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When you think about it, the pancreas is a lot like a cat: It typically goes about its business (of producing hormones and digestive enzymes) without a lot of fuss, but it definitely has a volatile and mysterious side that shows itself when the organ becomes inflamed.
The pancreas pulls double duty in the body. It produces hormones such as insulin and glucagon, which help maintain an appropriate level of glucose in the blood. But it also makes digestive enzymes that enable the body to use carbohydrates, fats and proteins for energy. That multitasking is all well and good, but it can cause confusion when a veterinarian is trying to diagnose a cat with pancreatitis.
Pancreatitis is one of the most baffling diseases veterinarians see in cats. The signs of pancreatitis can be difficult to spot. Loss of appetite, lethargy, dehydration, weight loss, vomiting, abdominal pain and diarrhea can be symptoms of pancreatitis — and of many other illnesses. And some cats won't present with any of thse symptoms: My own family cat, Varmie, had none of the typical signs of pancreatitis except for loss of appetite. Varmie’s case is a good example of why you should take your pet to the vet if you notice any changes in appetite, thirst, activity or elimination.
Another reason pancreatitis is such a puzzle is because we usually don’t know what causes it. In 90 percent of the cases we see, we don’t know why the pancreas has become inflamed. In cats, pancreatitis isn’t associated with obesity, high-fat foods, steroids or other drugs, as it is in dogs, but it can be linked with liver and/or inflammatory bowel disease. In addition, cats as young as 5 weeks and as old as 20 years can develop pancreatitis.
Solving the Mystery
As with any feline health problem, diagnosis begins with a medical history and a physical exam. Common signs we may see on examination of a cat who turns out to have pancreatitis are dehydration, low body temperature (or sometimes a fever) and icterus, a yellowish discoloration of the gums, whites of the eyes and ear tissue. We may also feel a mass in the abdomen, or note that the abdomen is painful when palpated.
Diagnostic tests don’t give us a definitive answer, but they can sometimes help. A blood test that measures what’s called pancreatic lipase immunoreactivity (fPLI) can give some useful answers, but results may not be available for a week or more.
An abdominal ultrasound may or may not indicate that the pancreas is inflamed, but certain findings are consistent with pancreatitis. On the other hand, some cats show no abnormalities on ultrasound but still have severe pancreatitis. One of the advantages of an ultrasound is that it may rule out or detect other diseases that cause similar symptoms.
A biopsy would let us know for sure that we were dealing with pancreatitis, but it’s a very bad idea to anger the pancreas. Poking and prodding at it to obtain a biopsy sample can trigger inflammation and make the condition much worse. Usually, our goal is to be as noninvasive as possible with both diagnosis and treatment.
Helping Cats Heal
Often, the best we can do is to start treating the cat’s symptoms while we wait for the results of the fPLI test. For instance, your veterinarian may prescribe anti-emetics if your cat is vomiting or pain-relief medication if the abdomen is tender. Antibiotics may be prescribed if your vet suspects that bacteria from the intestinal tract have traveled up the bile and pancreatic ducts to the pancreas, causing infection and inflammation. Cats who aren’t eating may need hospitalization for tube feeding.
Intravenous fluids are important, too. Giving fluids makes up for any fluid loss the cat may have experienced from vomiting, diarrhea or simply not drinking enough water. It also helps to improve blood flow through the pancreas.
If you’re lucky, your cat will have only a single acute bout of pancreatitis. Unfortunately, some cats develop chronic pancreatitis. That’s a low level of constant inflammation that can cause the cat to become deficient in digestive enzymes. Cats with chronic pancreatitis may need enzyme supplements to help them digest their food.
Pancreatitis isn’t easy to diagnose or treat, but it’s something your veterinarian may consider when nothing else seems to explain your cat’s illness.
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With the summer season upon us, the Centers for Disease Control has started to issue warnings about sun safety to help protect Americans against sun-induced tumors such as melanoma. Since pets don’t sunbathe or go the tanning parlor — both risky behaviors when it comes to skin cancer — and are covered in fur, how could that dark spot on your Fluffy or Fido be a melanoma? Melanoma in dogs and cats does not look like it does in people, but it can still be deadly. Here’s how you can recognize the dreaded disease in your best friend, despite its resemblance to other problems.
In my daily oncology practice, I often see pets because of a concern on the part of a human family member about dark spots that have appeared on a pet’s skin. The good news is that skin melanoma is quite uncommon in dogs and cats. There are some common pet skin conditions that often look like a possible melanoma, however, and they can get everyone concerned. For example, orange tiger cats commonly develop flat, round, pigmented areas surrounded by normal skin on their lips, gums, nose and eyelid margins. Known as lentigo simplex, the benign lesions require no treatment and do not transform into melanoma.
Another noncancerous skin abnormality often mistaken for melanoma in a dog is a macule, a round to oval, flat, pigmented area that often occurs after a skin infection. Before the skin developed pigmentation, the area may have been red, itchy and surrounded by a flaking, peeling ring. The lesions are not cancerous, but the infection may require antibiotic treatment. Macules are most readily seen on sparsely haired canine tummies.
Open Wide for Hard-to-See Melanomas
You can help your doctor detect a melanoma on your own skin, since nearly every inch of human skin can be seen. Your dermatologist can then biopsy suspicious lesions. The most common location for melanoma in your dog, however, makes this kind of easy discovery nearly impossible. That’s because melanoma is the most common oral tumor in dogs. (To a lesser degree, oral melanoma is also occasionally seen in cats.) In a reluctant patient, getting a good look in a dark mouth for a black tumor is no easy task. A bad case of hound halitosis may wind up being your first clue of a melanoma in the mouth. Oral melanomas are most commonly black, raised masses that frequently bleed. Pet owners may notice blood-tinged saliva or blood on their pets' teeth. Your veterinarian may need to sedate your pet to see the tumor and perform a biopsy in order to make a diagnosis. Surgery, radiation therapy and a melanoma tumor vaccine are just some of the common treatments for oral melanoma, but more and better treatments are needed, since a cure is rare.
Right Before Your (Cat’s) Eye
Feline ocular melanoma may be the most difficult form of melanoma to recognize. At first, the iris — the colored part of the eye — may look as if it simply has a freckle on it, but, as time goes by, that freckle expands over more and more of the iris. If you notice a dark spot on your cat’s iris, consultation with a veterinary ophthalmologist is critical to determine if there is a malignancy. If an iris melanoma is diagnosed, frequent ophthalmologic examinations are required to determine if the eye needs to be removed in order to stop the spread of the deadly tumor. Although heartbreaking, removal of the eye can keep your cat alive and well for many years.
Not Just a Broken Nail
Tricky melanoma may also masquerade as a broken toenail in your dog. Melanoma of the toe typically occurs at the junction between the toe and toenail. The tumor weakens the nail, which snaps off without provocation. Both a broken toenail without an apparent cause or a broken toenail and a very sore, swollen toe could be signs of a melanoma. When you take your dog to his veterinarian for a broken nail, don’t be surprised if he recommends an X-ray. The image will uncover any bone destruction typical of melanoma in the toe. Removal of the toe and treatment with an anticancer vaccine can result in prolonged survival in many dogs.
Any Concern? See Your Vet
Although the locations of melanoma in a dog or cat differ from the typical locations in people, melanoma is an aggressive cancer regardless. Whenever you notice a lump, bump or other abnormality in your pet, it is best to have your veterinarian check it out to keep your pet as healthy as possible.