How To Manage Pancreatitis In Cats: Nutritional Therapy
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 lo