A 9 year-old male castrated domestic shorthair cat presented to the Emergency Service at Cornell University for a two day history of lethargy. The animal was thin, obtunded, weak, hypothermic and dehydrated upon presentation. Bloodwork revealed a severe metabolic acidemia and hyperglycemia, as well as moderate electrolyte abnormalities, azotemia, and elevated liver enzymes. Urinalysis revealed a severe glycosuria and a moderate ketonuria. A diagnosis of diabetic ketoacidosis was made and supportive fluid, insulin, and electrolyte therapy was initiated. Abdominal ultrasound revealed hyperechoic splenic nodules, enlarged kidneys, and a diffusely enlarged liver and pancreas. These findings, as well as lack of response to therapy, led to an ultimate decision for euthanasia. Partial necropsy and histopathology revealed exocrine pancreatic carcinoma and hepatic lipidosis. This case will be used to discuss diabetic ketoacidosis and exocrine pancreatic carcinoma in cats.