How To Manage Pancreatitis In Cats: Nutritional Therapy
- Dr. Jules Mantler
- Jan 27, 2022
- 15 min read
Updated: Nov 4, 2022
It’s not exactly common, but it’s not exactly rare either—what it can be, is stressful. Pet parents of cats with pancreatitis can feel overwhelmed with information, potential causes, and treatment plans—and nothing ever seems to be a straightforward answer! The first thing to remember is that while it can be a serious and stressful time, you can manage pancreatitis in cats effectively so long as it’s caught in time and treated appropriately. But how do you catch it in time? And what is the appropriate treatment? This is a huge topic, but we’re here to walk you through the specifics, so buckle up and settle in: we’re going on a deep dive.
Index
Key Takeaways of Pancreatitis in Cats:
There is no single cut-and-dry cause for pancreatitis in cats.
Symptoms can be elusive and similar to other conditions—look for excessive lethargy, lack of appetite, or weight loss.
A pancreatitis diagnosis could indicate another underlying condition and vice versa, some diseases may indicate pancreatitis—be prepared to ask for more tests.
Treatment varies case-by-case and is largely subjective to any additional conditions and diseases alongside pancreatitis.
Can it be cured? If you can catch pancreatitis early on and get your cat the appropriate treatment, it can be resolved with no lasting damage to the body.
The only “right” diet for your cat battling pancreatitis is the one they will eat consistently.
Depending on your cat’s symptoms and diagnosis, some diets (like raw) may help resolve primary conditions—like diabetes or IBD—which can consequently improve chances of recovery from pancreatitis.
Not all supplements work with all cats, depending on their diagnosis. Consult a holistic veterinarian before supplementing your cat’s diet.
Lastly, this is a very particular and finicky disease. Treatment isn’t something you can just “wing it” or wait it out—your cat needs personalized help, so getting them to a holistic veterinarian is paramount.
What Causes Pancreatitis?
Strictly speaking, pancreatitis means "inflammation of the pancreas", which is a fun but ultimately useless piece of etymology: it doesn’t actually give us any insight into the cause.
There are some risk factors that may be associated with cats developing pancreatitis, but not all cats with these risk factors develop pancreatitis4,5,12 —it just means to be extra aware if they do.
Some of these risk factors include:
Breeds:
Himalayan
Domestic Shorthair
Siamese
Diet:
Unlike dogs, diet has no bearing on a cat developing pancreatitis
Drugs:
Organophosphate insecticides
Potentially others, or even just a particularly bad reaction to some drugs can be a trigger for pancreatitis
Infections:
Parasites
Toxoplasma gondii
Eurytrema procyonis
Amphimerus pseudofelineus
Viruses
Feline Infectious Peritonitis(FIP)/coronavirus
Parvovirus
Herpesvirus
Calicivirus
Other Factors
Hepatobiliary disease
Feline suppurative cholangiohepatitis
Triaditis (IBD, cholangiohepatitis)
Hypercalcemia
Intravenous calcium infusion
Duct obstruction
Trauma
Ischemia
Pancreatic tumours
Unfortunately, over 95% of cats diagnosed with pancreatitis are idiopathic—meaning that no cause was identified1, 20
What Does Pancreatitis Look Like in Cats?
There have been extensive studies on pancreatitis in humans and dogs, but unfortunately—as is often the case—our feline friends were left behind. Pancreatitis can have somewhat of an elusive presentation in cats with non-specific indicators, such as lethargy (already a difficult thing to spot in cats who sleep a minimum of 12 hours a day), decreased appetite, weight loss, and potential dehydration1,2,3. This variability in symptoms can make definitive studies difficult. What’s worse is these signs can be present with multiple different conditions, so you may not be able to detect pancreatitis in your cat unless you specifically test them for it. Because pancreatitis can often pop up in cats alongside other conditions, your vet may identify one of those conditions (we’ve listed some of them below), and focus on treating that. This in itself may resolve the underlying pancreatitis, and there would be no need for the added expense of a separate pancreatitis test.
What Happens if Pancreatitis Is Not Managed Properly?
Pancreatitis in cats can occur in two forms: acute and chronic, and it can be difficult to distinguish between the two because they can both present with mild or severe symptoms1,5. Acute cases tend to be more severe and require more intensive treatment; however, if treatment is successful, these cases often resolve with no permanent damage done to the pancreas1, 2.
On the other hand, chronic cases can linger; they may not have as severe clinical signs, and the signs that do show up may wax and wane. In these cases, there can be permanent damage done to the pancreas, which may (or may not) become bad enough to affect its function in the body1.
Pancreatitis in cats can lead to diabetes or exocrine pancreatic insufficiency (EPI), which can be temporary or permanent if the damage to the pancreatic cells occurs in the chronic form16,20. However, a cat with chronic pancreatitis does not necessarily mean they will develop diabetes or EPI...clear as mud, right?
The possible outcomes of pancreatitis are generally defined by how severe the symptoms appear. If things are mild, chances are things will turn out fine, but if symptoms are more serious, then you may have a very sick cat with prolonged hospitalization in your future—or worse, if things are allowed to progress too far1,3. As with any disease, if co-morbidities exist—such as diabetes or other chronic GI diseases—chances of a favourable outcome decreases. In the same vein, if complications arise during treatment, such as hepatic lipidosis or multiorgan failure, and are not promptly addressed and successfully treated, then the outcome could also be grave1,2,3,12.
Pancreatitis: Often Secondary to Other Underlying Diseases
Remember how we said pancreatitis can crop up in conjunction with other diseases? This is particularly true with chronic cases of pancreatitis, where it often appears alongside inflammatory bowel disease (IBD), diabetes, hepatic lipidosis (fatty liver syndrome), and cholangiohepatitis (inflammation of the bile ducts). In these cases, treating the primary disease is paramount1,2,7,20, because it can often manage pancreatitis as an additional benefit1.
This means that if your cat is diagnosed with pancreatitis, it is imperative that your veterinarian investigates further to see if there is another undetected underlying disease. This may involve more specific blood tests or serial blood tests (which is to say, at least two blood tests with 24 hours or more in between) to establish a trend. Ultrasounds, invasive tests (such as gastrointestinal biopsies to rule out IBD), or even referrals to internal medicine specialists may also be required. We get that this sounds like a lot, but it’s important to understand that if an underlying disease is present—even if it appears to be dormant and relatively ineffectual—but not diagnosed and treated, it’s unlikely their pancreatitis will ever be under control.
Let’s say you’ve done everything right: your veterinarian has done a thorough investigation and determined there are no other diseases at play alongside the case of chronic pancreatitis—or alternatively, there IS another disease, but pancreatitis is complicating or worsening the prognosis of that disease. In these cases, it’s pancreatitis management go-time. Unfortunately, there’s no standard one-size-fits-all treatment protocol for pancreatitis in cats. Most treatments revolve around supportive care with advice based on case reports rather than specific studies1. Supportive care may include hospitalization, IV fluid therapy, pain management, medications to stop vomiting and nausea, and other medications as indicated1,2,3. If a trigger or inciting cause can be identified—like a parasite or drug—then a specific treatment and complete cure may be possible1!
How To Manage Pancreatitis In Cats: Nutritional Therapy
One of the most important aspects of treating pancreatitis (and other ailments!) in cats is nutritional therapy1,3,12. It’s imperative that cats continue to eat regularly, which can be a challenge when they have pancreatitis; often, you’ll find they won’t eat as much or stop eating altogether.
Cats with reduced food intake are at risk of developing hepatic lipidosis1,2,3, which can happen in only a few days. This further complicates the situation because cats with hepatic lipidosis will feel even worse than they did before and be even less inclined to eat, but eating is the thing that will treat them! Before you know it, you and your cat can get stuck in a vicious cycle where the health of the gastrointestinal tract rapidly declines and leads to a poorer prognosis2… essentially, your cat’s body will be keeping them sick.
The most important step at this point is to get them to eat anything at all—there’s no point in trying to treat a sick cat if they don’t have the energy or nutrients to begin to heal. If you’ve reached the stage of having a sick and fasting cat, your next step will be treating hepatic lipidosis by inserting a feeding tube…and this is before you’ve even gotten to tackling the primary issues!
Should We Focus On Low-Fat Foods for Cats With Pancreatitis Like We Do With Dogs?
The short answer is NO!
There have been no studies that definitively point to any particular diet being better at treating a cat with pancreatitis than another2,20. Every cat’s case will be different, and their treatment must reflect that: above all, the goal is to get them to eat enough on their own as quickly as possible1,2,12. Remember, it's more important to get them to eat something than to eat the "right" thing. That said, Veterinary Nutrition experts do not believe that pancreatitis in cats is affected by high-fat diets1,2,3,12,20. Despite this, some Veterinary Internal Medicine Specialists avoid high-fat diets in treating pancreatitis due to personally observed associations rather than actual studies2,3. While there has been some extensive research in low-fat diets being essential for dogs with pancreatitis, the same studies are not present in cats, and—believe it or not—cats are not dogs. (Crazy, we know.) Joking aside, cats are obligate carnivores and can handle fats in their body differently and much more effectively than dogs.
In some cases, cat owners may see improvements with low-fat diets because they may help resolve the other factors contributing to pancreatitis, such as IBD. Keep in mind that many other gastrointestinal disorders respond to low-fat diets, so switching to a low-fat diet may produce some improvement to the contributing disease, therefore providing an additional benefit in improving the case of pancreatitis. However, if pancreatitis is the only disease present, a low-fat diet is not necessarily the proper treatment. In fact, cats with pancreatitis that need to be fed through feeding tubes in veterinary hospitals are often given high-fat liquid nutrition2,20.
What Kind of Diet Should I Feed My Cat if They Have Pancreatitis AND Another Disease?
When it comes to cats battling pancreatitis alongside other diseases like diabetes and IBD, some diets are particularly suited to resolving or alleviating these conditions and potentially helping them recover from their pancreatitis. Multiple studies have shown that cats with diabetes can benefit from a high protein, high moisture, low carbohydrate diet6—to the point they may even go into complete remission! The higher protein in the diet normalizes fat metabolism and provides a slow, consistent energy source; on the other hand, carbohydrate-rich diets may cause hyperglycemia from the sharp increase in glucose6.
We also know that cats with IBD can benefit from changing their diet to a gluten-free protein with a moderate amount of soluble fibre—particularly if it’s a protein they haven’t tried before6,13! The idea here is if they haven’t encountered a protein before, the body (in theory) shouldn’t react to it. This gives the gastrointestinal tract time to heal because it’s not being constantly bombarded with the food that was causing the inflammation to start with7,13.
You may notice a bit of a theme developing here: too much of the wrong food, inflammatory foods, or species-inappropriate foods could be the cause of chronic disease…just like in humans! (Any celiac readers out there?) Since pancreatitis fits into the category of chronic diseases, we think it’s fair to draw some inferences and assume these types of foods could be contributing factors. But since there are some less-than-flattering sayings about making assumptions, let's dig into this chronic inflammation theory a little bit more.
Which Foods Cause Inflammation, and How Can We Avoid It in Our Cat’s Diet?
While many things can cause inflammation, food is often the primary contributor. Without going too deep into the science of it, we should note that not all inflammation is bad—it’s an important part of the immune system’s basic functions—but as it’s often said, too much of anything can be detrimental. Furthermore, an excess and ongoing amount of inflammation in the body can lead to chronic diseases and even cancer. But since it’s difficult to tell when inflammation starts, the primary tactic is to avoid foods that cause it—and determining which foods are is easier than you may think.
Processed Diets
Let’s start by looking at processed diets, like kibble. Dry pet food is made by undergoing a high-temperature process at least four times (through various methods of cooking raw ingredients, making doughs, baking, and oven drying)4. While most of us know that heating food changes the basic chemical composition of ingredients9,10, we don’t often think about the actual effects those compositional changes have in our bodies or to what extent. When foods containing vegetable oils (most dry pet foods) are heated to high temperatures, they go rancid quickly and create ALEs (Advanced Lipoxidation End products)4,10. Consuming foods with these oxidized (or rancid) fats causes inflammation in the form of oxidative stress; this type of inflammation has been implicated in causing acute pancreatitis in humans and animal models4,8,9. In addition, the longer these foods are exposed to heat, the more ALEs are produced, which have adverse effects on pancreatic function and can promote chronic disease in the body4,10. If that sounds scary enough, buckle up: cooking or heat-treating carbohydrates and proteins together can create even more toxic end products, called Advanced Glycation End products, or AGEs, that have been thought to be linked to acute pancreatitis in humans4,8,9,10.
Since pancreatitis can strike a cat of any age, sex, or breed1, your best bet is to avoid foods that may be implicated in poor health, especially when there are so many other healthy and condition-appropriate diet options! While there’s never going to be a diet that guarantees a 100% disease-free life, preventative health measures are the best defence you can give your cat.
The Solution? Keeping it Simple: Raw Diets For Cats with Pancreatitis
Since we’ve already talked about having low-to-no carb diets and limiting the amount of heat your cat’s food is exposed to, it may not come as a surprise that we would argue that a balanced raw diet is the better choice for most cats with pancreatic issues. Unlike in processed foods where fats are heated and can potentially become rancid, the pancreas handles uncooked fats from raw animal sources very differently4,10 because they don’t undergo the same kind of oxidation as vegetable oils do4,11. An important amendment here: animal-sourced fats can go rancid, but they’re generally more stable, break down slower, and are therefore overall safer to feed.
That said, we don’t recommend throwing down a slab of steak and calling it a day: you’ll still want a good balance of saturated fats (mostly from beef, lamb & pork) and polyunsaturated fats (mainly from fish and poultry) for optimal nutrition.
Does It Matter What Raw Proteins You Choose?
In cats with ONLY pancreatitis, the protein choice and fat content of their raw meals don’t matter; what matters most is that they’ll eat enough of it, and consistently. In situations where there is another underlying disease, such as IBD, exotic proteins such as Venison, Buffalo, Kangaroo, or Wild Boar may be your best choice. Remember that if you’re using RDBK products, you’ll need to rotate proteins to achieve your cat’s complete nutritional requirements. If your cat is too sensitive to food changes or cannot handle rotating proteins for whatever reason, be sure to seek the advice of an animal or veterinary nutrition specialist to recommend appropriate supplements to fill in their remaining nutritional needs.
What Whole Food Supplements or Therapies Can Help Cats With Pancreatitis
Since pancreatitis is an inflammatory process driven by oxidative stress, it would make sense that supplements with anti-inflammatory and antioxidant properties might help. Wouldn’t it be nice if it were that easy? Unfortunately, not all supplements work for all cats, so your best bet is to consult with your holistic veterinarian to determine which supplements might work for your individual feline. Remember that pancreatitis often comes along with other conditions that might not react well to some of the supplements listed below. And of course, if anything added to your cat’s food stops them from eating, discontinue it immediately and re-evaluate your treatment plan with your veterinarian. Your cat’s continuous and adequate caloric intake is more important than any other supplements you may be providing.
Supplements for Cats With Pancreatitis
Bone Broth:
This can be soothing for a cat's GI tract; it can provide collagen, glucosamine, and minerals and may also help coax a cat with no appetite to eat again. Do not use human bone broths, as these often contain non-cat-friendly foods and can be high in sodium. The best option is to source a good quality cat product or make it yourself.
Omega Fatty Acids:
These are an ideal addition in reducing inflammation, but only if your cat can tolerate them. They have excellent anti-inflammatory properties and can help with overall health in many areas of the body.
B Vitamins
Cats with GI problems often have inadequate levels of B vitamins because their gut is not absorbing nutrients as efficiently as it should. This can be easily tested for via a fasting blood sample. Vitamin B supplementation comes in both injectable and oral forms for maximum convenience.
Probiotics:
This one is a little controversial! But only because a study in humans with pancreatitis showed probiotics making things worse15. On the other hand, a study in rats showed they had multiple benefits14; unfortunately, no similar studies exist in cats. This means that giving your pancreatic cat probiotics comes down to careful observation: if things are getting better, then carry on; if your cat takes any turn for the worse, discontinue immediately. Because of this potential variability, be discerning with the probiotic that you choose—if possible, choose one that is cat-specific. (Some of RDBK’s cat recipes already include feline-specific probiotics!) It might be tempting to write off adding probiotics entirely when managing your cat’s pancreatitis, but a healthy microbiome is the key to a healthy GI tract, a healthy pancreas, and a healthy immune system. Always introduce any probiotic slowly: start with 1/4 – 1/2 of the suggested dose and increase gradually; some less desirable bacteria may go through a “die-off” when beneficial probiotics are added, so a slow introduction will produce the least amount of digestive upsets.
Alternatively, there are excellent pre and probiotics readily available in whole foods such as fermented veggies, kefir, and plain, unsweetened Greek yogurt (just remember to read the label and avoid sweeteners such as xylitol at all costs).
Visit our blog 4 Essential Supplements for a Raw food Diet to see which probiotic supplements we recommend!
Digestive Enzymes
While some cats might benefit from giving the pancreas a little bit of help, we have to be careful with adding these to our cat’s meals. When they have digestive issues, and their pancreas is not functioning as it should—as in pancreatitis—these enzymes might be the little boost your cat needs. However, once your cat has recovered and is back to their usual self, there’s evidence to show that digestive enzymes have no added benefit. In fact, they might actually be suppressing the natural productions of the pancreas in its normal functioning state17,18,19. For this reason, we recommend using them as an aid when your cat is in the thick of the fight with pancreatitis but weaning them off once things have settled down.
Antioxidants
Since oxidative stress fuels pancreatitis, providing antioxidants to cats with pancreatitis makes sense. Studies were done using a combination of antioxidants with SAMe, selenium, beta-carotene, vitamin C and vitamin E, successfully showing that antioxidants can lead to reduced abdominal pain2. Always consult your veterinarian for cat-safe supplements, as human preparations of the same antioxidants can be harmful or even fatal to our feline friends.
Chinese Herbs
Many Chinese herbs may benefit cats with pancreatitis, but they can be very symptom-specific. Our only recommendation for this course of action would be to consult a veterinarian experienced in practicing Traditional Chinese Veterinary Medicine (TCVM) if you are interested in incorporating herbal medicine.
Integrative Therapies for Cats With Pancreatitis
Glandular supplements, acupuncture, homeopathy, chiropractic, and other holistic practices may be a great adjunct while your cat is healing from pancreatitis. Again, we encourage you to seek out experienced veterinary practitioners for any of these practices; be aware that what might have worked for one cat may not work for another.
In The End…
While we’ll stand by everything we’ve talked about in this article, managing a cat with pancreatitis is not the time to be seeking advice solely from a blog. As we’ve said before, your cat is an individual and will require an experienced veterinarian to assess them, especially if they are dealing with multiple diseases. Disease processes can be complex and have numerous factors at play. For these reasons, we cannot recommend highly enough that you find a veterinarian willing to take the time to work with you to find the right food, treatment, supplements, and supportive care for your unique furry ball of love.
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