What is it:

The pancreas produces 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. Exocrine pancreatic insufficiency, or EPI, develops when the pancreas fails to produce enough of these digestive enzymes. Both environmental and genetic factors are believed to cause EPI.

EPI may affect a dog’s gastrointestinal system, as well as general nutrition, and can cause problems such as weight loss and chronic diarrhoea.

Causes:

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.

Symptoms:

EPI may cause digestive problems, malnutrition and/or the improper absorption of nutrients into the body which can contribute to an overgrowth of bacteria in the intestines. Symptoms of malnutrition and/or bacterial overgrowth can include:

• Chronic diarrhoea
• Increased appetite
• Weight loss despite normal or increased appetite
• Frequent or greater volume of stool and gas
• Coprophagia, (a condition which causes an animal to eat its own faeces)
• Pica (eating non food items such as stones, paper etc)
• Abdominal discomfort
• Low immunity
• Lethargic

These signs are broad and could be related to a number of illnesses. Gastrointestinal infections or inflammations could also be responsible for symptoms similar EPI. It is always important to visit a vet and run lab tests for a definitive diagnosis.

Diagnosis:

EPI can be diagnosed using a number of different methods including:

• Clinical signs and medical history
• Blood and serum test
• Urine analysis
• Faecal analysis

The serum test measures the amount of trypsinogen (TLI) released into the blood from the pancreas. A dog with EPI will have reduced amounts of TLI.

Treatment:

The most common treatment is adding a pancreatic enzyme replacement to your dogs diet. 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 including B12 injections.

Additional treatment depends on the root cause of EPI. They may include treatments for infections, inflammation, bacterial infections, diabetes, fluid therapy etc. Each case is different and it depends on how severe your dog is.

Management:

Diet is very important when it comes to the management of EPI. 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. Diarrhoea should disappear within one week, and 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.

Recent studies have shown that pineapple (bromelain) and papaya (papain) work well together to aid protein digestion. Sweet Potato and pumpkin can also aid digestion and settle upset stomachs.   Coconut oil is also great for dogs with EPI as it is a Medium-Chain Triglyceride (MCT) and is more easily absorbed by the boy than other fats.

Breeds at Greatest Risk:

It’s estimated that over 50% (and possibly as many as 75%) of EPI cases occur in the following breeds:

• German Shepherds
• Shiloh Shepherds
• German Shepherd mixes

Some sources have reported higher-than-expected rates in the following breeds also:

• Rough-Coated Collies
• Terrier breeds
• Cavalier King Charles Spaniels
• Chow Chows
• English Setters

Please note, no breed is immune and any dog can suffer from EPI.

Prevention:

Animals who have EPI or related illnesses such as pancreatic acinar atrophy should not be bred from due to the genetic link to this disease.

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