Diabetes & pancreatitis in cats

Forcada Y, German AJ, Noble PJ, et al. Determination of serum fPLI concentrations in cats with diabetes mellitus. J Feline Med Surg. Oct 2008;10(5):480-487.

Diabetes Mellitus (DM) is one of the primary endocrine diseases of cats. Pancreatitis is suspected of being one of the main causes for poor control of DM in cats, yet no one knows how frequently this may occur. There are no prior reports indicating the prevalence of pancreatitis in live diabetic cats. In recent years, a test determining serum feline pancreatic lipase immunoreactivity (fPLI) has been evaluated as a possible test for pancreatitis. Researchers in this study compared samples from 29 diabetic cats and 23 non-diabetic cats for measurement of fPLI concentrations to serum fructosamine levels and clinical signs. The study had three aims. The first was to determine if fPLI concentrations were higher in cats with DM. The second was to see if serum fPLI levels could be linked to diabetic control, and last, to determine if these cats had any specific clinical signs of pancreatitis.
Researchers found the median fPLI concentrations were significantly higher in the diabetic patients than the median concentrations in the non-diabetic cats. This would suggest that pancreatic inflammation is likely more prevalent in diabetic cats than non-diabetic cats. Unfortunately, a limitation of the study is that the finding of increased fPLI levels implies but does not confirm the presence of pancreatitis. Since this was a retrospective study, the investigators were unable to support a diagnosis of pancreatitis by utilization of pancreatic histopathology or abdominal ultrasonography. The median serum fructosamine values were also found to be significantly higher in the diabetic cats than the non-diabetic cats. However, there was no clear association between serum fructosamine concentrations and the clinical judgment of diabetic control by the referring veterinarian. This study indicates that pancreatitis could be a major complicating factor in a percentage of diabetic cats, even those cases that appear to be under good control based on serum fructosamine concentration. Further studies are indicated to determine how pancreatitis influences the control, progression, and management of DM and how DM and other major diseases affect fPLI concentrations.
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Related articles:
Forman MA, Marks SL, De Cock HE, et al. Evaluation of serum feline pancreatic lipase immunoreactivity and helical computed tomography versus conventional testing for the diagnosis of feline pancreatitis. J Vet Intern Med. Nov-Dec 2004;18(6):807-815.
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Steiner JM, Wilson BG, Williams DA. Development and analytical validation of a radioimmunoassay for the measurement of feline pancreatic lipase immunoreactivity in serum. Can J Vet Res. Oct 2004;68(4):309-314.
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More on cat health: Winn Feline Foundation Library

Diagnosis of Feline Pancreatic Disease

Webb, C. B. and C. Trott (2008). "Laparoscopic diagnosis of pancreatic disease in dogs and cats." J Vet Intern Med 22(6): 1263-6.

Despite advances in diagnostic testing, the diagnosis of many pancreatic diseases is not straightforward. The pancreatic-lipase immunoreactivity (PLI) assay is sensitive and specific for pancreatic disease, but cannot identify the source of the inflammation. Pancreatic disease may be due to many different causes, such as acute nonsuppurative or chronic lympoplasmacytic pancreatitis, or pancreatitis secondary to another disease process such as inflammatory bowel disease or bile duct obstruction. Noninvasive imaging methods such as ultrasound or radiology have variable degrees of sensitivity and specificity. The gold standard for the diagnosis of exocrine pancreatic disease in animals remains biopsy and histopathology. Laparoscopy offers a minimally invasive route by which to obtain pancreatic biopsies. In this retrospective case series, the medical records of 18 dogs and 13 cats examined between 1999 and 2007 at Colorado State University that underwent laparoscopy during which observation or biopsy of the pancreas was recorded were examined. The presenting complaints, imaging studies, and histopathologic findings were recorded. For comparison, all hospital admissions were searched for animals with the same presenting complaints and of those it was determined which animals had exploratory surgery and their pancreas biopsied. In 14 animals a laparoscopic biopsy of the pancreas resulted in a histopathologic diagnosis when the sonographic findings or the gross assessment failed to do so. Results of this study suggests that laparoscopy is a safe and potentially underutilized diagnostic tool in animals where exocrine pancreatic disease is a prominent differential diagnosis, as in dogs and cats examined for vomiting, anorexia, or both.
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Related articles:
Richter, K. P. (2001). "Laparoscopy in dogs and cats." Vet Clin North Am Small Anim Pract 31(4): 707-27, ix.
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Zoran, D. L. (2006). "Pancreatitis in cats: diagnosis and management of a challenging disease." J Am Anim Hosp Assoc 42(1): 1-9.
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More on cat health: Winn Feline Foundation Library