The study of feline pancreatitis: 1. Establishment of severity scoring system 2. The therapeutic efficacy of fresh frozen plasma (FFP)

Feline pancreatitis is the most common exocrine pancreatic disorder with varied mortality. There is no available and reliable method to evaluate the severity and prognosis of the disease. Fresh frozen plasma (FFP) has been reported to treat acute pancreatitis of cats. However, the efficacy has not been determined. Forty-three cats diagnosed as pancreatitis with acute onset of compatible clinical signs and a positive SNAP® fPLTM Test that hospitalized at NTUVH for therapy between October 2011 and September 2013 were enrolled in this study. All Cats were divided into survival (21/43, 48.8%) and non-survival (22/43, 51.2%) group. Hemoglobin, albumin, BUN, total bilirubin, phosphorous and systolic blood pressure were found to be significantly associated with disease severity and prognosis, and were selected for constructing the system. The severity scores in this study achieved an area under receiver operating characteristic (AUROC) of 0.978. The optimal cut-off point for discriminating outcome was 17.5 with the sensitivity of 95.2% and specificity of 95.5%, respectively. The mortality was 95.5% with a score ≥ 18, and 4.8 % with a score ≤ 17. In addition, the scoring system can be used to monitor disease progression. The increase in the scores indicate poor outcome. All cats were stratified into Level 1 (score ≤12), Level 2 (score range 12-17), Level 3 (score range 18-30) and Level 4 (score ≥ 31) by the severity scoring system. The cats treated with FFP and supportive care was grouped into FFP Group, whereas treated with only supportive care into Control Group. The mortality in Level 1 was 0% in both groups. The mortality in Level 2 was 0% in FFP Group and 33.3% in Control Group. The mortality in Level 3 was 88.9% in FFP Group and 100% in Control Group. None of cats in Level 4 survived. There was no significant difference between different treatment groups, however, the cats treated with FFP in moderate disease stage including Level 2 and 3 showed a trend of lower mortality. In conclusion, the severity scoring system of this study provides a reliable and clinical applicable method to predict clinical outcome in cats with pancreatitis. Treatment combined with FFP is advisable for clinical usage of feline pancreatitis.