A retrospective study of 157 hospitalized cats with pancreatitis in a tertiary care center: Clinical, imaging and laboratory findings, potential prognostic markers and outcome

Abstract

BackgroundPancreatitis in cats (FP) has been increasingly diagnosed in recent years, but clinical studies of large numbers of affected cats are scarce.ObjectivesTo describe a large cohort of cats with FP requiring hospitalization.AnimalsOne hundred and fifty‐seven client‐owned cats.MethodsRetrospective study, including cats diagnosed with pancreatitis based on sonographic evidence, positive SNAP feline pancreatic lipase immunoreactivity test results, increased 1,2‐o‐dilauryl‐rac‐glycerol‐glutaric Acid‐(6′‐methylresorufin ester)‐lipase activity, histopathology, or some combination of these.ResultsOne‐hundred and twenty‐two cats (77.7%) survived to discharge.Median time from onset of clinical signs to presentation was longer (P = .003) in nonsurvivors. Causes of FP included recent general anesthesia, trauma, hemodynamic compromise, and organophosphate intoxication, but most cases (86.6%) were idiopathic. Ultrasonographic findings consistent with pancreatitis were documented in 134 cats, including pancreatomegaly (81.3%), decreased (31.3%), or increased (14.9%) pancreatic echogenicity, extra‐hepatic biliary tract dilatation (24%), and increased peri‐pancreatic echogenicity (13%). Lethargy (P = .003), pleural effusion (P = .003), hypoglycemia (P = .007), ionized hypocalcemia (P = .016), azotemia (P = .014), parenteral nutrition administration (P = .013), and persistent anorexia during hospitalization (P = .001) were more frequent in nonsurvivors, whereas antibiotics were more frequently administered to survivors (P = .023). Nevertheless, when Bonferroni's correction for multiple comparisons was applied, none of the variables was statistically significant.Conclusions and Clinical ImportancePreviously unreported, clinically relevant, potential prognostic factors, including hypoglycemia, azotemia, parenteral nutrition, and withholding antibacterial treatment were identified in this exploratory study. These preliminary results should be examined further in confirmatory studies.

Feline pancreatic ducts are consistently identified on CT and more likely to be dilated in the body of pancreas in cats with elevated feline pancreatic lipase immunoreactivity

“…Limitations of the current study include the lack of age matching and the relatively small sample size, which may have precluded identification of statistically significant differences in other parameters evaluated. As with many diseases, pancreatitis is often a disease of middle to older age cats . Unfortunately, we were unable to enroll older healthy cats to age match with the elevated fPLI cats in this study.…”

Feline comorbidities: What do we really know about feline triaditis?

“…In most cases, pancreatitis is considered idiopathic; however, some underlying causes such as viral infection, toxoplasmosis, fluke infection, trauma and organophosphate poisoning have been reported. [6][7][8] In humans, autoimmune and genetic components have been associated with pancreatitis; [9][10][11] and the role of the microbiome is currently gaining more interest as a study area. However, none of these have been recognised in feline pancreatitis as yet.…”

“…A separate study of 44 cats found that 81% of cats with cholangitis had some degree of nephritis, 2 while a more recent study reported acute and chronic kidney disease (26% and 34%, respectively) in cats with pancreatitis. 6 More studies are needed to evaluate the association between nephritis and triaditis; specifically to determine if nephritis occurs simply because of close physical proximity or whether triaditis is part of a larger multisystemic immune response, rather than just affecting the pancreas, biliary system and intestines. The term triaditis might not be correct if indeed this process affects more than the three recognised organs, and recently the term 'feline systemic inflammatory disease' has been proposed.…”

“…[1][2][3] While no sex, age or breed predisposition has been convincingly documented, cats with concurrent acute neutrophilic cholangitis (NC) tend to be younger than those with chronic lymphocytic cholangitis (LC), 4 and Siamese cats are overrepresented in some studies of pancreatitis. 5,6 This article reviews the literature on feline triaditis, focusing initially on pancreatitis, cholangitis and IBD. Histopathological descriptions, relative clinical significance and difficulties inherent in making these diagnoses are discussed, and recommendations given on how best to manage these conditions individually and collectively.…”

Feline abdominal ultrasonography: What’s normal? What’s abnormal? The pancreas

“…Pancreatitis is the most commonly diagnosed disorder of the feline exocrine pancreas 14 and yet, despite this, an underlying cause is not identified in the majority of cases and the condition is often considered to be idiopathic. [15][16][17] Cats of all ages may be affected, with reports in animals from 3 weeks to 20 years. 16,18 While any breed may be affected, Siamese are thought to be over-represented.…”