Pancreatitis in cats: the quiet signs, diagnosis and treatment

Pancreatitis in cats is easy to miss, because the signs are usually vague. Most cats don’t vomit dramatically. They just go quiet and stop eating. If your cat has gone off their food and you’re not sure how fast to act, our should I take my cat to the vet? check can help you decide.

What is pancreatitis in cats?

The pancreas is a small organ that sits next to the stomach and the start of the small intestine. It makes enzymes that digest food and hormones such as insulin that control blood sugar. Pancreatitis means the pancreas is inflamed. When that happens, digestive enzymes can be released inside the pancreas and into nearby tissue, where they cause damage and pain.

According to the 2021 ACVIM consensus statement on feline pancreatitis, more than 95% of cases have no identifiable cause. Known triggers are uncommon. They include trauma to the belly, such as a fall from a height or being hit by a car.

Acute vs chronic pancreatitis

Vets describe two forms:

• Acute pancreatitis comes on suddenly. The inflammation can fully settle once the trigger is gone, and it’s the easier form to diagnose.
• Chronic pancreatitis is long-lasting and causes permanent changes to the pancreas. It can simmer with mild signs or flare up from time to time.

Both forms range from mild to severe. Over time, chronic pancreatitis can lead to diabetes, or to the pancreas no longer making enough digestive enzymes, which causes weight loss and loose stools.

What are the signs of feline pancreatitis?

Feline pancreatitis looks different from pancreatitis in dogs or people. Belly pain and vomiting aren’t the main signs. The ACVIM consensus statement lists how often each sign was seen across studies:

On examination, vets often find dehydration, a low body temperature and sometimes yellowing of the skin and gums (jaundice). Obvious belly pain is reported in only 10% to 30% of cats. The consensus panel thinks that’s because cats hide pain well, not because pancreatitis doesn’t hurt.

International Cat Care notes that the only clues you may see at home are quieter ones: your cat interacts less with the family, sleeps more, rests in new places or grooms less. Our is my cat in pain? tool walks you through these subtle signs. A lethargic cat that is also eating less is always worth a call to the vet.

What is triaditis in cats?

Pancreatitis in cats often doesn’t come alone. Many cats have inflammation of the liver and bile ducts (cholangitis or cholangiohepatitis) and the intestines (inflammatory bowel disease) at the same time. When all three are inflamed together, it’s called triaditis.

The signs overlap: all three conditions can cause a poor appetite, vomiting and weight loss. That’s one reason your vet may run several tests, and why treatment sometimes targets the liver or gut as well as the pancreas. Pancreatitis has also been linked with diabetes, and it can make diabetes harder to manage. See our guide to diabetes in cats for more.

Why is a cat that stops eating at risk?

This is the biggest danger for many cats with pancreatitis. When a cat stops eating, the body moves stored fat to the liver faster than the liver can process it. Fat builds up in the liver cells and the liver starts to fail. This is hepatic lipidosis, or fatty liver disease. Overweight cats are at the highest risk.

The ACVIM panel notes that hepatic lipidosis substantially increases the risk of death in cats with pancreatitis. Cornell Feline Health Center advises seeing a vet if a cat with a normally good appetite suddenly refuses food, even for just a day. Our guide to a cat not eating explains how long is too long and how to tempt a poor eater.

How do vets diagnose pancreatitis in cats?

No single test confirms it. Your vet puts together the history, a physical exam, blood tests and imaging.

• fPLI test: a blood test that measures feline pancreatic lipase, an enzyme from the pancreas. It’s offered as a lab test (Spec fPL) and a quick in-clinic test (SNAP fPL). A high result makes pancreatitis likely. A normal result doesn’t fully rule it out, especially for chronic disease.
• Abdominal ultrasound: can show an enlarged or changed pancreas and fluid around it. It can also look normal in a cat with pancreatitis, because the changes can be subtle and depend on the severity and the scanner’s skill.
• Routine bloodwork and urine tests: check for dehydration, liver involvement, diabetes, kidney problems and low potassium or calcium.
• X-rays: don’t show pancreatitis well, but can help rule out other causes of the signs.
• Biopsy: the only definite test, but it’s rarely done because it needs surgery or anesthesia in a sick cat.

In practice, many cats start treatment based on the exam, bloodwork and ultrasound together. Getting the diagnosis exactly right matters less at first than treating the dehydration, nausea and pain.

How is pancreatitis in cats treated?

There’s no medicine that cures pancreatitis in cats. Treatment supports the cat while the inflammation settles, and treats any related illness. Cats with more than mild signs usually need to stay in the hospital, often for several days.

Why early feeding matters

Vets used to rest the pancreas by withholding food. That’s no longer recommended for most cats. Current guidelines say food should be started early, because cats with pancreatitis have usually already gone without eating, and further fasting raises the risk of fatty liver. A highly digestible diet is generally preferred.

If a cat doesn’t respond to appetite stimulants within 48 hours, or had gone a long time without food before coming in, the ACVIM panel recommends a feeding tube. Tubes placed through the nose or the side of the neck are the most common, and many owners feed through them at home for a while. Never force-feed a cat by mouth. International Cat Care warns it can make food aversion worse.

What about fuzapladib (Panoquell-CA1)?

Fuzapladib (Panoquell-CA1) is a drug that targets the inflammation in acute pancreatitis. The FDA gave it conditional approval in 2022, but only for dogs. It isn’t approved for cats, so feline treatment still relies on the supportive care above.

Your vet chooses each medicine and sets the dose for your cat. Never give human painkillers or anti-nausea medicines. Acetaminophen (paracetamol) and ibuprofen are toxic to cats. See our guide to human medications toxic to cats.

What is the outlook for a cat with pancreatitis?

It depends on how severe the attack is and on any other illness. Cats with mild to moderate acute pancreatitis generally do well with prompt treatment. Severe pancreatitis is much more serious: across four studies, 9% to 41% of cats with acute pancreatitis died. Low blood calcium, low blood sugar and kidney changes are linked with a worse outcome.

Cats with chronic pancreatitis may have flare-ups for life. Your vet may suggest a diet change, anti-nausea medicine or pain relief during bouts, and regular checks for diabetes and digestive enzyme problems.

At home, keep a simple daily log of how much your cat eats, any vomiting and their energy level. That log helps your vet spot a flare-up early. If your cat stops eating again, call your vet the same day, and go to an emergency vet if your clinic is closed.

Written by the CatsMed Team from the sources above. This guide isn’t reviewed by a veterinarian and isn’t a substitute for one. See how we research.