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Feline Exocrine Pancreatic Insufficiency

Thompson K, Parnell N, Hohenhaus A, Moore G, Rondeau M. Feline exocrine pancreatic insufficiency: 16 cases (1992-2007). J Feline Med Surg. 2009;11(12):935-940.

This study reviewed the medical records of 16 cats diagnosed with exocrine pancreatic insufficiency (EPI). The exocrine pancreas secretes digestive enzymes into the upper small intestine (duodenum) and when there is an insufficiency of pancreatic digestive enzymes, macronutrients (amino acids, triglycerides, and carbohydrates) are not broken down into smaller units and absorbed by the small intestine. Weight loss was the most common clinical sign noted in 15 cats (94%) followed by diarrhea, polyphagia and vomiting. Concurrent disease was found in 10 of 16 cats (63%). Some of the concurrent diseases were lymphoplasmacytic enteritis and gastritis, urinary tract disease and hepatic disease. Diagnosis was confirmed with either a serum feline trypsin-like immunoreactivity (fTLI) concentration less than 12 mcg/l or a fecal proteolytic activity (FPA) less than 6 mm for three consecutive days. The most common laboratory abnormalities were normocytic normochromic anemia, lymphopenia, neutrophilia, increased alanine transferase activity, hyperglycemia, and increased bilirubin concentrations. All 10 cats tested for serum cobalamin levels were found to be deficient. All 10 cats tested for serum folate concentrations had normal to increased levels. Ten of the 11 cats undergoing treatment with pancreatic enzyme replacement had a partial response. Feline EPI appears to be an uncommon disease in cats in that the prevalence at four institutions was less than 0.1% of all cats seen. EPI should still be considered as a differential diagnosis in any cat with weight loss or poor growth and when other more common diseases have been ruled out. Concurrent disease is common in feline EPI. Since cobalamin deficiency is common in cats with EPI, cats should also receive cobalamin supplementation to improve response to treatment. [VT]

Related articles:
Steiner J, Williams D. Serum feline trypsin-like immunoreactivity in cats with exocrine pancreatic insufficiency. J Vet Intern Med. 2000;14(6):627.

Steiner J, Williams D. Feline exocrine pancreatic disorders. Vet Clin North Am Small Anim Pract. 1999;29(2):551-575.