Exocrine Pancreatic Insufficiency (EPI)
is diagnosed most frequently in German Shepherd dogs, rough-coated collies,
and in dogs that have had severe or chronic pancreatitis.
"A veterinarian can suspect that your
dog has EPI based on his breed, medical history, and symptoms, but a
definitive diagnosis requires confirmatory testing."
The Pancreas in Health and Disease
The pancreas is an abdominal organ that lies adjacent to the small intestine. It has two main roles:
- The manufacturing and secretion
of hormones that regulate blood sugar levels (e.g., insulin).
When this part of the pancreas fails, the result is diabetes mellitus.
- The production of digestive
enzymes (e.g., amylase, lipase, and proteases) that are subsequently
excreted into the small intestine. When the pancreas cannot maintain
these functions, EPI is the result.
Anything that damages a large portion
of the pancreas (e.g., pancreatitis or a pancreatic tumor) can result
in EPI, but it is most commonly caused by an abnormal immune reaction
that destroys the pancreatic cells responsible for producing digestive
enzymes. Genetics may play a role in determining which individuals
develop EPI, especially in German Shepherd dogs.
The Symptoms of EPI
Without adequate levels of digestive
enzymes within the small intestine, a dog cannot break down and absorb
nutrients from its food. This explains why EPI is also sometimes
called a maldigestion disorder. Dogs with EPI may:
- Lose weight despite having
a ravenous appetite,
- Produce soft and greasy
stools or have diarrhea on a frequent basis,
- Eat their feces,
- Have dry, flaky skin.
Diagnosis and Treatment of EPI
A veterinarian can suspect that your
dog has EPI based on his breed, medical history, and symptoms, but a
definitive diagnosis requires confirmatory testing. The trypsin-like
immunoreactivity test (TLI) is the most common diagnostic tool used
and requires only one sample of blood taken after a 12-18 hour fast.
Fecal testing may also be appropriate under certain circumstances.
Treatment for EPI is based on replacing
the digestive enzymes that a dog is not producing on his own and feeding
a diet that is very easy to digest. Pancreatic enzymes are available
in powdered forms (e.g., Viokase-V and Pancrezyme) that work best if they are thoroughly mixed
in with a dog's food. Tablets are not as effective. Feeding
raw beef or lamb pancreas is another option, but the risks associated
with handling and eating raw animal products generally limit their use
to specific situations. Some dogs with EPI also have a small intestinal
bacterial overgrowth and require antibiotic therapy and vitamin B12
injections.
Most dogs respond well when treated
aggressively for EPI, but therapy must continue for the rest of the
pet's life. Unfortunately, about 20% of dogs with EPI do not
gain adequate amounts of weight or experience relief from their digestive
symptoms no matter what treatment is employed, and euthanasia is the
most humane option in these cases.
The above is provided for information purposes only and should not be used for the diagnosis or treatment of any condition.
This information does not cover all possible variables, conditions, reactions, or risks relating to any topic, medication, or product and should not
be considered complete. Certain products or medications may have risks and you should always consult your local veterinarian concerning the treatment of
your pet. Any trademarks are the property of their respective owners.