The Mystery of Pancreatitis

The pancreas is a strange and wonderful little organ that few of us normally know much about. It lies in the abdomen along the initial length of the small intestine and has a rather lovely description of being a lace-like organ as it has the appearance of a doily. Its work ethic, however, belies its delicate appearance and the pancreas performs two essential functions within the body. Its first function is to produce digestive enzymes which are sent by a small tube to the intestines to breakdown the fats, sugars and proteins in the digestive tract. The second function is to secrete hormones into the bloodstream, the main one we are likely to know is insulin which helps regulate blood sugar levels.

Pancreatitis is inflammation of this little gland and comes in two forms – acute and chronic but the signs can be non-specific and, in cats, very subtle indeed. There could be vomiting, diarrhoea and weight loss.  Anorexia occurs and there may be pain in the upper abdomen but cats, in particular, are very good at hiding this. Where dogs may groan and become grumpy towards their owners, cats will often just curl up and stay very quiet. Acute pancreatitis makes your pet very ill very quickly with associated illness, breathing problems and collapse, whereas chronic pancreatitis, which is more common in cats, leads to a gradual loss of condition.

Medicine, whether human or veterinary, is an art form rather than a science - so the saying goes - and the diagnosis of pancreatitis very much depends on the pattern produced by several factors. There is no specific blood test that absolutely diagnoses the condition and the clinical signs are vague to say the least, so it is the combination of clues that helps us reach a diagnosis. 

Treatment may need to be very aggressive including emergency hospitalisation, drips and intravenous pain relief and anti-emetics with repeated blood tests to monitor the progression of the disease. Humans that have had pancreatitis often state that it is one of the worst pains known. After an attack of pancreatitis, dogs are recommended to stay on a low-fat diet, as fat is a known trigger of episodes. However, because cats are obligatory carnivores, it is not possible to give them a fat-free diet but one to control digestive upsets is more appropriate.

Diabetes and pancreatitis in cats especially, go hand in hand. Pancreatitis can destroy the insulin producing cells in the gland and results in diabetes, however, it is also thought that the inflammation that results in diabetes can trigger pancreatitis too. 

So, what causes the disease? To be honest, we are not really sure. Full diagnosis depends on a biopsy of the pancreas during an attack, but surgery is risky in an extremely ill animal. Viruses and bacteria have been implicated as has reflux of gut contents into the pancreas itself. Trauma and diabetes are also in the mix of culprits. There is definitely a lot to learn about this difficult disease.