The chronic form of pancreatitis, defined histologically by mononuclear cell infiltration and variable amounts of fibrosis, is generally thought to be associated with less fulminant clinical signs that extend over a longer time period than is typical for either acute form, often with a waxing and waning course. 7, 8, 9, 10 The 3 best characterized forms are acute necrotizing pancreatitis, acute suppurative pancreatitis, and chronic nonsuppurative pancreatitis. Several studies have described and categorized the histopathological features of the pancreas in cats clinically ill with pancreatitis. Although much is still not known about feline pancreatitis, there have been major advances over the last few years. Fortunately, awareness of feline pancreatitis is increasing, and clinical tools to evaluate the pancreas are more accessible than ever. In cats with multiple diseases, it can be difficult to identify which disorder is most clinically important all may need attention to treat the patient most effectively. Pancreatitis may cause cats with diabetes mellitus to become ill and present with ketoacidosis. Furthermore, pancreatitis in cats commonly occurs concurrently with other disease(s), especially chronic inflammatory small intestinal disease, to a lesser extent hepatic lipidosis and cholangitis, and perhaps disease of other organs too. Clinical signs of chronic pancreatitis are often vague and nonspecific such that an index of suspicion for the disease is not readily triggered. Chronic disease is suspected to be more common than acute disease in cats. Predisposing causes such as hyperlipidemia and dietary indiscretion or ingestion of a high fat meal/diet that are thought to be important in dogs seem to be unimportant in cats. There is an emerging clinical impression, however, that there are also important differences between pancreatitis in the two species. Common nomenclature can be used to histopathologically define the categories of disease (even though that may not be clinically useful). 1, 2 It is likely that there is much common pathophysiology in the development of the disease in each species. Acute and chronic forms of pancreatitis are recognized in cats, and can be very similar to what is described in dogs. This is largely because of increased availability and utilization of abdominal ultrasonography (and growing veterinary expertise) as well as recognition of the limitations of classical diagnostic tests and development of newer, more sensitive and specific tests. Pancreatitis in cats is increasingly recognized as being far from rare. Less is known about chronic pancreatitis than the acute form, but chronic pancreatitis is more common in cats than it is in dogs and may respond positively to treatment with corticosteroids. Therapy is similar to that used in dogs, with added emphasis on early nutritional support to prevent hepatic lipidosis. Additionally, pancreatitis may trigger hepatic lipidosis, while other diseases, such as diabetes mellitus, may be complicated by pancreatitis. Pancreatitis in cats often co-exists with inflammatory bowel disease, less commonly with cholangitis, and sometimes with both. With increasing clinical suspicion, availability of abdominal ultrasonography, and introduction of pancreas-specific blood tests of increasing utility, it is now accepted that acute pancreatitis is probably almost as common in cats as it is in dogs, although the etiology(s) remain more obscure. It was apparent that few of the diagnostic tests of value in the dog were helpful in cats. Pancreatitis was considered a rare disease in the cat until a couple of decades ago when several retrospective studies of severe acute pancreatitis were published.
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