Recently, I highlighted a common pancreatic disorder in dogs, pancreatitis. The following day, the New York Times “Well Pet” blog wrote about a much less common, but equally serious pancreatic disorder, exocrine pancreatic insufficiency (EPI). The article focuses on EPI in dogs, but cats also can suffer from this disease.
The pancreas has two main functions: first to produce the hormone insulin to control blood sugar and second to produce digestive enzymes. Production of insulin is the pancreas’ endocrine function and production of digestive enzymes is an exocrine function. Deficiency of insulin is called diabetes.
Deficiency of the digestive enzymes has a much more descriptive name – exocrine pancreatic insufficiency.
What a cat with EPI looks like
The classic cat with EPI is skinny, greasy, and has bad diarrhea. The absence of digestive enzymes prevents the gastrointestinal tract from breaking food down into it components, and if they are not broken down, the nutrients cannot be absorbed. If your cat has this disorder, he will eat lots of food and lose weight rapidly. Cats with EPI are greasy because they cannot digest fats without pancreatic enzymes and all the undigested fat in their stool gives them nasty diarrhea.
The causes of feline EPI
This disorder is thought to be inherited in certain dog breeds, most commonly German shepherds. Cats never want to be like dogs. Exocrine pancreatic insufficiency in cats does not appear to have a genetic component and is more likely to be the result of chronic damage to the pancreas from long standing pancreatitis. These cats may also be diabetic if the pancreatic damage is severe enough to prevent production of both digestive enzymes and insulin.
Testing the skinny cat
When I see a cat with weight loss, I commonly collect blood for what The Animal Medical Center (AMC) calls a GI panel. This quartet of tests looks at the digestive function of the pancreas and small intestine. One of the tests measures trypsin-like immunoreactivity and is the diagnostic test of choice for feline EPI. Another important test on this panel measures vitamin B12 or cobalamin. A study of feline EPI cases at The AMC and Purdue University found all cats with EPI were deficient in this important vitamin.
Once lost, the pancreas do not typically regain exocrine pancreatic function. Management of EPI requires lifelong supplementation with pancreatic enzymes and vitamin B12. Vitamin B12 supplementation is simple: a small injection given under the skin once a week. Pancreatic enzymes come as a powder and are sprinkled on the food. This is where cats can be challenging since many cats refuse food that has been embellished. Raw pancreas (which contains the digestive enzymes) has been recommended, but I haven’t tried it on any patients, yet. The good news is our study of feline EPI showed most cats will respond to therapy.
Resources on pancreatic disease