{"topic_id":"evidence_feline_pancreatitis_diet","category":"evidence","context":"---\ntopic_id: evidence_feline_pancreatitis_diet\ncategory: evidence\ntitle: \"Evidence cluster — feline pancreatitis nutritional / enteral feeding support (peer-reviewed, Europe PMC + PubMed)\"\nlang: en\nsource_file: pdf-raw/evidence/europepmc_feline_pancreatitis_diet_2026-07-22.txt\nsource: Europe PMC REST search (first-hand PMIDs) + PubMed efetch verbatim abstracts, pulled 2026-07-22\ndate_parsed: 2026-07-22\nmodel: codebuddy\nbatch: P0-EVIDENCE-8\nverified: 2026-07-22 substring_match 24/24 claims passed\npath: evidence/evidence_feline_pancreatitis_diet/01_feline_pancreatitis_diet.md\n---\n## Representative peer-reviewed studies (verbatim abstracts)\n\nThe following studies were retrieved from Europe PMC / PubMed and are reproduced verbatim. Interpretive synthesis is left to the API user.\n\n### PMID:41017078 — Progression of lipase activity and pancreatic lipase immunoreactivity in clinically healthy cats and cats with diet-responsive enteropathy.\n- Source: J Feline Med Surg 2025\n1. J Feline Med Surg. 2025 Sep;27(9):1098612X251367621. doi: \n10.1177/1098612X251367621. Epub 2025 Sep 28.\n\nProgression of lipase activity and pancreatic lipase immunoreactivity in \nclinically healthy cats and cats with diet-responsive enteropathy.\n\nMoscoso Uribe F(1), Riond B(2), Del Chicca F(3), Ruetten M(4), Grimm F(5), \nLiesegang A(1), Kook PH(6).\n\nAuthor information:\n(1)Institute of Animal Nutrition and Dietetics, Vetsuisse Faculty, University of \nZurich, Zurich, Switzerland.\n(2)Clinical Laboratory, Vetsuisse Faculty, University of Zurich, Zurich, \nSwitzerland.\n(3)Clinic of Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, \nZurich, Switzerland.\n(4)Pathovet, Tagelswangen, Switzerland.\n(5)Institute of Parasitology, Vetsuisse Faculty, University of Zurich, Zurich, \nSwitzerland.\n(6)Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of \nZurich, Zurich, Switzerland.\n\nObjectivesThe aim of the present study was to describe the course of lipase \nactivity, pancreatic lipase immunoreactivity (PLI) and clinical findings over \ntime in cats.MethodsFour clinically healthy cats and two diarrhoeic cats from a \nresearch colony aged 2-8 years with normal haematology and serum biochemistry \nresults were followed up with lipase measurements over a total of 12 months in \nthis descriptive study. Lipase activity (LIPCRoche; reference interval [RI] \n8-26 U/l) was determined at day 0, and lipase activity and concurrent PLI (Spec \nfPL; RI 0-4.4 µg/l) were determined at days 19, 47, 54, 221 and 369. All cats \nwere examined weekly. The pancreas and gastrointestinal tract of all cats were \nexamined via ultrasonography.ResultsLipase activity and PLI in four clinically \nhealthy cats was in the range of 10-283 U/l (median 69) and 1.2-86 µg/l (median \n13), respectively. Lipase activity and PLI in two cats with enteropathy was in \nthe range of 16-130 U/l (median 42) and 1.9-36 µg/l (median 8.3). The magnitude \nand nature of change were always the same for both assays. The correlation \nbetween assays was very high (rs 0.984; P <0.0001). The pancreas was normal on \nultrasound in both diarrhoeic cats and two healthy cats, whereas a hypoechoic \nand enlarged pancreas was found in two clinically healthy cats with persistently \nincreased lipase values. All cats had ultrasonographic evidence of enteropathy. \nNo pattern could be recognised in the temporal lipase progression; only one \nhealthy cat with an ultrasonographically abnormal pancreas had continuously \nincreasing values. Both cats with large bowel diarrhoea were \ndiet-responsive.Conclusions and relevanceLipase activity and PLI varied from \nnormal to markedly increased in clinically healthy cats and cats with \ndiet-responsive enteropathy and a normal pancreas on ultrasonography. Both \nlipase assays yielded virtually identical results. No apparent association \nbetween lipase results and clinical or ultrasonographic findings was found. The \nresults illustrate the difficulties clinicians face when trying to assess the \nsignificance of lipase levels in cats.\n\nDOI: 10.1177/1098612X251367621\nPMCID: PMC12477377\nPMID: 41017078 [Indexed for MEDLINE]\n\nConflict of interest statement: Conflict of interestThe authors declared no \npotential conflicts of interest with respect to the research, authorship, and/or \npublication of this article.\n- Abstract (verbatim excerpt): \nJOURNAL:J Feline Med Surg 2025\n1. J Feline Med Surg. 2025 Sep;27(9):1098612X251367621. doi: \n10.1177/1098612X251367621. Epub 2025 Sep 28.\n\nProgression of lipase activity and pancreatic lipase immunor\n\n### PMID:42256055 — Acute vitamin D toxicosis in an adult cat.\n- Source: JFMS Open Rep 2026\n1. JFMS Open Rep. 2026 Apr 24;12(1):20551169261448248. doi: \n10.1177/20551169261448248. eCollection 2026 Jan-Jun.\n\nAcute vitamin D toxicosis in an adult cat.\n\nChasnick IR(1), Levy NA(1).\n\nAuthor information:\n(1)Michigan State University College of Veterinary Medicine, East Lansing, MI, \nUSA.\n\nCASE SUMMARY: A 4-year-old, female spayed domestic shorthair cat was presented \nto the Michigan State University emergency service for evaluation of vomiting 4 \ndays after exposure to vitamin D supplements. On intake, the patient was found \nto have ionized hypercalcemia and azotemia. The patient was hospitalized for \ncalciuresis therapy including fluid diuresis, diuretics, steroids, \nbisphosphonates and a nasogastric feeding tube. She was discharged and presented \nfor a recheck evaluation and was then hospitalized a second time for the same \ntherapy as her first hospitalization. Eventually the patient was discharged for \nat-home care with subcutaneous fluids and oral medications because of financial \nconstraints. Approximately 52 days after exposure, the cat was noted to have \npersistently normal ionized calcium and all medications were discontinued.\nRELEVANCE AND NOVEL INFORMATION: This case provides a unique example of acute \nvitamin D toxicosis in a cat and a financially conservative approach in treating \na toxicity with a significant half-life.\n\n© The Author(s) 2026.\n\nDOI: 10.1177/20551169261448248\nPMCID: PMC13234386\nPMID: 42256055\n\nConflict of interest statement: The authors declared no potential conflicts of \ninterest with respect to the research, authorship, and/or publication of this \narticle.\n- Abstract (verbatim excerpt): \nJOURNAL:JFMS Open Rep 2026\n1. JFMS Open Rep. 2026 Apr 24;12(1):20551169261448248. doi: \n10.1177/20551169261448248. eCollection 2026 Jan-Jun.\n\nAcute vitamin D toxicosis in an adult cat.\n\nChasnick IR(1\n\n### PMID:41369075 — Guidelines for nutritional management of feline diabetes mellitus: a proposed classification system integrating medical considerations.\n- Source: J Feline Med Surg 2026\n1. J Feline Med Surg. 2026 Mar;28(3):1098612X251409019. doi: \n10.1177/1098612X251409019. Epub 2025 Dec 10.\n\nGuidelines for nutritional management of feline diabetes mellitus: a proposed \nclassification system integrating medical considerations.\n\nHookey T(1), Backus RC(2), Bjørnvad CR(3), Davison LJ(4)(5), Fleeman L(6), \nFracassi F(7), German AJ(8), Gilor C(9), Gostelow R(4), Schoeman T(1), Flanagan \nJ(1).\n\nAuthor information:\n(1)Royal Canin Research Centre, Aimargues, France.\n(2)Department of Veterinary Medicine and Surgery, College of Veterinary \nMedicine, University of Missouri, Columbia, MO, USA.\n(3)Department of Veterinary Clinical Sciences, Faculty of Health and Medical \nSciences, University of Copenhagen, Denmark.\n(4)Department of Clinical Science and Services, The Royal Veterinary College, \nLondon, UK.\n(5)Department of Physiology, Anatomy and Genetics, University of Oxford, UK.\n(6)Animal Diabetes Australia, Melbourne, VIC, Australia.\n(7)Department of Veterinary Medical Sciences, University of Bologna, Italy.\n(8)Institute of Life Course and Medical Sciences, Faculty of Health and Life \nSciences, University of Liverpool, Neston, UK.\n(9)Department of Small Animal Clinical Sciences, University of Florida, \nGainesville, FL, USA.\n\nThe management of diabetes mellitus (DM) in cats can benefit from an integration \nof medical and nutritional strategies, based on an understanding of the dynamic \nnature of the disease, together with an appreciation of the interrelationships \nbetween nutritional status and clinical status. In this context, a new \nclassification system for feline DM is proposed, comprising three clinical \nstatus categories: those at risk of developing DM, those with clinical DM and \nthose in diabetic remission. The influence of individual dietary components \n(carbohydrate, protein, fat and water fractions) on clinical outcomes is \ndiscussed, followed by overarching principles for the dietary management of \ndiabetic cats, based on both the limited scientific evidence and the clinical \nexperience of the authors. Key aspects of nutritional assessment, the principles \nof therapeutic weight reduction and feeding practices are covered. Using the \nclassification framework, recommendations for nutritional management are \nproposed for cats at risk of development of DM, cats with clinical DM and those \nin clinical remission. Successful implementation of these recommendations can be \nachieved by using a relationship-centred approach, where owner concerns are \naddressed and goals for management are agreed in partnership. It is hoped that \nthese perspectives will help guide veterinary professionals in their clinical \nmanagement decisions, thereby improving health outcomes in cats in all three \ncategories of DM.\n\nDOI: 10.1177/1098612X251409019\nPMCID: PMC13009768\nPMID: 41369075 [Indexed for MEDLINE]\n\nConflict of interest statement: Conflict of interestTabitha Hookey, Tanya \nSchoeman and John Flanagan are employees of Royal Canin SAS. Charlotte R \nBjørnvad has research, advisory and speaking contracts with Royal Canin and \nBoehringer Ingelheim, and speaker contracts with Hills and Vuffeli, but with no \nconflict of interest associated with the current manuscript. Robert C Backus \nserved as director of the Nestlé Purina Endowed Program in Small Animal \nNutrition at the University of Missouri, Columbia, during the period of \nmanuscript preparation. Lucy J Davison is in receipt of research funding from \nthe UK Medical Research Council, PetPlan Charitable Trust, American Kennel Club \nCanine Health Foundation, Dechra Veterinary Products and Evetts-Luff Charitable \nTrust, but with no conflict of interest associated with this manuscript. Linda \nFleeman has received honoraria for educational seminars and manuscripts for \nBoehringer-Ingelheim, MSD Animal Health, Zoetis, Royal Canin and Nestle Purina, \nconsulting fees from Dechra Boehringer-Ingelheim and Amacas, and research \nsupport from Royal Canin. Federico Fracassi has received honoraria for \neducational seminars, financial research support or consulting fees from MSD \nAnimal Health, Dechra, Boehringer-Ingelheim, Royal Canin, Nestlé Purina, Hill’s, \nMyLav and Forza10. Alexander J German is an employee of the University of \nLiverpool but his position is funded by Royal Canin. He has also received \nfinancial remuneration and gifts for providing educational material, speaking at \nconferences and consultancy work. Chen Gilor had research, advisory and speaking \ncontracts with Dechra, Edge Animal Health, CEVA, Okava, Merck Animal Health, \nBiomEdit, Boehringer-Ingelheim and Baycom. Ruth Gostelow has research, advisory \nand speaking contracts with Royal Canin. She is a member of the Boehringer \nIngelheim Global Diabetes Advisory Committee.\n- Abstract (verbatim excerpt): \nJOURNAL:J Feline Med Surg 2026\n1. J Feline Med Surg. 2026 Mar;28(3):1098612X251409019. doi: \n10.1177/1098612X251409019. Epub 2025 Dec 10.\n\nGuidelines for nutritional management of feline diabetes mel\n\n### PMID:42071970 — Overweight and Obesity in Dogs and Cats: An Exploration of Animal Welfare and Behaviour Impacts, and Recommendations for Management in Veterinary Primary Care.\n- Source: Animals (Basel) 2026\n1. Animals (Basel). 2026 Apr 15;16(8):1204. doi: 10.3390/ani16081204.\n\nOverweight and Obesity in Dogs and Cats: An Exploration of Animal Welfare and \nBehaviour Impacts, and Recommendations for Management in Veterinary Primary \nCare.\n\nQuinn R(1), Quain A(1).\n\nAuthor information:\n(1)Sydney School of Veterinary Science, Faculty of Science, University of \nSydney, Camperdown, NSW 2006, Australia.\n\nOverweight and obesity are prevalent among companion dogs and cats in the \nWestern world. Affected animals are at risk of comorbidities and reduced \nlongevity. This narrative review found that veterinary literature generally \ncharacterises overweight and obesity as nutritional disorders that are primarily \naddressed by reducing caloric intake. However, veterinary management of \noverweight and obesity has limited success outside research settings. The Five \nDomains model for animal welfare assessment is applied to explore impacts of \noverweight and obesity and their management in dogs and cats by focusing on \nnutrition, health, physical environment, behavioural interactions and mental \nstate. A second focus is on the practical strategies for addressing \nnon-diet-related barriers and client communication through the provision of \nmanagement recommendations. This novel and integrative approach aims to inform \nveterinarians and improve the success of weight management protocols.\n\nDOI: 10.3390/ani16081204\nPMCID: PMC13113748\nPMID: 42071970\n\nConflict of interest statement: The authors declare no conflicts of interest.\n- Abstract (verbatim excerpt): \nJOURNAL:Animals (Basel) 2026\n1. Animals (Basel). 2026 Apr 15;16(8):1204. doi: 10.3390/ani16081204.\n\nOverweight and Obesity in Dogs and Cats: An Exploration of Animal Welfare and \nBehaviour Impacts, a\n\n### PMID:41992442 — Gastrointestinal microbiota and fecal fatty acids of cats with exocrine pancreatic insufficiency.\n- Source: J Feline Med Surg 2026\n1. J Feline Med Surg. 2026 May;28(5):1098612X261446328. doi: \n10.1177/1098612X261446328. Epub 2026 Apr 16.\n\nGastrointestinal microbiota and fecal fatty acids of cats with exocrine \npancreatic insufficiency.\n\nHuther A(1), Gould EN(2), Chang CH(2), Anderson-Kaapa M(2), Fosgate GT(3)(4), \nSuchodolski JS(2).\n\nAuthor information:\n(1)Department of Small Animal Clinical Sciences, College of Veterinary Medicine \n& Biomedical Sciences, Texas A&M University, College Station, TX, USA.\n(2)Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, \nCollege of Veterinary Medicine & Biomedical Sciences, Texas A&M University, \nCollege Station, TX, USA.\n(3)Department of Veterinary Clinical Sciences, Lewyt College of Veterinary \nMedicine, Long Island University, Brookville, NY, USA.\n(4)Department of Production Animal Studies, Faculty of Veterinary Science, \nUniversity of Pretoria, Onderstepoort, South Africa.\n\nObjectivesThe aim of the present study was to identify differences in fecal \nanalytes (ie, microbiota, fatty acids [FAs]) in cats with exocrine pancreatic \ninsufficiency (EPI) compared with healthy controls, and describe clinical signs \nat baseline and short-term follow-up.MethodsA cross-sectional, observational \nstudy was conducted of 55 client-owned cats with EPI and 37 healthy client-owned \nblood donor control cats. Eligible cases had a feline trypsin-like \nimmunoreactivity (fTLI) consistent with EPI. Fecal samples were analyzed for \nfecal microbiota dysbiosis index (DI) and FAs. Serum and fecal analytes from \ncontrols were compared with EPI cats using parametric and non-parametric methods \nincluding general linear models to adjust for potential confounding by \nsignalment differences. Clinical signs were described for cats with EPI at \nenrollment and for one short-term follow-up time point.ResultsFecal DI and FAs \nwere abnormal in EPI cases compared with controls. Cats with EPI had a higher \nmedian DI (1.5 [range -2.6 to 3.8]), total FAs (74.1 µg/g [range 4.7-162]), \narachidonic acid (2.54 µg/g [range 0.03-17.0]) and nervonic acid (0.37 µg/g \n[range 0.02-1.5]) than controls (-3 [range -4.4 to -0.6], 19.7 µg/g [range \n9.4-75.2], 0.57 µg/g [range 0.32-1.51] and 0.17 µg/g [range 0.09-0.54], \nrespectively), and a lower median Peptacetobacter hiranonis (4.8 log DNA [range \n0.1-6.1]) compared with controls (5.9 log DNA [range 3.2-6.8]). The most common \nclinical signs were weight loss and appetite disturbances.Conclusions and \nrelevanceCats with EPI have alterations in fecal microbiota and FA, and clinical \nsigns in this population of cats were similar to those previously reported.\n\nDOI: 10.1177/1098612X261446328\nPMCID: PMC13213120\nPMID: 41992442 [Indexed for MEDLINE]\n\nConflict of interest statement: Conflict of interestThe authors declared the \nfollowing potential conflicts of interest with respect to the research, \nauthorship, and/or publication of this article: three of the authors (EG, CHC, \nJS) are employed by the Gastrointestinal Laboratory at Texas A&M University, \nwhich offered the assays in this article on a fee-for-service basis.\n- Abstract (verbatim excerpt): \nJOURNAL:J Feline Med Surg 2026\n1. J Feline Med Surg. 2026 May;28(5):1098612X261446328. doi: \n10.1177/1098612X261446328. Epub 2026 Apr 16.\n\nGastrointestinal microbiota and fecal fatty acids of cats wi\n\n### PMID:42213695 — Effect of dietary Ca:P ratio on ionized calcium and calcium homeostasis in cats with early-stage chronic kidney disease.\n- Source: PLoS One 2026\n1. PLoS One. 2026 May 29;21(5):e0350414. doi: 10.1371/journal.pone.0350414. \neCollection 2026.\n\nEffect of dietary Ca:P ratio on ionized calcium and calcium homeostasis in cats \nwith early-stage chronic kidney disease.\n\nHall JA(1), Hancock LB(2), Morris EM(2).\n\nAuthor information:\n(1)Department of Biomedical Sciences, Carlson College of Veterinary Medicine, \nOregon State University, Corvallis, Oregon, United States of America.\n(2)Pet Nutrition Center, Hill's Pet Nutrition, Incorporated, Topeka, Kansas, \nUnited States of America.\n\nThe aim of the study was to compare two renal foods with different Ca:P ratios \non manifestation of hypercalcemia and regulation of calcium homeostasis in cats \nwith chronic kidney disease (CKD). Nine cats (11.0 ± 2.0 y) with \nnaturally-occurring IRIS Stage I or II CKD were fed a senior wellness food for \n28-days, then randomized into two groups and fed either a food providing 1.8 \ng/Mcal Ca, 1.3 g/Mcal P, and Ca:P ratio of 1.4:1 (MOD-Ca:P), or a food providing \n2.4 g/Mcal Ca, 1.3 g/Mcal P, and Ca:P ratio of 1.8:1 (HIGH-Ca:P) for 56 days. \nAfter a 28-day washout period, cats were crossed over to the other test food. \nBlood and urine samples were collected at the end of the prefeed/washout and on \ndays 28 and 56 of each study period. Data were analyzed using a linear mixed \nmodel with fixed effects of Diet, Day, Period and associated interactions. At \nbaseline, mean ionized calcium (iCa; 1.26 ± 0.03 mmol/L) was within the normal \nreference interval (1.10-1.40 mmol/L). Serum total Ca, phosphorus, calcitriol, \nand fractional excretion of calcium were not affected by diet and diet by day \ninteraction (P > 0.050). There was a trend for increased fibroblast growth \nfactor 23 (P = 0.058) and serum iCa (P = 0.067) in cats fed HIGH-Ca:P compared \nwith MOD-Ca:P food, although iCa remained within the normal reference interval. \nParathyroid hormone was reduced when cats were fed HIGH-Ca:P compared with cats \nfed MOD-Ca:P (P = 0.020), although concentrations were within the normal \nreference interval throughout the study. Fractional excretion of phosphorus was \nreduced when cats were fed HIGH-Ca:P compared with MOD-Ca:P (P = 0.050). Serum \nCr and SDMA were higher on days 28 and 56 compared with baseline (P < 0.002). \nHigher dietary Ca and a higher Ca:P ratio may not be the sole drivers of \nhypercalcemia in cats with progressive CKD. However, the observed alterations in \ncalcium homeostatic mechanisms warrant further research to identify strategies \nfor mitigating hypercalcemia risk.\n\nCopyright: © 2026 Hall et al. This is an open access article distributed under \nthe terms of the Creative Commons Attribution License, which permits \nunrestricted use, distribution, and reproduction in any medium, provided the \noriginal author and source are credited.\n\nDOI: 10.1371/journal.pone.0350414\nPMCID: PMC13221076\nPMID: 42213695 [Indexed for MEDLINE]\n\nConflict of interest statement: We have read the journal’s policy and the \nauthors of this manuscript have the following competing interests: two of the \nauthors have an affiliation (LBH, EMM) to the commercial funders of this \nresearch, as employees of Hill’s Pet Nutrition, Inc \n(http://www.hillspet.com/our-company.html). This does not alter our adherence to \nPLOS ONE policies on sharing data and materials.” (detailed online in our guide \nfor authors http://journals.plos.org/plosone/s/competing-interests). Data is \nfreely available upon request. The funder provided support in the form of \nsalaries for authors, but did not have any additional role in the study design, \ndata collection and analysis, decision to publish, or preparation of the \nmanuscript. The specific roles of these authors are articulated in the ‘author \ncontributions’ section.\n- Abstract (verbatim excerpt): \nJOURNAL:PLoS One 2026\n1. PLoS One. 2026 May 29;21(5):e0350414. doi: 10.1371/journal.pone.0350414. \neCollection 2026.\n\nEffect of dietary Ca:P ratio on ionized calcium and calcium homeostasis in cats\n\n","sources":[],"tokens_estimated":3797,"generated_at":null,"tip":"Use /api/v1/topics to discover more topics. /api/v1/nutrient for precise single-point queries. /api/v1/cross_compare for 2-3 standard comparisons."}