EPI and cancer in cats

Re: EPI and cancer in cats

Mark Hedberg — Thu, 05 Sep 2013 09:23:19 GMT

Well, considering that at a very minimum, most cats older than 8 yo have some form of kidney issues, I'd say every old cat has at least *something* wrong with it. (I apologize, I know that's not very helpful. My clients weren't keen on PM, despite my best efforts.)

Re: EPI and cancer in cats

Martin Atkinson — Thu, 05 Sep 2013 09:23:05 GMT

I hardly diagnose EPI in dogs these days let alone cats! I suspect in cats it is as the result of end stage chronic on acute pancreatitis i.e. repeated bouts of pancreatitis resulting in destruction of the pancreatic exocrine tissue. I have one such case now, I want to do pancreatic biopsies but the owner is reluctant. I think pancreatitis is far more common in cats than recognised and is often associated with colangio-hepatitis and IBD and as in dogs a lot of cats that are 'off colour' for a few days actually have a bout of acute pancreatitis. Cats don's present with classical symptoms and it is difficult to confirm diagnosis even with pancreatic lipase. Indeed I read somewhere that 30% of cats presented for PM examination for reasons other than for suspected pancreatitis show evidence of previous bouts of the condition.

Re: EPI and cancer in cats

scatty — Wed, 04 Sep 2013 23:01:46 GMT

Thanks for your replies everyone - nice to hear lots of advice which is reassuring. I agree, I think the pancreas was probably infiltrated as well as the liver.

Just wondered, has anyone ever seen EPI in a cat which is not associated with any other disease and in middle age to older age presentation? I've just read that the majority of cats with EPI have other concurrent disease of some description. I know every case is different, but in the future I think I will be much more suspicious of EPI being secondary to another cause, unless the animal is young and fit with no other suspicious signs!

Re: EPI and cancer in cats

Christopher Saul — Wed, 04 Sep 2013 20:22:52 GMT

The EPI may have been real, secondary to neoplastic infiltration of the pancreas.

Definitely don't beat yourself up though, you offered ex lap and this was declined; that's not your fault.

Re: EPI and cancer in cats

Mark Hedberg — Wed, 04 Sep 2013 14:25:15 GMT

Also, remember that highly digestible food and good supportive therapy treats more than just EPI; you were possibly inadvertently treating the underlying liver disease as well; taking strain off the organ function and thereby causing clinical improvement.

Re: EPI and cancer in cats

Martin Atkinson — Wed, 04 Sep 2013 11:01:09 GMT

No, but don't beat yourself up about it, you did everything any one of us would have reasonably done. It begs a question as to whether the EPI was a spurious diagnosis as it was in hindsight clearly not the only problem, and probably the pancreas was involved/associated with his liver disease. Without biopsies it may be difficult to say the liver lesions were neoplastic or advanced cholangio/lymphocytic hepatitis which may be associated with pancreatic disease and IBD, so called triaditis. You gave the owners the choice of ex. lap/biopsies they made their call not to so it was their choice. Just remember that up to 50% of diagnoses are proved wrong on PM examination even in humans (or should that be especially!) none of us are infallible.