Case Study

Pancreatitis in a 13 year old FS DSH cat

A 13-year-old FS DSH was presented for history of intermittent vomiting. On physical examination, the patient was QAR, painful on abdominal palpation, and vocalizing. The only abnormality on CBC was lymphopenia. Blood chemistry was within normal limits, and T4 was within normal range. Feline SPEC fPL was consistent with pancreatitis. The patient was treated with Pepcid, buprenorphine, and subcutaneous fluids.

DX

Chronic active pancreatitis

Sonographic Differential Diagnosis

Chronic active pancreatitis is highly likely.

Image Interpretation

The pancreas had a dilated pancreatic duct and swollen contour in the left base of the pancreas. It measured 1.1 cm, which is approximately 40% enlarged compared to a normal feline pancreas (0.5-0.7 cm). This is consistent with chronic active pancreatitis.

Outcome

The patient was treated gabapentin, Tramadol, a Fentanyl patch, Mirtazapine, Amoxicillin, and placed on a low fat diet. A month later the patient was still being treated with Buprenex, was on a duck and pea diet, and taking pancreas enzyme powder supplement.

Comments

Full-thickness biopsies of the gastrointestinal tract were discussed as being ideal. Supportive care with intravenous fluid therapy support and treatment with Zithromax could be considered as an interim measure. Testing for toxoplasmosis and Bartonella was also advised, and prednisolone therapy recommended if the patient appeared to be nonresponsive to therapy.

Clinical Differential Diagnosis

Pancreatic disease (chronic pancreatitis, neoplasia), GI pathology (neoplasia, IBD, partial obstruction).

Sampling

None

Patient Information

Patient Name : Blossom T

Gender : Female, Spayed

Species : Feline

Type of Imaging : Ultrasound

Status : Complete

Liz Wuz Here : Yes

Code : 05_00065

Clinical Signs

Vomiting

Exam Finding

Abdominal Pain
Vocalizing

Images

CBC

WBC, Low

Clinical Signs

Vomiting

Special Testing

fPLI Positive