Steiner J M, Williams D A
Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, Texas A & M University, College Station, USA.
Vet Clin North Am Small Anim Pract. 1999 Mar;29(2):551-75.
Despite the uncommon clinical diagnosis, cats frequently suffer from disorders of the exocrine pancreas. Pancreatitis is the most common feline exocrine pancreatic disorder. Pancreatitis can be acute or chronic and mild or severe. The etiology of most cases of feline pancreatitis is idiopathic. Some cases have been associated with severe abdominal trauma, infectious diseases, cholangiohepatitis, and organophosphate and other drug intoxication. The clinical presentation of cats with pancreatitis is nonspecific. Vomiting and signs of abdominal pain, which are the clinical signs most commonly observed in humans and dogs with pancreatitis, are only uncommonly observed in cats with pancreatitis. Routine laboratory findings are also nonspecific. Abdominal ultrasonography is a valuable diagnostic tool in feline patients with pancreatitis. Serum activities of lipase and amylase are rarely increased in cats with pancreatitis; however, these cats often have elevated serum fTLI concentrations. The goals of management are removal of the inciting cause, provision of supportive and symptomatic therapy, and careful monitoring for and aggressive treatment of systemic complications. Exocrine pancreatic insufficiency is a syndrome caused by insufficient synthesis of pancreatic digestive enzymes by the exocrine portion of the pancrease. The clinical signs most commonly reported are weight loss, loose and voluminous stools, and greasy soiling of the hair coat. Serum fTLI is subnormal in affected cats. Treatment of cats with EPI consists of enzyme supplementation with powdered pancreatic extracts or raw beef pancreas. Many cats with EPI have concurrent small intestinal disease. Most cats with EPI also have severely decreased serum cobalamin concentrations and may require parenteral cobalamin supplementation. Pancreatic adenocarcinoma is the most common neoplastic condition of the exocrine pancreas in the cat. At the time of diagnosis, the tumor has already metastasized in most cases, and the prognosis is poor. Pancreatic pseudocyst, pancreatic abscess, pancreatic parasites, pancreatic bladder, and nodular hyperplasia are other exocrine pancreatic disorders, that are less commonly seen in cats.
尽管临床诊断并不常见，但猫经常患有外分泌性胰腺疾病。胰腺炎是猫最常见的外分泌性胰腺疾病。胰腺炎可分为急性或慢性，轻度或重度。大多数猫胰腺炎病例的病因不明。一些病例与严重腹部创伤、传染病、胆管肝炎以及有机磷和其他药物中毒有关。患有胰腺炎的猫的临床表现不具有特异性。呕吐和腹痛症状是人类和患有胰腺炎的狗中最常见的临床症状，但在患有胰腺炎的猫中很少见。常规实验室检查结果也不具有特异性。腹部超声检查是诊断猫胰腺炎患者的重要工具。患有胰腺炎的猫血清脂肪酶和淀粉酶活性很少升高；然而，这些猫的血清fTLI浓度通常会升高。治疗的目标是消除诱因，提供支持性和对症治疗，并密切监测和积极治疗全身并发症。外分泌性胰腺功能不全是一种由胰腺外分泌部分合成的胰腺消化酶不足引起的综合征。最常报告的临床症状是体重减轻、粪便松散且量大以及被毛油腻弄脏。受影响猫的血清fTLI低于正常水平。治疗患有EPI的猫包括补充酶，使用粉状胰腺提取物或生牛肉胰腺。许多患有EPI的猫同时患有小肠疾病。大多数患有EPI的猫血清钴胺素浓度也会严重降低，可能需要胃肠外补充钴胺素。胰腺腺癌是猫外分泌性胰腺最常见的肿瘤性疾病。在诊断时，大多数情况下肿瘤已经发生转移，预后很差。胰腺假性囊肿、胰腺脓肿、胰腺寄生虫、胰腺囊肿和结节性增生是其他外分泌性胰腺疾病，在猫中较少见。
