Pancreatic Insufficiency Symptoms

My nearly 14 year old female cat is showing signs of pancreatic insufficiency. She has lost half her body weight in the last year, she's always hungry and I feed her as often as I can, but she continues to lose weight. She also has horrible diarrhea, it has no form, is tan in color and very smelly. We've tried everything else and I going to call the vet in the morning about putting her on enzymes supplements, but I was wondering if anyone else has experience with this and could offer any advice.

She slowly started loosing weight at the beginning of last year. At first I thought this was good because she was overweight and had been on a diet for a while. She kept loosing and eventually stopped eating. I had her teeth done in the summer and she had 3 resorptive molars removed. They ran a CBC, chem panel and thyriod panel at the same time, everything came back normal. I hoped this would solve the problem, but it took a long time for her to recover. She eventually started eating again, but kept loosing weight and developed horrible diarrhea. We've tried her on antibiotics and now Sucralfate to try and stop it. The antibiotics made it worse and the Sucralfate helps a bit but not much.

Does anyone have any ideas, suggestions or advice? I've had this cat since she was about a month old, I need to help my baby.

Has the vet mentioned IBD or IBS (Inflammatory Bowel or Irritable Bowel) Syndromes?  That can cause the diarrhea and diarrhea can cause weight loss.  I would recommend having the blood panel with thyroid test repeated, cats age 7 years for each one of our years so a lot can happen in that time frame.  What antibiotic was she on?  Has she had a fecal panel ran to test for fecal parasites?

You need to take her to a vet to have her checked or pretty much anything would be a guess. The symptoms you describe sound like my guy who has IBD and also higher than normal numbers for pancreatic issues. The last blood test his pancreas numbers were a bit high but everything else was normal and the one before that everything was perfect. My guy's sister had perfect blood numbers and she was littered with cancer so you can never be sure.

In older cats food can make a big difference in how the whole system works so this is the first thing to look at. If she is eating hard food then change it to moist food and try different foods until you find one that works. My guy gets weighed every day and any new food I try I watch the weight carefully and if it drops too much I change it. The only food I have found that works with him is Medley's Chicken fare and Chicken Medley, this allows him to maintain a weight of about 6.7 lbs (from a cat that was 11 pounds) and his stools are fairly well formed most of the time. If I try different foods his body usually takes a bit of time to adjust to it and  his stools go from wet back to pretty good. He also goes through about 5 to 6 - 85g cans of food a day and leaves 3 - 5 stools per day. My guy also has IBD even though his pancreas numbers are a bit high it is the IBD that is causing it. This didn't show in an x-ray but it was clear when he had an ultrasound done.

If you want to try something I would suggest trying a different food to see if her body is having a reaction to it. Different foods may sit with her a little better and she may gain some of the weight back. If nothing else it may stabilize her but if she hasn't been to a vet for a while it may be time.

Actually the old adage that cats and dogs age 7 years to every one human year has been discredited. It's now, the first two years equals 25 years and then four years for evey year after. Not really relevant to my post, but... From what I've read IBS and IBD are often caused by chronic panreatic problems. The weight loss started long before the diarrhea. I had just wormed all my animals a week before the last vet visit and my 11 year old male, who was in for different problems, had a negative fecal. She was on Metronidazole for possible small intestine bacterial overgrown. When it made her diarrhea worse the vet told me to stop useing it. Now we're trying the Sucralfate. It helps some but she still has very loose watery stools.

http://www.catster.com/cats-101/calculate-cat-age-in-cat-years

There is a special blood test that is only done at a couple of places, one is Texas A&M that is a definitive test for chronic pancreatitis.  The tan colored stool is one of the classic signs of a problem with the pancreas.  From what I have read enzymes are kind of iffy, for some cats it really helps it makes other cats worse.  http://www.idexx.com//view/xhtml/en...menu/innovative-tests/spec-fpl.jsf?SSOTOKEN=0  is a little about this specific test if it hasn't been done.

http://www.2ndchance.info/pancreatitiscat.htm  is another article about it.  http://ibdkitties.net/pancreatitis.html  is a good resource for IBD but this is their article on pancreatitis.

So much of this chronic digestive stuff is difficult to get a definitive diagnosis and it's trial and error to find what works for a kitty.  What works for one kitty doesn't work for another.  Some vets use steroids some don't and some kitties improve with steroids some don't.

In addition to the specific pancreatitis test that @Denice mentioned, there is also one for feline EPI (exocrine pancreatic insufficiency).

My Sebastian had both tests done with the same blood draw. If you suspect EPI in your cat, I would strongly encourage getting the special blood test run. It is the most accurate and will either give a confirmed diagnosis, or will help you rule it out.

The pancreatitis test is called Spec fPL (feline pancreas-specific lipase).

The EPI test is called Feline TLI (trypsin-like immunoreactivity).

Here's the info from Idexx:

http://www.idexx.com//view/xhtml/en...menu/innovative-tests/spec-fpl.jsf?SSOTOKEN=0

If your cat has true EPI, which is a disorder in which not enough pancreatic enzymes are being produced to properly digest food, then your vet will likely have you supplement enzymes. If your cat has pancreatitis, but not EPI, this is where enzymes are iffy. If there are no problems with the pancreas, then IBD/malabsorption is suspect.

Have an appointment on Monday to get the TLI done. She has to fast for 8-12 hours before, so Monday was the soonest I can get her in.

Let us know what the results are!

I will. They have to send it off so normally it would take 5-7 days to get the results. With New Year's in the middle of the week, I don't know how much that will delay it. I'll just get to sit and wait, I guess.

Couldn't wait for the test results. Bear ate 1/3 her body weight in less than 48 hours. I started her on pancreatic enzymes yesterday afternoon and she already seems to be feeling better. She's been out a lot more. Before, when she wasn't eating, she was sleeping on one of the dining room chairs. Right now she's laying behind me on the couch, purring. She slept in the bed with me last night; she hasn't done that in months. She also seems to not be quite as ravenously hungry as she was. I've also started her on vit B12 with biotin. Hopefully she'll continue to improve and start to gain weight. I'm going to call the vet tomorrow and see if her results are in.

Great to hear she seems to be feeling better on the pancreatic enzymes! It will be interesting to know if she has confirmed EPI. Even if she doesn't, you can't argue with what works, right?     Just make sure you let your vet know what you've started her on.

I know exactly what you mean about certain sleeping spots. When Sebastian isn't feeling well, there are a few spots he'll sleep that are kind of like hiding spots, the dining room chairs being one of them. When he is feeling good, he'll sleep on the couch with Boo or on my bed with me.

When we were testing Sebastian for EPI, I was doing some research. Here's a link to the largest study done on EPI in cats. Thought you might find it interesting:

http://veterinarynews.dvm360.com/dv...ore-com/ArticleStandard/Article/detail/807422

Don't know how today's going. I switched her to animals based enzymes yesterday. The ones before were plant based with a probiotic. The vet prescription enzymes are animals based so I thought it would be better. She's in the living room with everyone else, but acted very hungry at dinner time. She hasn't gone to the litter box since I got home so don't know how her bowels are. I'm just afraid yesterday was a fluke. I will call the vet Monday to see if her test results are in.

Finally, she used the litter box. They need to change the saying to a watched kitty never poops. It had less form than yesterday, but still more than without any enzymes. There was less smell than before though. I'll keep her on the new enzymes over the weekend and see if she makes any progress. I let my mom borrow the other to try on her 16 y/o and she forgot it at work, so I really have no choice. Thought I was going to have a nice relaxing day off tomorrow, but I guess I'll be kitty watching and anxiously waiting for poo to analyze.

LOL...being on poo (and pee) watch is a regular occurrence around here!    Since I've never actually used enzymes, I don't know how long they take to work. You may need to give them a week.  

I've read that once the enzymes are started you should see "rapid improvement" and on the other I saw noticable differences after only 2 days. She's so skinny I'm afraid she doesn't have a week. Wednesday I was afraid she didn't have until the weekend, until I put her on the meds and started to see the improvement. She ate approximately 2.5lbs of food in 36 hours and was still starving and screaming for more. The plant enzymes' website claims that it lasts longer in the diegestive process than animal based and has additional enzymes, probiotics and calcium. It would certainly be nice if she did well on it as it's much cheaper and easier to give, but whatever works best for her I will use.

http://www.animalessentials.com/#products:63

I read that , too - that plant enzymes survive the trip through the stomach so that they will still work in the intestines. It seems that with true EPI they use animal enzymes to mimic the real enzymes that are missing. I think you're right - it's a matter of what works best for Bear.

Finally got Bear's test results back! Went in to get the little dog's Phenobarb and the vet tech showed me the results even though the vet wasn't there. Her pancreatic enzymes were fine, 64 in a range of 12–82 µg/L. Her foliate test was normal also, but I don't remember the numbers. Her Cobalamin (vit B12) was low, 153 in a range of 290 - 1,500 ng/L. I have noticed that when I'd forget to give her the vit B12 supplement that I bought to go along with her enzymes she'd get diarrhea again. Guess I can stop the enzymes and just up her vit B supplement. It's crazy that one vitamin deficiency could cause all those problems.

Finally! 

Hypocobalaminemia (low levels of vitamin B12) can indicate small intestinal disease. It has to do with malabsorption. Here are some great resources:

TAMU: Serum Cobalamin (Vitamin B12) and Folate

TAMU: Diagnostic Tests for Gastrointestinal Disease (PDF)

Merck: Malabsorption Syndromes in Small Animals

NVS (France): Laboratory Tests for Diagnosis of Gastrointestinal and Pancreatic Diseases (PDF)

Abstract: Early biochemical and clinical responses to cobalamin supplementation in cats with signs of gastrointestinal disease and severe hypocobalaminemia

I think Sebastian has some malabsorption due to his pancreatitis/IBD and intestinal cell damage. I read that omega-3s can help with this, so I started him on a fish oil from sardines and anchovies with a good levels of EPA and DHA.

Anyway, I'm glad to hear she doesn't have EPI. I hope the continuous B12 supplementation works! 

Thanks! I hope it works too. I guess lymphoma is still a possibility, but all her other blood work was normal too, so hoping not. She has severe food allergies, she's allergic to poultry (including eggs and chicken fat), grains and peas. It's been very hard to find a food without any of her allergens. So I'm sure 13+ years of digesting allergens could have put a strain on her body. She did the best on Nature's Instinct Rabbit formula before they changed their formula, but was only on that for a couple of months. Right now she's pretty much on a canned food only diet. She'll eat dry every once in a while, but mostly she eats Fancy Feast Classic Beef because that's all she wants to eat.

Hello CareBearBaby's Mom:

I read with interest your journey to help your kitty. It's hard to watch our babies suffer for so long. I have been through similar challenges since one of mine was a kitten, and now with my 10 y.o. male. It's a daily effort and still symptomatic (tho' some improvement after a year+).  I feel like I've tried almost everything. How's yours doing now…? Would like to know the dose and source you used for the B12 and enzymes.  Were they specifically for cats and what is the best way to administer them...My kitties can be quite wary of anything new I add to their food. (Also, I live in France where there's little available for animals let alone humans in terms of supplements.)

Thanks in advance for any help!

Shawn