Fat-soluble vitamin deficiency and subsequent coagulopathy in a cat with exocrine pancreatic insufficiency

Abstract

This report describes the clinical signs, diagnostic findings and treatment of a female spayed Domestic Shorthair with exocrine pancreatic insufficiency (EPI) who presented in shock due to severe gastrointestinal haemorrhage secondary to coagulopathy caused by vitamin K-dependent clotting factor deficiency. Diagnostics revealed a prolonged prothrombin time, activated partial thromboplastin time, low trypsin-like immunoreactvity and gross evidence of pancreatic atrophy. Gastrointestinal haemorrhage resolved quickly with transfusion of fresh frozen plasma and vitamin K supplementation. Following treatment with oral pancreatic enzyme supplementation, the cat was found to have resolution of gastrointestinal signs, improved body condition and normalisation of clotting times. Fat-soluble vitamin levels were below the expected range and improved following treatment. This is the second report of coagulopathy in a cat with EPI and the first to describe fat-soluble vitamin deficiency that improved with pancreatic enzyme supplementation.