Exocrine Pancreatic Insufficiency - Cat
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Description
A rare disease in cats but can occur following chronic pancreatitis.
Diagnosis
History
Cats with EPI have a history of chronic small bowel diarrhoea and weight loss combined with a ravenous appetite.
Clinical signs
Weight loss and muscle wastage are usually seen in assosiation with EPI. Diarrhoea and steatorrhoea are also common. Cats may present with a wet, greasy looking body coat particularly around the perineal area this may be a result of fatty soiling or secondary to cobalamin deficiency. Cats with EPI may also have concurrent Diabetes mellitus.
Laboratory Tests
Routine hamatology and biochemistry are often unremarkable in cats with EPI. Serum concentrations of cobalamin are often decreased. Serum folate concentrations may also be decreased due to concurrent Inflammatory bowel disease or Intestinal lymphoma. The most sensitive and specific test for the diagnosis for feline EPI is the feline trypsin-like immunoreactivity assay(fTLI). The values are greatly reduced as compared to normal animals. Values <8µg/l in cats are considered diagnostic. This test must be carried out after withdrawing food for several hours.
Other
Atrophy of the pancreas seen via exploratory laparotomy or laparoscopy
Treatment
Enzyme replacement
Pancreatic enzyme replacement, raw pancreas (10-20g/feed is generally more effective than dried enzyme replacment and can be stored frozen for at least three months.
Dietary modification
A fat restricted diet is advised.
Vitamin supplementation
Levels of vitamin B12 (cobalamin) and vitamin E (tocopherol) are often found to be low and hence should be supplemented. Similarly Cobalamin supplementation is often required.
Antibiotic therapy
Dogs with EPI often have Small Intestinal Bacterial Overgrowth (SIBO). This can be treated with oral oxytetracycline, tylosin or metronidazole.
Glucocorticoid therapy
Oral prednisolone may be useful in animals that do not respond to the above treatment.
Prognosis
EPI is generally irreversible and hence life-long treatment is needed. The prognosis is generally good as long the owner is aware of the longevity of the disease and the cost involved with treating it.