Cat Exocrine Pancreatic Insufficiency: A Vet’s 2025 Guide to Diagnosis, Treatment & Lifelong Care 🐱🍽️
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Cat Exocrine Pancreatic Insufficiency: A Vet’s 2025 Guide to Lifelong Care 🐱🍖
By Dr Duncan Houston, BVSc
🔍 What Is EPI?
Exocrine pancreatic insufficiency (EPI) in cats is a condition where the pancreas fails to produce enough digestive enzymes—lipase, protease, amylase—needed for normal nutrient breakdown. It often results from chronic pancreatitis or significant loss of pancreatic tissue :contentReference[oaicite:3]{index=3}.
⚠️ Who Gets EPI & Why?
Although rare (prevalence ~0.013–0.1 %), EPI primarily affects middle-aged to older cats of any breed :contentReference[oaicite:4]{index=4}. The leading cause is chronic pancreatitis; other causes include pancreatic cancer, duct blockage, or developmental defects :contentReference[oaicite:5]{index=5}.
🍃 Key Clinical Signs
- 💡 Weight loss, despite good or increased appetite (polyphagia) :contentReference[oaicite:6]{index=6}
- 💩 Loose, voluminous, pale, foul-smelling stools—sometimes greasy (steatorrhea) :contentReference[oaicite:7]{index=7}
- 😿 Intermittent vomiting, poor coat condition, occasional anorexia or lethargy :contentReference[oaicite:8]{index=8}
- 😺 In some cats, GI signs may be mild or absent—weight loss alone can be a clue :contentReference[oaicite:9]{index=9}
🔬 Diagnosis: Tests You Need
- fTLI (feline trypsin-like immunoreactivity): Gold-standard—values ≤ 8 µg/L confirm EPI :contentReference[oaicite:10]{index=10}.
- Abdominal ultrasound: Can show thin/absent pancreatic tissue or dilated ducts, often with small-bowel changes :contentReference[oaicite:11]{index=11}.
- Blood & urine tests: Check for concurrent diabetes, kidney or thyroid disease :contentReference[oaicite:12]{index=12}.
- Cobalamin (B12) levels: Nearly all EPI cats are deficient—essential to test :contentReference[oaicite:13]{index=13}.
💊 Treatment Strategies
- Pancreatic enzyme supplementation: Powdered or enteric-coated—mixed with food; initial dose ~½–1 tsp per meal :contentReference[oaicite:14]{index=14}.
- Cobalamin injections: Weekly until low-normal; often lifelong monthly supplementation :contentReference[oaicite:15]{index=15}.
- Diet selection: Highly digestible diets, moderate fat; fiber to slow transit—some cats do well with canned food :contentReference[oaicite:16]{index=16}.
- Additional support: Probiotics, appetite stimulants as needed :contentReference[oaicite:17]{index=17}.
- Treat underlying disease: Chronic pancreatitis, GI conditions, diabetes—manage holistically :contentReference[oaicite:18]{index=18}.
📈 How Cats Respond
Most cats improve within a week—weight gain and firmer stools are seen. Lifelong therapy is required. Without treatment, EPI leads to progressive malnutrition and poor quality of life :contentReference[oaicite:19]{index=19}.
⚖️ Long-Term Management
- Routine vet check-ups every 3–6 months—monitor weight, stool, appetite, B12 and TLI)
- Adjust enzyme dose with life stage and diet
- Continue monthly B12 and use probiotics for gut health
- Record symptoms and use the Ask A Vet app for ongoing guidance
🏡 Home Environment Tips
- Feed small meals multiple times daily
- Keep water available and encourage hydration
- Use calming products from Woopf and Purrz to support wellbeing
- Ensure stress-free environment—routine, play, comfort—important for GI function
- Monitor body condition—hold slow weight gain after treatment begins
📝 Summary Table
| Aspect | Details |
|---|---|
| Definition | Insufficient digestive enzymes from pancreas |
| Causes | Chronic pancreatitis, duct obstruction, cancer, congenital |
| Signs | Weight loss, loose stools, increased appetite, poor coat |
| Diagnosis | fTLI ≤8 µg/L, ultrasound, B12 level, bloodwork |
| Treatment | Enzyme + B12 supplements, diet, treat underlying disease |
| Outcome | Excellent with treatment; lifelong care |
| Monitoring | Adjust doses, recheck labs, track symptoms |