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Your dog's nutrition is important for a healthy & happy life. petMD experts help you to know what to feed your dog, how much food to feed, and the differences in dog foods, so your dog gets optimum nutrition.
Nutrition Nuggets is the newest offshoot of petMD's Dog Nutrition Center. Each week Dr. Coates will use her expertise and wisdom to blog about the intricacies of dog nutrition.

Meeting the Nutritional Needs of Dogs with Exocrine Pancreatic Insufficiency

May 11, 2012 / (10) comments

If you have a dog with Exocrine Pancreatic Insufficiency (EPI), you are in tune with the concept, "What goes in must come out." A lack of digestive enzymes produced by the pancreas is at the heart of EPI. If a dog doesn’t have the enzymes necessary to digest food, he or she can’t absorb it, which leads to some serious digestive problems.

This is a roundabout way of saying that dogs with EPI tend to produce a lot of feces — often in the form of greasy, soft stools or diarrhea. Other common symptoms include dry, flaky skin and a ravenous appetite paradoxically accompanied by weight loss. Most cases of EPI are caused by an abnormal immune reaction. This reaction attacks and destroys the pancreatic cells responsible for producing digestive enzymes while leaving the ability to produce insulin intact. An especially severe or chronic case of pancreatitis can also be to blame.

EPI cannot be cured, but in many cases it can be managed successfully enough that affected dogs live long and relatively symptom-free lives. Owners and veterinarians do this by closely controlling two aspects of the "what goes in" part of the equation, both of which are outlined below.

1. Medications

Because the pancreas is no longer making adequate amounts of digestive enzymes, we must provide them as a supplement to the diet. Manufacturers give these medications different trade names, but they all contain amylase, lipase, and protease – enzymes needed to break down carbohydrates, fats, and proteins, respectively. Research has shown that the best way to use these supplements is to mix the powdered form with the food right before offering it to your dog. Feeding raw beef or lamb pancreas is another option, but in most cases the risks associated with handling and eating raw animal products outweighs any benefits. Some dogs with EPI also have a small intestinal bacterial overgrowth and require antibiotic therapy and vitamin B12 (i.e., cobalamin) injections.

2. Food

Even with pancreatic enzyme supplementation, dogs with EPI are still somewhat restricted in their ability to digest food. Therefore, feeding a diet that is highly digestible and made from quality ingredients is vitally important. The last thing you want to do is to make your dog’s digestive tract work harder than necessary breaking down ingredients of questionable value. The general recommendation is to feed a diet that is low in fat and high in carbohydrates and protein. Fats are harder to digest than carbohydrates and proteins, so this makes sense, but in my experience there is no one best food for dogs with EPI. Some dogs seem to do better with a little more fat than you’d expect, others need a little less protein, and so forth.

What holds true in all cases, however, is that dogs with EPI should not eat foods made from low-quality ingredients that offer a questionable balance of nutrients. Of course, I’d argue against feeding these products to any dog, but optimal nutrition is especially important for dogs with impaired digestive function.

Dr. Jennifer Coates

Image: dean bertoncelj / via Shutterstock

Comments  10

Leave Comment
  • Acidophilus
    05/11/2012 11:50am

    Do these dogs also lack the necessary "good bacteria" in the gut to properly process food? Is there any chance that adding acidophilus to their food would help?

  • 05/11/2012 04:07pm

    Since many patients are put on antibiotics to control small intestinal bacterial overgrowth it's not a bad idea to add a probiotic to the protocol to encourage the return of "good" bacteria.

  • low-quality ingredients
    05/11/2012 05:12pm

    What do you consider to be "low-quality ingredients" in commercial pet food?

  • 05/11/2012 10:21pm

    It's less about good and bad ingredients, per se, than about the quality of what is included. Take this human example to illustrate. A small amount of beef in the human diet can be fine, but there is a big difference between a piece of lean steak and low-grade burger (complete with pink slime). The same is true for pet food ingredients. In other words, not all "chicken" is created equal. Unfortunately, ingredient quality is very hard for the consumer to evaluate.

  • Natural Food
    05/11/2012 06:47pm

    Most of the ingredients in commercial dog food are total garbage. I know I was reading awhile back that cats have the same problem and that it can lead to lead to allergies. I know quite of people recommend the raw diet, but I'm not really sold on that (my blog shows that). Do you think commercial natural pet food is better, or homemade food?

    Budget Earth - Should You Feed Your Pets Natural Dog & Cat Food?

  • 05/11/2012 06:49pm

    Ugh, sorry for the typos! Pushed enter without seeing them first...

    Most of the ingredients in commercial dog food are total garbage. I know I was reading awhile back that cats have the same problem and that it can lead to allergies. I know quite a few people recommend the raw diet, but I'm not really sold on that (my blog shows that). Do you think commercial natural pet food is better, or homemade food?

    Budget Earth - Should You Feed Your Pets Natural Dog & Cat Food?

  • 05/11/2012 10:23pm

    I think both can be good, but feeding a nutritionally balanced home prepared is MUCH more difficult (and requires the involvement of a veterinary nutritionist) so for most owners, commercial is the way to go.

  • medication costs
    08/18/2012 09:30pm

    I was just wondering what kind of medicinal costs are involved with supporting a dog with EPI?

  • 08/20/2012 03:53pm

    EPI is an expensive disease to treat. The pancreatic enzyme supplements alone are not cheap and need to be continued for the rest of the dog's life.

  • 05/29/2015 08:34pm

    Hi Dr. Coates and thank you for this great website with great info! I am particularly interested in the EPI section, as I am an Executive Board member for www.Epi4Dogs.com, which is the on-line resource recommended by the AVMA and I have 2 EPI german shepherds. If you have a chance, please check out the website and if you feel appropriate, we would love for you to include a link to the site in your section on EPI. Also, while enzymes from the vet can be expensive, Enzyme Diane (www.enzymediane.com) sources enzymes from the same source vets do and she provides them at 1/3 the cost of the vet, enabling many people to care and treat for their EPI dogs. Diane has no overhead or marketing expenses so she passes on that savings to help others. I hope sharing this information can help save some animals and keep them in their loving homes.




Photo of Jennifer

... graduated with honors from the Virginia-Maryland Regional College of Veterinary Medicine in 1999. In the years since, she has practiced veterinary medicine in Virginia, Wyoming, and Colorado. She is the author of several books about veterinary medicine and animal care, including the Dictionary of Veterinary Terms, Vet-Speak Deciphered for the Non-Veterinarian .

Jennifer also writes short stories that focus on the strength and importance of the human-animal bond and freelance articles relating to a variety of animal care and veterinary topics. Dr. Coates lives in Fort Collins, Colorado with her husband, daughter, and pets.