In my last blog, you heard about my Mickey, who was sickey. Well, the mystery has been solved! The abdominal ultrasound discovered an unsuspected culprit in the demise of his personality and comfort: pancreatitis. Wow, I didn’t see that coming! Considered acute, the poor guy must have been suffering with discomfort for several months; we know how painful pancreatitis can be for humans, and so we assume the same for animals. But in cats especially, it’s a difficult thing to detect. My main experience with pancreatitis comes from my years working in internal medicine and critical care, where our odds of pulling a dog through were pretty high, and our odds of pulling a cat through were dismal. Mickey’s hope rested on the fact that at least he was still nibbling food, and not consistently vomiting so we had a chance to turn things around. He has been responding to medical treatment thus far (famotidine and cerenia for nausea, and gabapentin for pain) and is finally showing some of his old personality! Such a relief … but it was so aggravating to have taken so long to identify the issue. As most pet owners do, I went back to the internet to read more about pancreatitis after we had a firm diagnosis. I came across a really good article at /redirect.aspx?location=http%3a%2f%2fwww.vetinfo.com%2fcpancrea.html. Although it was written in 2005, before they were using gabapentin for the pain portion of the condition, it validated so many of the things I had seen when I tried to report that something "just wasn’t right.” See, I wasn’t crazy after all! Here’s what I found out in the article: Signs seen in dogs are not common in cats—seen less than 25 percent of the time in fact. Cats are much better at hiding the symptoms, to the point where pancreatitis isn’t even suspected in most cases and it doesn’t make it on the list of differential diagnoses. Even in necrotizing pancreatitis, a cat may be depressed and won’t eat, but may not show much else even though the pancreatitis is severe. Lethargy and low body temperature is common, which explained why Mickey was sleeping so much and crawling UNDER the heated bed pad to hide in the warmth. Cats sometimes exhibit difficulty in breathing. The last time I whisked him to the vet, I was sure he was suffering from dyspnea, or difficulty breathing. But nothing unusual was detected with his respiratory or cardiac functions. Routine blood counts and blood chemistry analysis in cats is less helpful than in dogs, which explains why two rounds of lab work didn’t demonstrate an issue. Amylase and lipase values in cats do not correspond well to pancreatitis. Serum chemistry values tend to be normal. Radiographs are also less useful in cats than in dogs, which explains why the radiographs left us with nothing solid. In fact, the article states that even good ultrasonographers have difficulty identifying pancreatitis, which made me very thankful that we waited a few extra days for the boarded radiologist to perform the ultrasound. Mickey is responding well, although slower than I would have liked. But last weekend, he finally repeated some of his nuisance behavior (banging the bedroom door, climbing up on any shoulder nearby, etc.) and I knew we were headed in the right direction … I’ll take naughty over sick any day! Pancreatitis in cats can occur along with IBD and cholangiohepatitis (known as the "triad syndrome”), so we’re not out of the woods yet, but it’s nice to at least see a clearing in the trees in the distance!
