Missy's pancreas produces hormones to regulate her body functions and enzymes to aid in food digestion. Blood work may reveal high levels of enzymes in the pancreas. However, the enzymes measured in routine blood tests aren't limited to her pancreas, and vets don't often rely on their values to diagnose pancreatitis.
The Pancreas and Pancreatitis
If you rolled Missy over to her back and looked into her belly with X-ray vision, you'd find her pancreas tucked just under her stomach on her right side. In a healthy cat, digestive enzymes pass through the pancreas in an inactive state to the small intestine, where they activate to aid digestion. If the pancreas is inflamed, the digestive enzymes become active before leaving the pancreas, breaking down fat and proteins in the pancreas and other organs; essentially, Missy's body is digesting itself. If the enzyme activation is significant enough, a cat can develop acute pancreatitis, ranging from mild to life threatening. If she has mild activation of those enzymes, she could develop chronic pancreatitis. Symptoms of pancreatitis include nausea, lethargy, vomiting, decreased appetite, weight loss, dehydration and diarrhea.
Many ailments, such as chronic kidney disease, can be confirmed through lab work, but it's not so simple with pancreatitis. The pancreas secretes two enzymes, serum amylase and lipase, which theoretically would indicate the organ's health. However, other organs produce or excrete the enzymes, so high levels can indicate other ailments. Other elevated values, such as white blood cells and liver enzymes, are common in pancreatitis and other conditions, so they can't confirm a diagnosis. The fPLI test is the only test confirming pancreatitis, as it measures pancreas-specific lipase, the only lipase unique to the pancreas. Unfortunately, the test isn't widely available and most samples have to be sent away for confirmation. The bottom line is blood work isn't a reliable way to confirm pancreatitis, so high levels in pancreatic enzymes are only one element a vet may consider if Missy's not well. Some vets may use ultrasound or needle biopsy to help diagnose pancreatitis. It's not unusual for vets to base a diagnosis only on symptoms and medical history.
If Missy is suffering from a bout of pancreatitis, she'll probably be spending a few days at the vet. Her pancreas will need a rest to stop the flow of the enzymes causing the problems, so she'll require intravenous fluids to keep her fluid and electrolyte levels stable. It's very difficult to pinpoint a cause for pancreatitis, though sometimes a parasite or infection, such as feline distemper, can trigger the condition. In the very rare occasion the cause of the illness is determined, the vet will also address the trigger. The prognosis depends on the severity of the pancreatitis, as well as how the cat responds to treatment. In most cases, mild forms of acute pancreatitis have a good outlook with aggressive treatment.
High amylase levels can indicate kidney disease, gastrointestinal issue or the effects of certain medications. Lipase, the other enzyme produced by the pancreas, is often also elevated in these conditions. If Missy's amylase and lipase levels are high, the vet will look at other values in her blood work, as well as her medical history and symptoms.
- 2ndChance.info: Pancreatitis in Cats
- PetMD: Inflammation of the Pancreas in Cats
- Manhattan Cat Specialists: Pancreatitis
- Cornell University College of Veterinary Medicine: Pancreatitis
- Mar Vista Animal Medical Center: Pancreatitis in the Cat
- All Feline Hospital: Pancreatitis
- Idexx Laboratories: Understanding Your Pet's Diagnostic Testing
- VCA Animal Hospitals: Pancreatic Lipase Immunoreactivity in Cats