Probable pancreatic pseudocyst in a cat

Re: Probable pancreatic pseudocyst in a cat

Rebecca MacMillan — Wed, 10 Jun 2015 11:18:46 GMT

The owner doesn't report him having a reduced appetite, and he wasn't showing any real clinical symptoms at home.

Re: Probable pancreatic pseudocyst in a cat

Rory Bell — Mon, 08 Jun 2015 18:56:49 GMT

Whether or not you should be doing anything more medically does depend a little on whether the cat has ongoing evidence of pancreatitis, so a fPL assay would be useful. We also do not know what the parenchymal changes in the liver represent, and whether they are playing a role in the cat's previous weight loss or not.

You don't mention whether the cat previously had a poor appetite; if he did, then it is possible that the cyst might have been responsible for the inappetence by virtue of compressing adjacent structures (bile duct and/or intestines).

cheers

rory

Re: Probable pancreatic pseudocyst in a cat

Rebecca MacMillan — Mon, 08 Jun 2015 18:14:10 GMT

Thanks for your reply!

Should I be doing anything medically for this cat following drainage? Would antiinflams/pain relief be of benefit in case of active pancreatitis grumbling on? The cat is eating well and bright, no abdo pain and normal faeces according to owner. Would the cyst alone contribute to weight loss?

Re: Probable pancreatic pseudocyst in a cat

Rory Bell — Mon, 08 Jun 2015 16:57:14 GMT

Hi Rebecca

I'd agree with the differentials you listed for this cyst. It is possible, but less likely, that this is part of a more malignant process (cystadenocarcinoma). If you wanted to confirm pancreatic origin and you still had cyst fluid available, you could run a fPL assay in the fluid as well as the serum. One old case series did this (albeit with old-fashioned lipase) and lipase in the fluid was elevated, and generally higher then serum lipase in dogs and cats with pancreatic pseudocysts.

I don't think you have a lot of convincing evidence of liver failure here, so I would not be in a hurry to run a BAST in this cat.

The time to recurrence following drainage is variable, and while some do, some don't! In this cat, provided that the owner is aware that there might be something nasty lurking underneath all this, I would not be pushing for surgery. It is quite possible that if there was an underlying neoplasm, that it would not be amenable to surgical excision and you do run the risk of considerable post surgical morbidity in a cat that was outwardly well to begin with.

cheers

J Vet Intern Med. 1999 Jul-Aug;13(4):309-13.

Pancreatic pseudocysts in 4 dogs and 2 cats: ultrasonographic and clinicopathologic findings.

VanEnkevort BA1, O'Brien RT, Young KM.

Author information

Abstract

Pancreatic pseudocysts were diagnosed in 4 dogs and 2 cats based on ultrasonographic and clinicopathologic findings. All 6 animals had a clinical diagnosis of pancreatitis. Five of 6 pseudocysts were in the left pancreatic limb, and in 1 cat the pseudocyst was in the pancreatic body region. Cyst size ranged from 2 x 2 cm to 7 x 6 cm. All pseudocysts had anechoic regions that were aspirated using ultrasound guidance for diagnostic and therapeutic purposes. No morbidity was associated with the aspiration procedures. Cytologically the pseudocyst fluid was aseptic in all patients and had low numbers of inflammatory cells in 5 of 6 patients. All animals had high lipase activity in the pseudocyst fluid and in 2 dogs and 1 cat the lipase activity in the fluid was greater than in serum. Three of the 4 dogs were managed medically. In the 1 dog that had long-term follow-up ultrasound examination, the pseudocyst persisted for several days following aspiration and had disappeared 8 months after diagnosis. All 3 of these dogs were clinically normal 1.5-4 years after presentation. The 4th dog underwent surgical exploration and was euthanized shortly thereafter because of bronchopneumonia and chronic pancreatitis. The 2 cats died 10 days and 2 months, respectively, following initial diagnosis of the pseudocyst, but necropsies were not performed in either case. Ultrasound-guided fine-needle aspiration of pancreatic pseudocysts and clinicopathologic evaluation of cystic fluid are useful for diagnosis of pancreatic pseudocysts.

Re: Probable pancreatic pseudocyst in a cat

Rebecca MacMillan — Mon, 08 Jun 2015 12:21:29 GMT

Also this cat is also not insured, and clinically has been well at home according to his owner, good appetite etc!