Exocrine Pancreatic Insufficiency - Cat

Definition

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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. Hair coat is often in a poor condition and Cats presenting 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 of EPI is the TLI serum assay. The values are greatly reduced as compared to normal animals. Values <2µg/l in dogs 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.