Exocrine Pancreatic Insufficiency (EPI) in Cats
Exocrine pancreatic insufficiency (EPI) develops when the pancreas fails to produce enough digestive enzymes. 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 a cat’s diet).
EPI may affect a cat’s general nutrition, as well as its gastrointestinal system. Chronic diarrhea and weight loss are common complications of this disease.
Symptoms and Types
EPI may cause digestive problems, malnutrition, and/or improper absorption of nutrients in your cat's 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.
Causes
One common cause of EPI is idiopathic pancreatic acinar atrophy (PAA). The enzymes responsible for aiding in 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.
Another common cause of EPI is chronic inflammation of the pancreas (pancreatitis). This is the most common cause in cats. If chronic pancreatitis is the cause, it is possible your cat has diabetes, which will also need to be treated.
Diagnosis
A number of pancreatic function tests can be done if symptoms of exocrine pancreatic insufficiency are apparent. 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 cat with EPI will have reduced amounts of TLI.
Urine and stool analyses may be conducted along with a number of other tests. Gastrointestinal infections or inflammations may be among the other problems responsible for symptoms similar to those of EPI.
Treatment
Once EPI has been diagnosed, treatment most commonly consists of supplementing your cat's diet with a pancreatic enzyme replacement. These enzyme supplements come in a powdered form which may be mixed with food. If your cat is undernourished, vitamin supplements may also 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. It is necessary to monitor your cat's progress on a weekly basis after initiating treatment. Diarrhea should disappear within one week, and the consistency of stools should normalize soon after. Your cat will also begin to regain lost weight.
The dosage of enzyme supplements can be decreased as your cat's health and weight normalizes. Your veterinarian will guide you through this process.
Prevention
Breeding cats with pancreatic acinar atrophy is not advisable, as the condition can be passed to offspring.