001;62:1852-1858 [DOI] [PubMed] [Google Scholar]
  24. Clinical biochemistry of domestic animals. 6th ednKaneko J.J., Harvey J.W., Bruss M.L., ed. Philadelphila: WB Saunders; 2008:722-726. [Google Scholar]
  25. Toh B.,Alderuccio F..Pernicious anemia.Autoimmun. 2004;37:357-361 [DOI] [PubMed] [Google Scholar]
  26. Williams A.L.,Steiner J.M.,Ruaux C.G.,Williams D.A..Retrospective study of 52 cats with exocrine pancreatic insufficiency (1997–2000) [abstract].J Vet Intern Med. 2002;16:385 [Google Scholar]

Articles from Journal of Feline Medicine and Surgery are provided here courtesy of SAGE Publications

RESOURCES