Exocrine Pancreatic Insufficiency (EPI) in Dogs
The pancreas is the organ in the body responsible for producing insulin (which regulates the body’s blood sugar levels) and digestive enzymes (which aid in the digestion of starches, fats, and proteins in an animal’s diet). If the pancreas fails to produce enough of these digestive enzymes, exocrine pancreatic insufficiency, or EPI, develops.
EPI may affect a dog's gastrointestinal system, as well as general nutrition, and can cause problems such as weight loss and chronic diarrhea. The condition is thought to be hereditary in German Shepherds.
The condition or disease described in this medical article can affect both dogs and cats. If you would like to learn more about how this disease affects cats, please visit this page in the PetMD health library.
Symptoms and Types
EPI may cause digestive problems, malnutrition, and/or improper absorption of nutrients into the body, which can contribute to an overgrowth of bacteria in the intestines. Symptoms may include chronic diarrhea; weight loss despite a normal or increased appetite; frequent or greater volume of stool and gas; and coprophagia, a condition which causes an animal to eat its own stool.
The most common cause of EPI in dogs is idiopathic pancreatic acinar atrophy (PAA). The enzymes responsible for aiding the digestion of starches, fats, and proteins, are produced by cells in the pancreas known as pancreatic acinar cells. PAA develops when these cells fail to function properly, thereby leading to EPI.
The second most common cause of EPI in dogs is chronic inflammation of the pancreas (pancreatitis). If chronic pancreatitis is the cause, it is possible your dog has diabetes, which will also need to be treated.
If symptoms of exocrine pancreatic insufficiency are apparent, a number of pancreatic function tests can be done. A serum sample that measures the amount of the chemical trypsinogen (TLI) released into the blood from the pancreas should reveal problems in the pancreas. A dog with EPI will have reduced amounts of TLI.
A number of other tests may be conducted, including urine and stool analyses. Gastrointestinal infections or inflammations may be among the other problems responsible for symptoms similar to those of EPI.
Once EPI has been diagnosed, treatment most commonly consists of supplementing your dog's diet with a pancreatic enzyme replacement. These enzyme supplements come in a powdered form which may be mixed with food. Also, if your dog is undernourished, vitamin supplements may be necessary.
Additional treatment depends on the root cause of EPI. Most causes of EPI, such as pancreatic acinar atrophy (see above), are irreversible. This means that life-long therapy and enzyme supplements will be needed.
Living and Management
Avoid high-fat and high-fiber diets, which are more difficult for digestion. Weekly monitoring of your dog's progress is necessary after initial treatment. Diarrhea should disappear within one week, and the consistency of stools should normalize soon after. Your dog will also begin to regain lost weight.
The dosage of enzyme supplements can be decreased as your dog's health and weight normalizes. Your veterinarian will guide you through this as your dog progresses.
Breed animals with pancreatic acinar atrophy is not advised, as the condition can passed along to offspring.