A pril 2009-JuNE 2009
Vol. 24, No. 2
v e t e r i n a r i a n s
F e l in e P a n c r e a t it is :
C h a l l e n g e s in D ia g n o s is
and T h era py *
Page 1
F e l in e I n f l a m m a t o r y
B o w e l D is e a s e *
Page 5
2 1 st A n n u a l F r e d S c o t t
F e l in e S y m p o s iu m
Page 16
*Adapted with permission
from the proceedings o f the
New York State Veterinary
Conference held at Cornell
on October 2-5, 2008.
health to
Feline Pancreatitis:
Challenges in Diagnosis and Therapy
P. Jane Armstrong, D.V.M., M.S., M.B.A., Diplomate ACVIM
University of Minnesota
Risk Factors
In m ost cases o f pancreatitis in cats, an
underlying cause or instigating event
cannot be determ ined, leading to classifi­
cation as idiopathic. A bdom inal traum a,
infectious diseases (toxoplasm osis, liver
flukes, FIP and FIV), lipodystrophy, and
organophosphate adm inistration have
been associated w ith feline pancreatitis,
but appear to account for a very small
percentage o f cases. Hypercalcem ia
precipitated pancreatitis in one experi­
m ental study in cats and aspirin induced
pancreatic cell dam age in another. M ost
surveys associate underw eight body
condition, not obesity, w ith the develop­
m ent o f feline acute necrotizing pancre­
atitis. Evidence for glucocorticoid ad m in ­
istration as a cause o f acute pancreatic
inflam m ation rem ains anecdotal in cats.
The causal role o f intercurrent inflam m a­
tion in the billiary tract and intestine in
the pathogenesis of pancreatitis rem ains
the subject of speculation. Cholangitis is
the m ost im portant type o f biliary tract
disease for w hich an association has been
m ade, but other form s o f pathology (e.g.,
stricture, neoplasia, and calculus) also
have know n associations.
Clinical Signs
N o significant age or gender predisposi­
tion has been recognized in cats with
pancreatitis and no relationship has been
established with body condition score. A
wide age range (5 weeks to 20 years) has
been reported, but som e authors suggest
that cats older than 7 years are m ore
likely to be affected. M ost cases are seen
in dom estic short hair cats. Lethargy
(86-100 percent) and partial to com plete
anorexia (95-97 percent) are the m ost
com m on clinical signs in cats diagnosed
w ith acute necrotizing pancreatitis. All
other clinical signs occur only sporadi­
cally. In particular, “textbook” signs of
pancreatitis in dogs are usually absent in
cats - vom iting occurring in 35-52 percent
of cats vs. 90 percent o f dogs, abdom inal
pain in 25 percent vs. 58 percent, d iar­
rhea in 15 percent vs. 33 percent, and
fever in 7 percent vs. 32 percent. O ther
reported clinical findings in affected
cats include dehydration (92 percent),
tachypnea (74 percent), hypotherm ia (68
percent), tachycardia (48 percent), and
dyspnea (20 percent). A lm ost one q u ar­
ter o f cats w ith pancreatitis (23 percent)
have a palpable abdom inal m ass that
m ay not appear painful and can be easily
m isdiagnosed as a lesion o f o ther in tra­
abdom inal structures such as intestinal
tract or m esenteric lym ph nodes. Tachy­
pnea/dyspnea m ay be due to pain, but
pleural effusion and pulm onary th ro m ­
bosis are other potential causes. Some
cases o f acute pancreatitis are associated
w ith severe clinical syndrom es including
shock, dissem inated intravascular coagu­
lation and m ulti-organ failure, and both
acute and chronic pancreatitis m ay be
involved in the developm ent of transient
or perm anent diabetes mellitus.
co n tin u ed on p a g e 2

Laboratory Evaluation
H em atologic abnorm alities in cats
w ith pancreatitis are non-specific. In
cats with acute necrotizing pancre­
atitis, findings included nonre­
generative anem ia (26 percent),
hem oconcentration (13 percent),
leukocytosis (30 percent), and
leukopenia (15 percent). Biochem i­
cal abnorm alities in affected cats
often reflect concurrent disease.
High serum bilirubin concentrations
and increases in serum alkaline
phosphatase and alanine am ino-
f-
The ultimate
purpose of the
Cornell Feline
Health Center
is to improve
the health of
cats everywhere by developing
methods to prevent or cure feline
diseases, and by providing continu­
ing education to veterinarians and
cat owners. All contributions are
tax-deductible.
In te rim D irecto r:
Fred W. Scott DVM, PhD
V ete rin ary C o n su lta n ts:
Christine Bellezza, DVM
Marnie FitzMaurice, DVM
Paul Maza, DVM
Carolyn McDaniel, VMD
A d m in istra to r:
Michael Lenetsky
A d m in istrativ e A ssistants:
Danielle Diaz
Kathleen Mospan
Donald Personius
Pamela Sackett
Sheryl Thomas
Phone: (607) 253-3414
Consultation: 1-800-KITTYDR
Web: www.vet.cornell.edu/FHC
©2009 by Cornell University on
behalf of the Cornell Feline Health
Center, College of Veterinary Medi­
cine, Ithaca, NY 14853.
All rights reserved. Permission to reprint se­
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________________________
-2-
Vo m iting occurs in up to one half
o f cats w ith pancreatitis but is
less common than non-specific
signs, such as lethargy, anorexia,
dehydration, and hypotherm ia
\ transferase activities are com m on in
cats with pancreatitis. Serum glucose
and cholesterol concentrations m ay
be high, and azotem ia and decreases
in serum potassium and calcium
concentrations are com m on. Low
plasm a ionized calcium concentra­
tion has been correlated with a
poorer outcom e in cats with acute
pancreatitis.
Serum lipase activity is m odestly
increased very early in experi­
m ental feline pancreatitis and
serum amylase actually decreases.
Serum activities o f both enzymes
are frequently norm al in cats with
spontaneous pancreatitis. N ote also
that increased amylase and lipase
are both associated w ith chronic
m alabsorption in cats w ith chronic
intestinal disease (and both m ay
increase w henever the glom erular
filtration rate is reduced). Therefore,
neither serum lipase n o r amylase
activities are of clinical value in the
clinical diagnosis o f pancreatitis in
cats. In contrast, m easurem ent of
serum amylase an d /o r lipase activi­
ties in dogs rem ains m eaningful in
the diagnosis o f pancreatitis, even
though the sensitivity o f these tests
is relatively low, m eaning that som e
affected dogs have norm al values
o f one or both enzymes. The lack
of usefulness o f serum amylase
and lipase in cats has prom pted the
developm ent o f other serum tests
for pancreatitis. The use o f serum
pancreas-specific lipase (spec fPL)
J is now recom m ended instead of
the previously validated serum fTLI
(feline trypsin-like im m unoreactiv-
ity) as a serum test for pancreatiff
in cats exhibiting clinical sig,
com patible w ith this diagnosis.
A lthough initial data look encour­
aging, the specificity and sensitiv­
ity o f the Spec fPL still need to be
established in a large population of
sick cats.
Imaging
A bdom inal radiographs in cats
with pancreatitis m ay show a loss
o f detail in the cranial abdom en,
and, in som e cases, there m ay be a
suggestion of a mass in the cranial
abdom en. A diagnosis of pancre­
atitis is not possible by abdom inal
radiography alone. Exclusion of
some o f the other causes of vague
gastrointestinal signs, however, is
still a m ajor diagnostic rationale for
survey abdom inal radiographs in
cats with the clinical signs described
above.
A bdom inal ultrasonography is a kf
diagnostic test in cats w ith suspecte._
pancreatitis. Findings m ay include
peritoneal effusion, a hypoechoic
pancreas w ith hyperechoic peripan-
creatic fat and m esentery, cavitary
lesions, a m ass effect in the cranial
abdom en, an d /o r biliary duct dila­
tion. In som e cases, however, there
will be no detectable abnorm alities.
O ne feline study showed abdom inal
u ltrasound had a sensitivity o f 24
percent for detecting pancreatitis.
A bnorm al sonographic findings,
HYPERECHOIC
MESENTERY
Ultrasonographic appearance of
pancreatitis in a 6 -ye a r-o ld cat. The
edem atous (enlarged, hypoechoic)
pancreas and inflam ed (h ype rechoic)
peripancreatic fat m ay result in a
mass th a t can be palpated on physical
exam ination.

Examples o f pancreatic samples obtained by ultrasound-
guided fine needle aspiration. Norm al fe lin e pancreas
(le ft ) and acute pancreatic inflam m ation (rig h t ). Both
photom icrographs at 50x. Im ages courtesy o f Drs. Am y
Cordner and Sara H ill, U n iversity o f Minnesota.
however, are highly specific for
pancreatitis, m eaning th at a cat
w ith com patible clinical signs and
changes in the pancreas on sonog­
raphy is very likely to be correctly
diagnosed w ith pancreatitis. Ultra-
sound-guided fine needle aspirates
o f the pancreas and peri-pancreatic
tissue an d /o r fluid m ay assist in the
diagnosis o f pancreatitis.
Biopsy
If clinically indicated, pancreatic
biopsy m ay be obtained by lapa-
iscopy or exploratory laparotomy.
Severe pancreatitis patients are poor
anesthetic risks, however. Gross
observation at the tim e of laparos­
copy or exploratory laparotom y
m ay confirm the diagnosis o f acute
necrotizing pancreatitis and inspec­
tion o f o th er viscera (e.g., intestine,
biliary tract, liver) is of param ount
im portance because o f the high
rate o f concurrent disease in this
species. In equivocal cases, biopsy
m ay be safely perform ed as long as
blood flow is preserved at the site of
the biopsy. A single biopsy m ay be
insufficient to exclude pancreatitis
as inflam m ation has been show n to
occur in discrete areas w ithin the
pancreas.
Treatment
Supportive care continues to be
the m ainstay of therapy for feline
cute pancreatitis. Efforts should be
m ade to identify and elim inate any
inciting agents, sustain blood and
plasm a volum e, correct acid/base,
electrolyte, and fluid deficits, control
vom iting, provide pain relief and
nutritional support, and
treat any com plications
that m ight develop. H ypo­
calcem ia is a com plication
o f severe cases of feline
acute necrotizing pancre­
atitis and is associated with
a worse prognosis. Calcium
gluconate should be given
at doses o f 50-150 mg/kg
intravenously over 12-24
hours and serum total or
ionized calcium concentra­
tions should be m onitored during
therapy. Nausea and vom iting may
be pronounced in affected cats.
The a 2 adrenergic antagonists and
5-HT3 antagonists appear to be the
m ost effective anti-emetics in cats;
Dopam inergic antagonists (m eto­
clopram ide) are less effective. Cats
may be treated with chlorprom azine
(a.2 adrenergic antagonist) at a dose
of 0.2-0.4 m g/kg subcutaneously or
intram uscularly every 8 hours, or
with one of the 5-HT3 antagonists
(ondansetron 0.1- 1.0 m g/kg or
dolasetron 0.5-1.0 mg/kg, orally or
intravenously ql2-24 h), or the NK-
1 receptor antagonist, m aropitant, at
1 m g/kg intravenously, subcutane­
ously or orally q24 h.
Analgesia is an im portant com po­
n ent o f therapy for pancreatitis
and other painful intraabdom inal
disorders th at can be easily over­
looked as cats m ay n o t exhibit
easily-recognized signs o f pain.
Acute pain control can be
accom plished through the use
of intram uscular hydrom or-
phone or buprenorphine. The
latter dru g can also be ad m in ­
istered sublingually (0.02-0.03
m g/kg q 6-8h) has transm ucosal
absorption is excellent. M eperi­
dine ( 1-2 m g/kg intram uscu­
larly or subcutaneously q2-4 h)
or butorphanol (0.2-0.4 m g/kg
subcutaneously q 6 h) have also
been recom m ended. Tram adol
is usually avoided in cats as it
can cause severe dysphoria. A
fentanyl patch provides good
analgesia in cats w ithin 12
hours o f placem ent.
Enteral nutritional support is not
considered contraindicated in the
absence o f vom iting in affected
cats, a departure from the stan ­
dard N PO com ponent o f treat­
m ent in dogs w ith pancreatitis
designed to m inim ize the cephalic,
gastric, an d duodenal sources of
pancreatic stim ulation. Moreover,
recent studies suggest th at it m ay
be appropriate and necessary to
stim ulate pancreatic secretion (via
feeding) in affected anim als. A
short p erio d o f w ithdraw al o f food
and w ater is recom m ended only in
those cats in w hich there is severe
vom iting and risk for aspiration
pneum onia. A nasoesophageal
tube is usually placed in cats for
short-term , in hospital feeding. It
can be replaced by a gastrostom y
or esophagostom y tube for longer-
term feeding in severe cases or in
cats w ith concurrent diseases, such
as hepatic lipidosis, th at prolong
their return to unassisted feeding.
Parenteral nutrition is indicated in
feline patients only w hen vom it­
ing precludes enteral support. The
standard diet o f choice for canine
pancreatitis patients, a low-fat
diet, has no t been shown to be of
benefit in cats. The au th o rs choice
is to feed affected cats a diet high in
antioxidants, and to provide SAMe
(see below) as a supplem ent, based
on prelim inary hu m an and canine
Analgesia is a very im portant com ponent o f
therapy in cats w ith pancreatitis. Cats often fa il
to dem onstrate "classic" evidence o f abdom inal
pain but may have tachycardia, tachypnea or other
more subtle signs. Buprenorphine is a good choice
fo r providing im m ediate analgesia. Effective blood
levels can reliab ly be reached w ithin 6-12 hours of
application o f a transderm al fentan yl patch. Use
of a 25 pg/hr patch is shown here.
 evidence th at antioxidant therapy
(selenium ) is beneficial.
A ntibiotic th erap y has not been
ro u tin ely reco m m en d ed because
cats w ith pancreatitis, unlike
hu m an s, rarely have infectious
com plications (abscessation).
E xperim ental data in acute
n ecro tizin g pancreatitis, however,
indicates th at it m ay begin as
a sterile process, but necrosis
an d in flam m atio n predispose to
colonic bacterial translocation
and colonization o f the pancreas.
H igh colonization rates suggest
th at b acteria m ay spread to the
inflam ed pancreas m ore frequently
th an is cu rren tly th ought. Coli-
form s are th e prin cip al pathogens,
as th ey are in bile cultures from
cats w ith cholangitis. B road spec­
tru m antibiotics may, therefore, be
ap p ro p riate in cases o f feline acute
pancreatitis. It has been show n in
people and dogs w ith ex p e rim en ­
tal pan creatitis th at circulating
m acroglobulins are depleted in
severe pancreatitis. This form s the
ratio n ale for ad m in isterin g plasm a
to cats w ith severe pancreatitis.
Two drugs are o f interest based on
experim ental data but they have
no t yet been investigated in clinical
pancreatitis. Low-dose dopam ine
infusion (5 |ig /k g /m in) improves
pancreatic blood flow and reduces
m icrovascular perm eability in
experim entally induced acute feline
pancreatitis, even w hen it is given
up to 12 hours after induction o f the
disease. H istam ine and bradykinin-
induced increases in m icrovascular
perm eability are associated with
the developm ent o f hem orrhagic
necrosis in experim ental feline
pancreatitis. Treatm ent w ith H, or
H 2 histam ine receptor antagonists
protects against the developm ent
o f hem orrhagic pancreatitis in
these m odels. For this reason, and
to m itigate the esophageal effects
of vom iting acidic gastric contents,
an H 2-receptor antagonist such as
fam otidine (0.5-1.0 m g/kg every
12-24 hrs) is usually adm inistered.
Coexisting conditions, such as
inflam m atory liver disease, inflam ­
m atory bowel disease, hepatic
lipidosis, or diabetes mellitus are
com m on in cats with pancreatitis
and m ust be m anaged concurrently.
There is no evidence that steroid use
is contraindicated w hen necessary
for controlling som e o f these p ro b ­
lems and a single dose o f steroids
has been anecdotally advocated
in severe clinical cases o f pancre­
atitis. Surgery m ay be indicated in
occasional cases, such as for biliary
obstruction or pancreatic abscess.
Summary
In spite o f advances in diagnostic
capabilities, especially ultrasonog­
raphy and fPLI o f the Spec fPL test,
the diagnosis o f feline pancreatitis
rem ains challenging in m any cases
The use o f pancreatic biopsy as tl
‘gold standard’ for ante-m ortem
diagnosis will be facilitated by m ore
routinely obtaining pancreatic biop­
sies during exploratory laparotomy,
and by the increased availability of
laparoscopic biopsy through referral
centers. Better understanding will
be gained of the range o f pancreatic
pathology in an older cat population.
Undoubtedly, as the index of suspi­
cion for this disease rises, the appar­
ent prevalence o f this disease in the
feline population will rise. O nce the
diagnostic hurdles are surm ounted,
further work on risk factors (to
guide prevention strategies) and on
treatm ent will be possible.
In studies on feline liver disease at
the University o f M innesota, we
reported that 83 percent o f cats w ith
cholangitis also had inflam m atory
changes in the bowel and 50 percent
had evidence o f concurrent chrom
pancreatitis. C oncurren t inflam m a
tion in these three organs has been
term ed “triaditis”. This association
has been docum ented histologi­
cally, but fu rth er clinical investiga­
tion is w arranted. Awareness o f the
association o f these three disorders,
however, m ay affect the diagnostic
evaluation o f individual patients. W

Selected References:
Saunders H M , Van W inkle TJ, D robatz K, et al: U ltraso n o g rap h ic findings in cats w ith clinical, gross pathologic, a n d histologic evidence o f
acute pancreatic necrosis: 20 cases (1994-2001). I A m Vet M ed Assoc 2002;221(12): 1724-30.

F orm an M A, M arks SL, De C ock HEV, et al. Evaluation o f seru m feline pancreatic lipase im m u n o reactiv ity a n d helical c o m p u ted tom ography
versus conventional testing for th e diagnosis o f feline pancreatitis. J Vet Int M ed 2004; 18:807-815.

W h ittem o re JC an d C am pbell VL: C an in e a n d Feline Pancreatitis. C o m p e n d C o n tin Educ P ract Vet. O cto b er 2005;27(10):766-776.

Allen HS, Jorg Steiner J, B roussard J, et al: S erum a n d u rin e co n cen tratio n s o f trypsin o g en -activ atio n p ep tid e as m arkers for acute
pancreatitis in cats. C an J Vet Res 2006;70(4):313-6.

De C ock HEV, F orm an MA, Farver TB, et al: Prevalence a n d h istopathologic characteristics o f pancreatitis in cats.
Vet Pathol 2007;44(l):39-49.

Forcada Y, G erm an AJ, N oble PJM et al: D eterm in atio n o f seru m fPLI co n cen tratio n s in cats w ith diabetes m ellitus. I Feline M ed Surg.
July 2008; 10(5):480-7.

F orm an MA, J S hirom a J, A rm stro n g PJ: Evaluation o f Feline Pancreas- Specific Lipase (Spec fPL) for th e D iagnosis o f Feline Pancreatitis
(abstract). ACV IM A nnual F orum , 2009.

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Client Information Brochure:
celine Inflammatory Bowel Disease
What is inflammatory
bow el disease?
Feline in flam m ato ry bow el disease
(IBD) is n o t a single disease,
b u t ra th e r a g ro u p o f ch ro n ic
g astro in testin al d iso rd ers caused
by an in filtra tio n o f in fla m m a ­
to ry cells in to th e w alls o f a cat’s
g astro in testin al tract. T he in fil­
tra tio n o f cells th ick en s th e wall
o f th e g astro in testin al tra c t and
d isru p ts th e in testin e’s ability to
fu n c tio n properly. C ats o f any age
can be affected by IBD; how ever,
th e disease o ccu rs m o st o ften in
m id d le-ag ed a n d o ld er cats.
C h ro n ic in flam m atio n o f th e
g astro in testin al tra c t can o ccu r
as a resu lt o f a specific disease,
such as a p arasitic o r bacte-
ial in fectio n or a specific food
allergy. H owever, th e cause o f
IBD in m any cases is co n sid ered
to be “id io p a th ic ”, o r un k n o w n .
C u rre n t th eo rie s suggest th at
th ese cases o f IBD m ay be due to
a b reak d o w n in th e relationship
betw een th e n o rm al b acteria th at
resid e in th e g astro in testin al tra c t
a n d th e im m u n e system o f the
g astro in testin al wall.
IBD can p resen t in d ifferent
form s d e p e n d in g on the type
o f in flam m ato ry cells a n d the
region o f th e g astro in testin al
tra c t involved. T he m ost co m m o n
form o f IBD involves an in flam ­
m a to ry in filtrate co n sistin g o f
lym phocytes (sm all w hite blo o d
cells) an d p lasm a cells (cells th at
p ro d u ce an tib o d ies) an d is called
lym phocytic-plasm acytic enteritis.
E nteritis refers to th e sm all intes-
ne. If th e sto m ach is involved
the in flam m atio n is d escrib ed as
gastritis, an d if th e colon (large
in testin e) is involved, th e term
colitis is used. E osin ophils are
a n o th e r cell type co m m o n ly p re s­
en t in feline IBD. E osinophils m ay
be p re sen t as the p re d o m in a n t
cell (for exam ple, in eosinophilic
gastroenteritis), b u t are m ore
co m m o n ly seen as p a rt o f a m ixed
p o p u la tio n o f o th e r in flam m ato ry
cells. Two less co m m o n form s o f
IBD are called n eu tro p h ilic an d
g ran u lo m ato u s.
What are the symptoms o f
IBD?
Som e co m m o n sym ptom s o f
feline IBD in clu d e v om iting,
w eight loss, d ia rrh e a a n d le th ­
argy. A ppetite can be variable,
ra n g in g from ravenous to
anorexic. W hile som e cats will
show obvious sym ptom s o f
disease, such as v o m itin g after
every m eal, o th e r cats m ay exhibit
sym ptom s m u ch less frequently,
ing a n d d iarrh ea, are also co m m o n
such as v o m itin g o r p ro d u c in g
sym ptom s o f o th e r diseases. First,
h airballs once o r tw ice a m o n th .
specific causes o f g astro in testin al
T he sym ptom s o f IBD can also
in flam m atio n m u st be ru led
vary d e p e n d in g on th e area o f
out. Your v e te rin a ria n will likely
the digestive tra c t affected by
re c o m m en d bloodw o rk , fecal
the disease. For exam ple, if the
ex am in atio n s, ra d io g rap h s a n d /o r
in fla m m a to ry cells are affecting
u ltra s o u n d check for m etab o lic
th e sto m ach o r h ig h e r areas o f
disease, feline leukem ia, p arasitic
the sm all in testin e, th e n th e cat
o r b ac te rial in fectio n s a n d certain
m ay exhibit sym ptom s o f ch ro n ic
types o f cancer. A hyp o allerg en ic
v om iting. If the in flam m ato ry
food trial m ay also be conducted to
cells are in th e colon, th e n the
rule out food allergy.
cat m ay have d ia rrh e a o r blood
in th e stool. T he sym ptom s m ay A definitive diagnosis o f feline
n o t always c o rre sp o n d to the area IBD can only be m ad e based
affected, especially if th e en tire o n m icroscopical evalu atio n o f
digestive tra c t is involved. tissue collected by m ean s o f an
in testin a l (or gastric) biopsy. In
a p a tie n t w ith IBD, th e tissue
How is felin e IBD
sam ple will show in creased
diagnosed?
n u m b ers o f in fla m m a to ry cells
M aking a diagnosis o f feline IBD in th e in testin a l wall. T he types
req u ires an extensive w o rk up o f cells fo u n d will in d icate w hat
because m any o f th e co m m o n type o f IBD is p re sen t an d help to
sym ptom s o f IBD, such as v o m it­ g uide trea tm e n t. G a stro in testin al
-5-
 biopsies m ay be p e rfo rm e d w ith
th e use o f an en d o sco p e o r d u rin g
ab d o m in al surgery. E ndoscopy is
a less invasive p ro ced u re; how ever,
su rg ery m ay be reco m m en d ed for
p atien ts in w h o m liver or p a n c re ­
atic disease is also suspected, so
th a t th o se o rgans can be biopsied
as well. B oth p ro c ed u re s req u ire
general an esth esia, and the
associated risks m u st be co n sid ­
ered w hen d ecid in g w h e th e r to
p erfo rm th ese tests.
How is IBD treated?
The tre a tm e n t o f in flam m ato ry
bowel disease usually involves a
co m b in atio n o f change in diet and
th e use o f various m edications.
Because th ere is no single best
treatm en t, your v eterin arian m ay
need to try several different com bi­
natio n s in o rd er to d eterm in e the
best th erap y for y o u r cat.
D ie ta ry M a n a g e m e n t
B ecause d ie ta ry allergens m ay
play a role in in flam m ato ry bow el
disease, a fo o d trial u sing hypoal-
lergenic d iets m ay be re co m ­
m en d ed by y o u r v e terin arian . In
using a hypo allerg en ic diet, the
key is to use a p ro tein a n d c a rb o ­
h y d rate source th a t the cat has
n ever eaten before. R abbit, duck
or v en iso n -b a sed diets are often
trie d initially.
If th e sym ptom s o f IBD are not
im proved w ith a hypoallergenic
diet, o th er diets m ay be tried.
D iets high in fiber, low in fat and
easily digestible can be beneficial
and are generally b etter tolerated
in cats w ith IBD. It is im p o rta n t to
n o te th a t it m ay take several weeks
or lo n g er for cats to im prove
after a d iet change, an d d u rin g a
food trial, all o th er food sources
(inclu d in g table food, flavored
m ed icatio n s, an d treats) m u st be
elim in ated from th e diet.
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M edical T re atm en t
C ats th a t have b een diag n o sed
w ith IBD m ay be p u t on a course
o f co rtic o ste ro id s, usually p re d ­
n isolone. C o rtico stero id s have
p o te n t an ti-in fla m m a to ry and
im m u n o su p p ressiv e p ro p erties.
D iabetes a n d excessive im m u ­
n o su p p re ssio n are am ong the
serious side effects these dru g s
can pro d u ce. C ats sh o u ld be
m o n ito re d closely w hile th ey are
on co rtico stero id s, alth o u g h they
te n d to to lerate these d ru g s well
as long as th ey are given at an
ap p ro p riate dose a n d schedule.
C o rtico stero id s are usually given
orally, a n d are sta rte d at a h ig h er
dose, w ith a g rad u al re d u ctio n in
dose over several weeks. In cats
th a t are difficult to m ediate orally
o r in cases w here th e v o m itin g is
severe, y o u r v e te rin a ria n can give
th e m ed ica tio n as an injection.
If co m b in atio n s of d ietary
m an ag em en t a n d co rtic o ste ro id
th era p y have failed to adequately
co n tro l feline IBD, th e n a n tib io t­
ics m ay also be a d d e d to the tre a t­
m e n t regim en. M etro n id azo le is a
co m m o n m ed ica tio n th a t is used
by itself o r in c o n ju n c tio n w ith
co rtic o ste ro id s to co n tro l IBD.
M etro n id azo le has an tib acterial,
an ti-p ro to z o al an d im m u n o m o d ­
u lato ry p ro p e rtie s. A lth o u g h side
effects are u n c o m m o n , som e cats
m ay experience loss o f ap p etite
and v o m itin g w hen given m e tro ­
nidazole. T his is likely a response
to the u n p leasan t taste o f the
m ed icatio n .
If n o n e o f th ese m e d ic a ­
tio n s successfully co n tro ls the
sym ptom s o f IBD, m o re p o te n t
im m u n o su p p ressiv e d rugs, such
as ch lo ram b u cil o r azath io p rin e,
m ay be necessary. T hese dru g s
can suppress th e bo n e m arrow , so
cats m u st be carefully m o n ito red
by a v e te rin a ria n w h en tak in g
these drugs. B ecause th e g a stro in ­
testin al m icro flo ra (b acteria) m ay
play a role in th e d ev elo p m en t
o f IBD, new er th era p y co n sid er
ations include using prebiotic§
(substances th a t p ro m o te certain
b ac te rial p o p u latio n s) and
p ro b io tics (b acterial strain s th a t
p ro m o te g astro in testin al h ealth )
to help m a in ta in b en eficial b a c te ­
rial p o p u latio n s in th e g a stro in ­
testin al tract.
What is the prognosis for
cats with inflammatory
bow el disease?
In fla m m a to ry bow el disease
can often be co n tro lled so th at
affected cats are h ealth y an d
com fortable. H ow ever, even w ith
p ro p e r m an ag em en t, th e disease
m ay w ax a n d w ane; an d an im als
m ay have p e rio d s d u rin g w hich
th e y are sym ptom atic. O p tim al
co n tro l is d e p e n d e n t u p o n th e
p ro p e r selection o f diet and med.
cations. Vigilant m onitoring by the
veterinarian and ow ner are critical
so that relapses can be assessed and
m anaged and appropriate adjust­
m ents in the dosing o f long term
m edications can be m ade. W
The Cornell Feline H ealth Centers
client education brochures address
the m ost com m only asked questions
on feline disorders a n d are a valuable
resource to help y o u in educating
clients on felin e health issues. To
place an order fo r Feline Respira­
tory Infections or any o f the other
brochures in this series, please call
Pam Sackett at 607-253-3443. To
dow nload an order fo r m fr o m our
website, please visit:
w w w .v et.co rn ell.ed u /fh c/
b ro c h u re s /o rd e rB ro c h u re .p d f
 2 is t A n n u a l

Fred S cott F elin e Sy m po siu m

July 24-26, 2009 • Cornell University • Ithaca, New York
Schedule
Friday, July 24th
Update on the Managemertt of Feline Infectious Gastrointestinal Diseases
James R. Richards, Jr. Memorial Feline Lecture: Feline Vaccine Controversies
Pet Ownership for Immune ressed Individuals
Diagnostic Medicine: Use of Molecular Assays in Feline Infectious Diseases
Annual Picnic Six Mile Creek Winery

Saturday, July 25th

Feline Obesity
Feline Diabetes Mellitus:
Pathogenesis & Principles of Therapy
Which Insulin Do I Choose and How Do I Adjust the Dose?
• What Diet Should I Choose and How Do I Manage Problem Cats?
fhe State of Feline Nutrition: Where Are We and What Do We Know about Disease Management and
Prevention?
Feline Pancreatitis: Where Are We?
A New Perspective on Feline Inflammatory Liver Disease
Cayuga Lake Dinner Cruise (optional)
Sunday, July 26
W h at’s New in Feline Kidney Disease?
Update on Feline Anesthesia and Analgesia
Speakers:
Sharon Center, DVM, DACVIM, Cornell University
Richard Goldstein, DVM, DACVIM, DECVIM-CA, Cornell University
Michael Lappin, DVM, PhD, Colorado State University
Andrea Looney, DVM, DACVA, Cornell University
Jacquie Rand, BVSc, DVSc, DACVIM, University of Queensland, Australia
Kenneth Simpson, BVM&S, PhD, DACVIM, DECVIM, Cornell University
Joseph Wakshlag, DVM, PhD, DACVN, Cornell University

For m o re i n f o r m a t i o n , p l e a s e c o n t a c t :

C o lle ge o f V e t e r i n a r y M e d ic in e , Office o f C o n t i n u i n g E d u c a t i o n , C o rne ll U n iv e rsity ,

S 2 1 6 9 V e t e r i n a r y E d u c a ti o n C e n te r, Box 5 2 , I t h a c a , NY 1 4 8 5 3 - 6 4 0 1
P h o n e : 6 0 7 . 2 5 3 . 3 2 0 0 • Fax: 6 0 7 . 2 5 3 . 3 1 9 8 • Email: a m m 3 6 @ c o r n e l l . e d u • w w w . v e t . c o r n e l l . e d u / e d u c a t i o n / C o n E d . h t m

-7-
Cornell Feline Health Center
Cornell University
College of Veterinary Medicine
Ithaca, New York 14853 O

RECEIVED
SEP 1 0 2009

r lo w r /S Pr .c h .r Vet Librerf
Cornell University

New S Updated
Brochures Available:
• Feline Respiratory Infections NEW!
• Feline Inflammatory Bowel Disease *
• Gastrointestinal Parasites in Cats

N ew an d revised editions o f these ed u ca­

tio n al bro ch u res for clients are available for
purchase. To request sam ples or to place an
order, please call (607) 253-3443. We have
pro v id ed a lin k for a p rin tab le o rd er form ,
an d th e co n ten t o f each o f th e b ro ch u res can
be view ed on o u r w ebsite at:

w w w .v e t.c o r n e ll.e d u /F H C /b r o c h u r e s/in d e x .h tm

*featured in this issue on pages 5 and 6