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Exocrine Pancreatic Insufficiency in Dogs (EPI)

By: Dr. Bari Spielman

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Exocrine pancreatic insufficiency (EPI) is a disorder in which the pancreas does not produce an adequate amount of digestive enzymes. This deficiency results in maldigestion (poor digestion) and malabsorption (poor absorption). EPI is most commonly found in German shepherd dogs, but can be seen in any breed. It is rare in cats.

EPI is seen most commonly in young dogs secondary to pancreatic acinar atrophy (a decrease in the enzyme producing cells of the pancreas). EPI, however, can occur in older animals secondary to chronic pancreatitis (pancreatic inflammation).

General Causes

  • Pancreatic acinar atrophy (most common cause)
  • Chronic pancreatitis
  • Pancreatic cancer
  • Congenital abnormality (an abnormality present since birth)

    What to Watch For

  • Chronic diarrhea
  • Excessive food intake
  • Weight loss
  • Flatulence (gas)
  • Coprophagia (eating feces)
  • Pica (eating unusual things such as dirt)
  • Borborygmus (a rumbling noise caused by gas passing through the intestines)

    Diagnosis

    Veterinary care includes diagnostic tests and subsequent treatment recommendations. Diagnostic tests are needed to identify EPI and exclude other diseases. Your veterinarian will take a complete history and perform a thorough physical examination. A thorough knowledge of the history and clinical signs is very important in the diagnosis of EPI. Tests may include:

  • Fecal examination to check for the presence of fat and starch which indicates maldigestion or malabsorption. A fecal flotation and direct smear also will be performed to evaluation for parasites.

  • A complete blood count (CBC or hemogram) to evaluate for anemia, inflammation, infection or low platelet count.

  • Serum biochemistry profile to evaluate the general health of your dog and to determine the effect of EPI on other organ systems.

  • Urinalysis to evaluate kidney function and to check for the presence of urinary tract infection.

  • Abdominal X-rays to evaluate organs such as liver, spleen, and kidneys and to check for masses.

  • Serum trypsin-like immunoreactivity (TLI) to evaluate for the presence of the pancreatic enzyme trypsin. Animals with EPI have extremely low concentrations of this enzyme in their serum.

    Treatment

    Dogs with EPI generally feel well and are otherwise healthy. Treatment often is administered on an outpatient basis and may include one or more of the following:

  • Dietary modification
  • Pancreatic enzyme replacement
  • Concurrent antibiotic therapy

    Home Care and Prevention

    Administer any medications that your veterinarian has prescribed. Feed your dog as directed by your veterinarian. Watch your dog carefully for resolution of symptoms, especially resolution of diarrhea and gain in body weight. Contact your veterinarian if improvement is not observed over the first few weeks.

    The cause of pancreatic acinar atrophy is unknown and this cause of EPI cannot be prevented. Diets high in fat can predispose pets to pancreatitis. Thus, feed your pet a diet low or moderate in fat content and avoid feeding high fat table scraps.

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