Cardiomyopathies (CM) are the most common acquired feline cardiac diseases and frequently result in congestive heart failure (CHF). Low cardiac output and poor peripheral perfusion may cause multisystemic injury such as pancreatitis. Measurement of feline pancreatic lipase immunoreactivity (fPLI) and trypsin-like immunoreactivity (TLI) aid in the assessment of pancreatitis and pancreatic exocrine function. Previous studies have assessed the association between cardiac disease, CHF, and pancreatitis in humans and dogs. The aim of this prospective study was to assess fPLI and TLI values between healthy cats and cats with primary CM with or without CHF. In addition, a retrospective evaluation of pancreatic histology from cats with CM was performed.
Cats were prospectively recruited into three groups: 1) healthy controls (H group), 2) primary CM (CM group), and 3) CM with active or historical CHF determined by a board-certified cardiologist (CHF group). All included cats underwent a physical exam, blood pressure, echocardiogram, fPLI, TLI, complete blood count (CBC), and chemistry panel. Cats with evidence of hypertrophic cardiomyopathy (HCM) also had total T4 measured. Routine pancreatic histopathology from cats affected by primary CM were retrospectively reviewed by a board-certified anatomic pathologist for histologic evidence of pancreatic injury. Differences between groups were assessed by Kruskal-Wallis tests and association assessed by Fisher’s exact tests.
A total of 25 cats were included and classified into the H (n=4), CM (n=10), and CHF (n=11) groups. There were no statistical differences in age, body weight, or body condition score between groups. CM diagnoses included HCM (4 CM, 5 CHF), hypertrophic obstructive cardiomyopathy (5 CM, 2 CHF), unclassified cardiomyopathy (1 CM, 2 CHF), and restrictive cardiomyopathy (2 CHF). In the CHF group, 6/11 cats had active CHF (pulmonary edema or pleural effusion) at the time of blood collection. Gastrointestinal signs included vomiting (2 CM, 2 CHF), anorexia (2 CM, 1 CHF), and weight loss (1 CM, 2 CHF). Median values for the control, CM, and CHF groups did not differ for fPLI (1.6, 2.2, and 1.8 μg/L) or TLI (35, 27.4, and 39.9 μg/L). Five CM and 3 CHF cats had fPLI values greater than the feline reference range, 2 CM cats had increased TLI values, and 1 CM cat had a deceased TLI value. Active CHF was not statistically associated with an abnormal fPLI or TLI result (P > 0.99; P > 0.99).
Retrospective pancreatic histopathology of 16 cats with CM found a spectrum of morphologic lesions potentially related to pancreatic ischemia. These included exocrine vacuolation (6/18), focal or multifocal coagulation necrosis (2/16), and saponification of pancreas-associated adipose tissue (5/16). Of the 10 cats with possible cardiac-related pancreatic ischemia, 5/10 had active or historical CHF. Other common feline pancreatic lesions were also identified, including islet amyloidosis (6/16), mild to moderate lymphocytic inflammation (8/16), and periductular fibrosis (6/16).
These preliminary data demonstrate no statistically significant differences in pancreatic biomarkers of cardiomyopathic cats with or without CHF. Potentially relevant histopathologic pancreatic changes were identified, suggesting that biomarkers may vary with time or disease severity and not reflect cardiac-induced injury.
Small Animal Internal Medicine Intern
Oregon State University
Dr. Laetitia Duler obtained her veterinary degree from the Toulouse School of Veterinary Medicine in Southern France. Upon graduation she completed a small animal rotating internship followed by an internal medicine specialty internship at Oregon State University. Dr. Duler’s clinical and research interests include multimodality imaging and cardiovascular impacts of systemic diseases. Dr. Duler will be starting an emergency and critical care internship at UC Davis in July 2018, with the long-term goal of becoming a board-certified veterinary cardiologist.
Friday, June 15
2:15 PM – 2:30 PM
Friday, June 15
2:30 PM – 2:45 PM
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