Veterinary Medicine - November 2008 - (Page DM4)

In cats, clinical signs of pancreatitis commonly include: • lethargy • inappetence • weight loss • anorexia • mild or intermittent vomiting. Other signs may include: • dehydration/hypotension • fever • cavitary effusions • diarrhea • abdominal pain. Diagnosing pancreatitis can be difﬁcult because these clinical signs are often associated with other diseases and pancreatitis can occur simultaneously with other diseases, such as hepatic lipidosis, cholangitis, IBD, and diabetes mellitus. a cat with pancreatitis doesn’t need to be on an ultralow-fat diet like a dog, but it should not be fed a highfat diet either. Williams: There still remains the issue of whether or not any trend for an association of pancreatitis with mild hyperlipidemia is the cause or the effect of pancreatitis. Cats with pancreatitis and feeding tubes are often fed very high-fat content liquid diets and seem to tolerate them well. It Is not standard practice to formulate lower fat content liquid diets. There are no published studies of this; only the observations of criticalists and nutritionists who do not seem to worry about dietary fat content in cats with pancreatitis. Twedt: Dogs that develop acute pancreatitis after eating a high-fat meal are classically small breed and obese. In cats with pancreatitis, that is not the classic presentation. Robertson: Does obesity predispose cats to developing pancreatitis? Steiner: I don’t think so. Forman: We treat a fair population of cats that are overweight with hepatic lipidosis and pancreatitis. Williams: Patients with pancreatitis are not all overweight—many are normal or even underweight. I don’t believe that obesity is a basis for worrying more or less about pancreatitis in any species. rather than a side effect of the drug. I think that’s also true in cats, but hasn’t been studied enough. When a cat has pancreatitis, I believe it’s important to look at the medications the cat is receiving. Trauma Forman: Do you believe that trauma causes pancreatitis in cats? Steiner: This occurs most commonly in dogs and cats hit by a car. They develop pancreatitis a couple of days later. In children, trauma is one of the most frequent causes of acute pancreatitis. It’s probably not that common in cats, but it happens. Williams: Several case reports of cats falling from highrise buildings show the development of pancreatitis. I think that is more likely related to pancreatic ischemia subsequent to shock because the blood gets diverted away from the gastrointestinal tract. Associated conditions Robertson: What other diseases predispose cats to developing pancreatitis? Are there infectious causes of feline pancreatitis? Forman: There is a paper in press on a pancreatic uke that causes pancreatitis in cats.8 Twedt: Yes, there is a pancreatic uke, Eurytrema procyonis. There is also a causal relationship with toxoplasmosis. Also, ascending bacteria into the pancreatic ducts from the gastrointestinal tract are another cause of pancreatitis. Robertson: Do most cases of pancreatitis have a bacterial or infectious component? Steiner: Based on cultures, the answer is no. Individual cats may have an infection, but most don’t. However, the question is whether bacteria exist that we just can’t nd with traditional culture methods. The problem is that there are digestive enzymes in the pancreas, and they digest not only proteins but also RNA and DNA. All of the sensitive methods for detecting infectious agents that have been used in the liver, blood, and brain cannot easily be used in the pancreas. Twedt: We’ve found bacteria in some cats with chronic Diet Robertson: What about diet? Dogs that eat a high-fat meal, get into the garbage, or are given leftovers are more apt to develop acute pancreatitis. Have there been similar associations in cats? Steiner: I believe this does happen in cats. My colleagues and I at the Gastrointestinal Laboratory at Texas A&M University have recently studied the association of hypertriglyceridemia and pancreatitis in cats. We analyzed the data in four ways. One of the analyses was statistically signi cant, which suggests that there may be some relationship. I think that this relationship is not as important as it is in dogs, but I think there is an association. Based on this, I think that 4

Table of Contents Feed for the Digital Edition of Veterinary Medicine - November 2008

Veterinary Medicine - November 2008 Contents Leading Off Editors' Guest Just Ask the Expert Letters Practice Makes Perfect Clinical Exposures Practice Matters Idea Exchange Author Guidelines A Challenging Case: Esophageal Leiomyoma in a Dog Osteoarthritis in Cats: What We Now Know About Recognition and Treatment Product Preview CE Form/Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - November 2008

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