Exocrine Pancreatic Insufficiency in Cats

The pancreas is a complicated organ responsible for producing a variety of substances important for breaking down food and aiding in digestion, which allows your cat to properly absorb nutrients. In cats suffering from exocrine pancreatic insufficiency, the pancreas fails to produce sufficient amounts of digestive enzymes. This starts off a chain reaction of poor nutrient absorption and poor digestion of food that can have a significant impact on the health of your cat if left untreated for a long period of time.

Exocrine pancreatic insufficiency is a difficult condition to diagnose given the individual symptoms can often mimic other conditions. The differentiating characteristic is a chronic presence of one or more of the following symptoms:

• Weight loss despite adequate appetite
• Chronic diarrhea
• Poor coat condition
• Increased appetite
• General lethargy
• Vomiting

Exocrine Pancreatic Insufficiency occurs when the pancreas produces insufficient quantities of digestive enzymes. These enzymes are secreted into the digestive system of your cat, allowing for food to be broken down into micronutrients, which provide important support for your cat’s daily functions. Some of the most common causes of exocrine pancreatic insufficiency include:

• Chronic inflammation of the pancreas
• Parasitic infections
• Cancer
• Diabetes
• Damage caused by chronic pancreatitis

Diagnosis of exocrine pancreatic insufficiency in your cat will begin with a thorough physical exam by your veterinarian. Given the way the symptoms have commonalities with other diseases, your veterinarian will perform a differential diagnosis. A differential diagnosis is a type of procedure in which a veterinarian rules out conditions with similar symptoms, rather than using symptoms to identify one particular condition. It will be important to provide your vet with a complete list of symptoms as well as their approximate date of onset and whether they have remained stable or have changed over time.

During the exam, your veterinarian will perform a full blood panel, a urinalysis, and a test for parasites. Drawing blood for the tests requires a simple needle stick and is quick and relatively painless. In order to test for parasites, your vet may need to collect a stool sample.

Your veterinarian will also order a blood panel that looks at digestive function and the pancreas, called a GI panel. This is a series of four analyses, one of which measures trypsin-like immunoreactivity. This is the definitive test for diagnosing Exocrine Pancreatic Insufficiency in cats. The test will also measure levels of vitamin B12. Most cats suffering from exocrine pancreatic insufficiency are also deficient in this vitamin.

Finally, if your cat is found to be suffering from exocrine pancreatic insufficiency, your veterinarian may also want to run additional tests to confirm whether your cat has diabetes. Diabetes causes damage to the pancreas over time and exocrine pancreatic insufficiency can often be a side effect. 

Once the pancreas has sustained damage, it does not typically recover full function. Treatment of Exocrine Pancreatic Insufficiency in your cat will usually involve lifelong supplementation with digestive enzymes to allow the cat to appropriate process food and nutrients. Digestive enzymes typically come in powdered form and some cats may be unwilling to eat the supplement. Owners should work with their vets to identify appropriate soft foods to mix with the enzymes. Alternatively, eating raw pancreas has been shown to increase pancreatic enzyme levels. This may be used in cats with extreme aversions to supplemented enzymes.

Cats with exocrine pancreatic insufficiency will also need to be supplemented with vitamin B12 since they are unable to absorb appropriate amounts of this important vitamin from their food. Vitamin B12 can be administered on a routine basis with shots given beneath the skin.

While exocrine pancreatic insufficiency can be managed over the life of your cat, there is generally no known cure for the condition. Supplementation with appropriate levels of enzymes will help your cat with absorbing food, but will not completely manage the condition. Your cat’s diet will most likely need permanent modification. It will be particularly important to reduce fat intake, since fat is typically highly dependent on pancreatic enzymes for appropriate absorption.

Long-term, cats who suffer from exocrine pancreatic insufficiency suffer no loss of lifespan or quality of life as a result of their condition. Your cat will need to maintain a regular veterinarian visit schedule in order to monitor blood levels and to ensure your cat is gaining weight and getting appropriate nutrition.