Exocrine pancreatic insufficiency occurs uncommonly in cats and is poorly described in the veterinary literature. The purpose of this retrospective study is to describe a population of cats with feline exocrine pancreatic insufficiency (EPI). Databases from 1992-2007 of four referral practices were searched for cases of feline exocrine pancreatic insufficiency. Inclusion criteria included at least one clinical sign compatible with exocrine pancreatic insufficiency and a feline trypsin-like immunoreactivity (fTLI) of < 12ng/L or three consecutive day fecal proteolytic activity results < 6mm.
Fifteen cats met the enrollment criteria and their medical records were reviewed. The median age of cases was 7 years (range: 0.3-15 years). The majority of cats were castrated males (9). The most common breed was the domestic short hair (9).
Clinical signs and physical examination findings were recorded for all 15 cats. Weight loss was the most common clinical manifestation and found in 14/15 cats (93%), followed by diarrhea/loose stools (11), vomiting (5), polyphagia (4), anorexia (4), lethargy (4), and fecal incontinence (3). Stool was described as voluminous (7), loose (6), hematochezia (4), increased frequency (4), malodorous (4), discolored (4), steatorrhea (3) and greasy (3). The most common physical examination findings included thin/emaciated body condition in 9/15 cats (60%), muscle wasting (6), unthrifty hair coat (5), and thickened intestinal loops (5). Concurrent disease was present in 11 of 15 cats (73%). The most common concurrent diseases were urinary tract disease (5), enteritis (3), gastritis (2), Helicobacter infection (2), and hepatic disease (2).
The most common complete blood cell count abnormalities included normocytic, normochromic anemia 7/14 cats (50%), lymphopenia (6/13) and neutrophilic leukocytosis (4/13). The most common serum chemistry abnormalities included hyperglycemia (5/13), increased ALT (5/13) and total bilirubin (4/13). Serum cobalamin concentration was measured in 10 cats and was abnormal in all 10. The median serum cobalamin concentration was 99ng/L (range: <27-176ng/L), [reference range 290-1499ng/L]. Serum folate concentrations were increased in 4/10 cats with a median value of 21.1µg/L (range 12.2-42.5µg/L) [reference range 9.7-21.6µg/L].
Fourteen of 15 cats received treatment including pancreatic enzyme supplementation (13/14), parenteral cobalamin supplementation (7/14) and metronidazole (5/14). Data regarding response to treatment was available in 12/15 cats. Of these 12 cats, 11 responded (92%).
This study shows cats with EPI exhibit many signs typical of EPI in the dog; however the majority of cats with EPI will have a concurrent disease and are likely to be cobalamin deficient.