Exocrine Pancreatic Insufficiency (EPI) in Dogs

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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:

  1. 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.
  2. 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.

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