Pancreatitis in Cats: A Vet’s 2025 Guide to Diagnosis, Treatment & Recovery 🐱

Hello, I’m Dr. Duncan Houston BVSc, veterinarian and founder of Ask A Vet. In 2025, we understand feline pancreatitis better than ever—but it remains a challenge due to vague symptoms and overlapping illness. In this comprehensive guide, we'll explore causes, recognize signs, discuss diagnostics and treatment options, and outline an actionable home-care plan to support your cat’s recovery and long-term health.

📘 What Is Feline Pancreatitis?

Pancreatitis means inflammation of the pancreas. In cats, it's often idiopathic (unknown cause). It ranges from mild and chronic to severe and acute, sometimes with systemic impacts like multi-organ inflammation aka “triaditis” (pancreatitis, cholangitis, inflammatory bowel disease) :contentReference[oaicite:3]{index=3}. While enzymes are prematurely activated within acinar cells, leading to cellular damage and inflammation, clinical signs are often subtle.

🐾 Who Is at Risk?

• Middle-aged to older cats, though all ages can be affected :contentReference[oaicite:4]{index=4}.
• No clear breed or sex predilection :contentReference[oaicite:5]{index=5}.
• Concurrent conditions—diabetes, IBD, cholangitis—are common :contentReference[oaicite:6]{index=6}.
• Rare causes: trauma, toxins, infection, certain drugs :contentReference[oaicite:7]{index=7}.

⚠️ Key Clinical Signs

Signs are often **vague** and nonspecific:

• Inappetence or anorexia (63–97% of cases) :contentReference[oaicite:8]{index=8}
• Lethargy, dehydration, weight loss :contentReference[oaicite:9]{index=9}
• Vomiting (≈50%), occasionally diarrhea :contentReference[oaicite:10]{index=10}
• Jaundice seen in 10–30%, due to biliary involvement :contentReference[oaicite:11]{index=11}
• Abdominal pain reported in 10–30%—often hidden due to feline stoicism :contentReference[oaicite:12]{index=12}
• In severe cases: fever, shock, respiratory distress, multi-organ failure, DIC :contentReference[oaicite:13]{index=13}.

🔍 Diagnostic Strategy

A multi-pronged approach is essential:

1. Clinical exam & history: Rule out other explanations with CBC, chemistry, urinalysis :contentReference[oaicite:14]{index=14}.
2. Feline Pancreatic Lipase Immunoreactivity (fPLI): most specific blood test, ~80% sensitive/specific :contentReference[oaicite:15]{index=15}.
3. DGGR lipase: lab-based complementary test with comparable utility :contentReference[oaicite:16]{index=16}.
4. Abdominal ultrasound: evaluates pancreas, ducts, fat, and associated organs; often shows hypoechoic pancreas, peripancreatic fluid, fat echogenicity :contentReference[oaicite:17]{index=17}.
5. Advanced diagnostics: biopsy or fine-needle aspiration for chronic/recurrent cases—but often not performed in acute illness :contentReference[oaicite:18]{index=18}.

📊 Acute vs Chronic Pancreatitis

Acute: marked neutrophilic infiltration, edema, necrosis—rapid onset, potentially life-threatening :contentReference[oaicite:19]{index=19}.
Chronic: infiltration with lymphocytes, fibrosis, long-term changes—may be intermittent, subtle signs :contentReference[oaicite:20]{index=20}.

🛠️ Treatment Protocols

Early intervention: hospitalization, prompt supportive care. Without intervention, cat may develop liver lipidosis, coagulopathy, or systemic failure.

1. Fluid & Electrolyte Support

• IV crystalloid fluids—careful selection especially in liver disease :contentReference[oaicite:21]{index=21}.
• Correct hypokalemia, hypocalcemia (often severe)—calcium gluconate may be required :contentReference[oaicite:22]{index=22}.
• Monitor for hypoproteinemia; consider colloids if needed :contentReference[oaicite:23]{index=23}.

2. Pain Management

• Cats often in pain—pain control essential :contentReference[oaicite:24]{index=24}.
• Use buprenorphine, hydromorphone, or fentanyl under close supervision :contentReference[oaicite:25]{index=25}.

3. Antiemetics & Appetite Stimulation

• Maropitant for nausea; may have analgesic effects :contentReference[oaicite:26]{index=26}.
• Capromorelin or mirtazapine to encourage eating and prevent hepatic lipidosis :contentReference[oaicite:27]{index=27}.

4. Nutritional Support

• Unlike dogs, cats must eat to avoid liver lipidosis—enteral feeding early :contentReference[oaicite:28]{index=28}.
• Highly digestible or GI-supportive diet; low-fat isn’t essential unless concurrent disease :contentReference[oaicite:29]{index=29}.
• Feeding tubes (e.g. esophagostomy) if anorexic >3 days :contentReference[oaicite:30]{index=30}.

5. Antibiotics & Additional Therapies

• Not routine—only if infection suspected via culture or septic signs :contentReference[oaicite:31]{index=31}.
• Pancreatic enzyme supplements may support digestion in chronic cases :contentReference[oaicite:32]{index=32}.
• Steroids (prednisolone) may be considered in chronic inflammatory cases under veterinary supervision :contentReference[oaicite:33]{index=33}.

6. Address Underlying or Related Conditions

• Manage IBD and cholangitis (“triaditis”) concurrently :contentReference[oaicite:34]{index=34}.
• Treat diabetes, hepatic lipidosis, or other identified causes :contentReference[oaicite:35]{index=35}.

📈 Monitoring & Prognosis

- Mild-to-moderate pancreatitis: generally excellent prognosis with early, supportive care :contentReference[oaicite:36]{index=36}.
- Severe acute cases: guarded-to-fair—risk of organ failure or DIC :contentReference[oaicite:37]{index=37}.
- Chronic cases: manageable long-term with lifestyle and dietary adjustments :contentReference[oaicite:38]{index=38}.
- Recurrent cases: predisposed to exocrine pancreatic insufficiency or diabetes—monitor closely :contentReference[oaicite:39]{index=39}.
- Follow-up with serial fPLI/DGGR lipase, ultrasound, and clinical monitoring at 4–6 weeks, then every 3–6 months based on severity.

🏡 Home Care Essentials

• Strict medication adherence—set reminders using the Ask A Vet app.
• Encourage eating—offer favorite foods, warm broth, frequent small meals.
• Clean water and comfortable rest areas; maintain a low-stress environment.
• Monitor appetite, vomiting, energy levels, and watch for signs like jaundice or pain during palpation.
• Keep a log of symptoms and share progress with your vet.
• Schedule follow-up bloodwork and ultrasound as recommended.

📚 Case Vignette: “Luna”

Luna, a 9-year-old domestic shorthair, presented with lethargy and inappetence. Workup revealed elevated fPLI and hypoechoic pancreas with mesenteric fat changes. Hospitalized with IV fluids, buprenorphine, maropitant, and nutritional support. Appetite returned within 48 hours. Discharged on a GI-supportive diet and oral pain meds. At 6-month follow-up, Luna remained bright and asymptomatic.

🚨 When to Call the Vet

• Vomiting for >24 hours or decreased appetite despite anti-nausea meds
• Yellow gums/eyes, severe lethargy, abdominal discomfort
• Any neurologic changes or collapse
• Signs of dehydration after discharge
• Recurring symptoms or lab/imaging changes

✨ Final Thoughts

Feline pancreatitis, while complex, is treatable—especially when diagnosed early. A holistic approach—fluids, pain control, anti-nausea therapy, nutrition, and supportive home care—gives your cat the best chance at recovery and long-term health. Ask A Vet is here to guide you with personalized care plans, medication reminders, lifestyle strategies, and expert support every step of the way.

For tailored veterinary plans, access to tele‑support, prescription tracking, and ongoing health monitoring, visit AskAVet.com or download the Ask A Vet app. Together, we can help your feline friend thrive again. 🐾❤️