Exocrine Pancreatic Insufficiency (EPI) in cats is a condition where the pancreas, a vital organ located near the stomach and small intestine, fails to produce sufficient digestive enzymes. This impairment affects the breakdown of food, leading to a range of digestive and nutritional issues. While there is no cure for EPI, with consistent treatment and management, affected cats can lead long and fulfilling lives.
The pancreas plays a dual role: producing insulin for blood sugar regulation and secreting digestive hormones. EPI specifically impacts the latter function, leading to a deficiency in crucial enzymes like lipase (for fat digestion), proteases (for protein digestion), and amylase (for starch digestion). When these cells are damaged, cats can develop EPI.
Symptoms of EPI in Cats
Recognizing the signs of EPI is crucial for early diagnosis and intervention. A 2016 study highlighted the most prevalent symptoms observed in cats with EPI:
- Weight loss: Affecting 91% of cats in the study.
- Unformed feces: Observed in 62% of cases.
- Poor hair coat: Noted in 50% of cats.
- Anorexia (loss of appetite): Present in 45% of affected felines.
- Increased appetite: Paradoxically, 42% of cats showed an increased desire to eat.
- Lethargy: Observed in 40% of cats.
- Watery diarrhea: Occurring in 28% of cases.
- Vomiting: Reported in 19% of cats.
It’s important to note that the frequency of these symptoms can vary, and many cats with EPI (58% in the study) often present with at least one other concurrent health issue. For instance, a cat with both EPI and diabetes mellitus might exhibit weight loss, soft stools, and increased thirst and urination.
Causes of EPI in Cats
Any condition that significantly damages the pancreas can lead to EPI. The most common culprit is chronic pancreatitis, which is the inflammation of the pancreas. However, other potential causes include:
- Congenital defects: Cats born with a malformed pancreas.
- Pancreatic cancer: Tumors affecting the pancreas.
- Duct obstruction: Blockages in the tube connecting the pancreas to the intestine.
- Parasitic infections: In rare cases, certain parasites, like pancreatic flukes contracted from ingesting infected grasshoppers, can damage the pancreas sufficiently to cause EPI.
Genetics does not appear to be a significant risk factor for EPI, and it can affect cats of any age or breed.
Diagnosing EPI in Cats
The symptoms of EPI can overlap with other feline diseases, making veterinary diagnosis essential. A veterinarian will typically perform several tests to confirm the diagnosis:
Blood Chemistry Tests and Complete Blood Cell Count
These tests provide a comprehensive overview of a cat’s overall health, helping to identify issues such as anemia that can sometimes accompany EPI. As many cats have concurrent conditions, a general health assessment is vital for accurate diagnosis and treatment planning.
Trypsin-Like Immunoreactivity (TLI) Test
The TLI test is the most specific diagnostic tool for EPI in cats. It measures the levels of trypsin, a digestive enzyme produced by the pancreas, in the bloodstream. Cats with EPI typically have significantly lower TLI levels than normal. This test requires a blood sample, and cats must fast for 8-12 hours prior to collection.
Vitamin Levels
Deficiencies in cobalamin (Vitamin B12) and altered folate levels are common in cats with EPI. Blood tests will be conducted to measure these essential B vitamins.
Treatment and Management of EPI in Cats
The cornerstone of EPI treatment involves supplementing the cat’s diet with the missing pancreatic enzymes, administering vitamin supplements, and addressing any other health problems.
Pancreatic Enzyme Supplements
Digestive enzymes should be added to every meal. Commercially available powdered enzyme supplements are often effective and easy to administer. While tablets exist, powders tend to be more successful. It’s recommended to mix the powder thoroughly into the cat’s food. Some owners find success by letting the food sit for a short period to allow for “predigestion,” although research supporting this is limited. The initial dosage should follow veterinary or product label recommendations, with the goal of finding the lowest effective dose for long-term management.
Pancreas Meat
An alternative source of pancreatic enzymes is raw pancreas meat from other animals, available from butchers or raw pet food suppliers. However, handling raw meat increases the risk of foodborne illnesses. A typical starting dose is one ounce mixed with each meal, but this should be guided by veterinary advice.
Cobalamin (Vitamin B12) and Folate Supplementation
Most cats with EPI require regular cobalamin injections, especially early in treatment. As their condition stabilizes, the frequency of injections may decrease, and oral supplements might become an option. Folate supplementation may also be necessary, at least temporarily. Regular monitoring of vitamin levels by a veterinarian is crucial to prevent deficiencies.
Antibiotics
Some cats with EPI develop bacterial overgrowth in their intestines. This condition can be managed with antibiotics, such as Tylosin. While some cats may only need a short course of antibiotics, others might benefit from long-term therapy.
Recovery and Dietary Considerations
With appropriate treatment, most cats with EPI show rapid improvement within days to weeks. If symptoms persist or worsen, consulting your veterinarian for alternative treatment options or further diagnostic testing is recommended.
Diet for Cats with EPI
There isn’t a single “EPI diet” that suits all cats. Since many cats with EPI also have inflammatory bowel disease, a hypoallergenic diet, such as Hill’s Prescription Diet z/d Original Skin/Food Sensitivities canned cat food, may be beneficial. In many cases, a high-quality cat food that is easily digestible can be sufficient.
Frequently Asked Questions About EPI in Cats
What is the best food for a cat with EPI?
Many cats with EPI can thrive on high-quality, easily digestible cat foods. Dietary changes are not always necessary. However, if inflammatory bowel disease is also present, a veterinarian might suggest a hypoallergenic diet like Hill’s Prescription Diet z/d Original Skin/Food Sensitivities canned cat food. Consulting with your veterinarian is key to determining the most appropriate diet for your individual cat.
