Exocrine Pancreatic Insufficiency in Cats

Exocrine Pancreatic Insufficiency (EPI), also known as pancreatic insufficiency or maldigestion disorder, is rare in cats.  Though EPI is rare in cats, it's important to know the signs and symptoms of the condition as it can have serious consequences for a cat who suffers from it.

The Structure and Function of the Pancreas

A cat's pancreas is located in its abdominal cavity and consists of two lobes.  The left lobe is located by the stomach, and the right lobe is located along the descending part of the duodenum, which is the first segment of the small intestine.  A small central portion joins the two lobes of the pancreas together.  

A feline's pancreas has two functions.  It produces insulin which helps control a cat's blood sugar, and it produces digestive enzymes that help with digestion.  Acinar cells located in a cat's pancreas produce the digestive enzymes trypsin, amylase, chymotrypsin, and lipase.  Chymotrypsin and trypsin break down protein molecules, lipase breaks down triglycerides and fats, and amylase breaks down starches.  Once broken down, the cells lining the intestine can absorb the food molecules.  From there, the nutrients can be sent to the rest of a cat's body through her bloodstream.  

What is Exocrine Pancreatic Insufficiency?

Exocrine Pancreatic Insufficiency occurs when a cat's pancreas fails to make enough of the digestive enzymes needed to break down fats, proteins, and starches in his diet.  When this happens, the food molecules cannot be absorbed into the intestinal wall.  The undigested food molecules remain in the gastrointestinal tract and are passed out of the body through the cat's feces.  Without treatment, a kitty with EPI can starve to death even though he may be eating an adequate amount of food.

Symptoms

Weight loss is the most prominent symptom of EPI in cats and will occur despite a normal or increased appetite.  In fact, many affected cats have a ravenous appetite.  Cats with this condition often have chronic, voluminous diarrhea or semi-formed stools as well.  Stools may contain large amounts of undigested fat, according to Dr. Becker at Mercola, making them appear greasy.  Flatulance is also a common symptom experienced by felines with EPI.  Some kitties with Exocrine Pancreatic Insufficiency look unkempt and have poor coat quality.  

Causes

Though there are several possible causes of EPI, the most common cause of the condition in cats is chronic inflammation of the pancreas.  Parasitic infestations and cancer can also lead to EPI. 

Diagnosis

The condition is diagnosed using the serum trypsin-like immunoreactivity test.  According to The Merck Veterinary Manual, a serum trypsin-like immunoreactivity concentration of 8mcg/L or lower is diagnostic of EPI in felines.  Because the symptoms of EPI are similar to those of other conditions, such as hyperthyroidism and Irritable Bowel Disease, other tests should also be done to rule out additional diseases.  Sometimes cats with EPI also have diabetes, which will need to be addressed as well. 

Treatment

Treatment of EPI involves replacing pancreatic enzymes.  Treatment is lifelong, and the enzymes are available in both tablets and powder.  Powder is generally the recommended form of administration as it is more effective than capsules, tablets, and enteric-coated products, according to The Merck Veterinary Manual.  The powder is mixed into each meal a kitty eats to ensure she can digest her food.  

If you have a cat with symptoms of EPI, please take him to the vet.  Your veterinarian will take a symptom history and determine which tests are necessary to make a proper diagnosis. 

Sources:

PetPlace: Structure and Function of the Pancreas in Cats.

Doctors Foster and Smith: Exocrine Pancreatic Insufficiency (Maldigestion Disorder) in Cats.

The Merck Veterinary Manual: Exocrine Pancreatic Insufficiency in Small Animals.

PetMD: Lack of Digestive Enzymes in Cats.

Mercola: Exocrine Pancreatic Insufficiency: Can Cause Your Kitty to Starve to Death - Even While Eating Plenty.