The pancreas is a small pink organ located under the stomach
and next to the upper small intestine. It plays an important
role in various processes in your pet’s body, including glucose
regulation and digestion.
One part of the pancreas, the endocrine pancreas, secretes
hormones like insulin and glucagon that work to regulate blood
sugar levels. Another part of the pancreas, the exocrine
pancreas, aids in digestion by releasing digestive enzymes into
the small intestine.
In some pets, the cells responsible for releasing digestive
enzymes are damaged or inadequate. This is what is referred to
as Exocrine Pancreatic Insufficiency (EPI). When the pancreas
is not able to release sufficient enzymes, it means that
nutrients cannot be absorbed, and malnutrition may set in even
if the pet is eating enough food.
In most cases of EPI, only the exocrine pancreas is affected,
and the endocrine pancreas involved in blood sugar regulation
remains intact. In rare cases, however, the endocrine pancreas
may be concurrently damaged, and the pet may develop diabetes.
Causes of Pancreatic Insufficiency in Dogs and Cats
The most common cause of EPI in dogs is pancreatic acinar
atrophy. Pancreatic acinar atrophy is a condition that causes
the pancreas to become shriveled and the size and number of
pancreatic cells responsible for producing and releasing
enzymes to decrease. This condition is most likely the result
of a genetic predisposition that causes immune-mediated
destruction of the pancreas. It can show up at any age, and the
most commonly affected breeds include the
Rough Collie, and Chow
Dogs can also develop EPI as a result of chronic pancreatitis
or pancreatic cancer.
In cats, the most common cause is chronic pancreatitis.
Symptoms of Pancreatic Insufficiency in Dogs and Cats
The symptoms of EPI will depend on the pet’s diet and how long
the condition has been present.
Common symptoms include:
- Large amounts of light-colored diarrhea
- Increased gas
- Rumbling abdomen sounds
- Poor coat and skin condition
- Bouts of anorexia, especially in cats
- Once the disease has progressed, the pet may appear
extremely hungry and attempt to eat their own feces or other
Treatment for Pancreatic Insufficiency in Dogs and Cats
EPI is diagnosed through blood or fecal testing that reveals a
lack of certain digestive enzymes in the bloodstream or feces.
The fecal test is only available for dogs.
Treatment for pets diagnosed with EPI generally involves some
combination of the following:
Pancreatic Enzyme Supplements: These
supplements can partially replace those that the pancreas is
failing to secret. Powdered enzymes -- such as Pancrezyme and
Viokase-V -- work well. Most
animals with EPI will take enzyme supplements for the rest of
Modified Diet: Some cases of EPI may improve
with a modified diet that is highly digestible and low in
fiber. Ask your
veterinarian to recommend an appropriate food for your
pet. Many animals will need to eat larger portions in order
to maintain a normal weight. If the pet has lost a great deal
of weight as a result of EPI, additional meals may be added
in the short-term to get the pet back to their normal weight
Antibiotics: Due to problems with digestion,
pets with EPI commonly have more bacteria than normal in
their intestines. This is what is referred to as small
intestinal bacterial overgrowth, and it is commonly treated
with a course of antibiotics.
B12 & Other Vitamins: Small intestinal
bacterial overgrowth can result in a B12 deficiency because
the bacteria in the intestines consumes the vitamin before
the pet is able to absorb it. This problem is commonly
treated with periodic B12 injections. Other nutrient
deficiencies that can result from EPI -- folate, Vitamin E,
and Vitamin K -- are usually treated with supplements.
Many pets respond well to continued treatment and can live a
comfortable life. Others may not respond, and may never return
to their normal weight. Keep a close eye on your pet and
contact your veterinarian if you notice weight loss or any
other symptoms of pancreatic insufficiency.
What Should You Do if Your Dog is Suffering From Pancreatic
What is Exocrine Pancreatic
Exocrine Pancreatic Insufficiency (EPI) is a condition where
the gastrointestinal system of dogs is affected by the lack of
digestive enzymes produced in the pancreas. The pancreas is
responsible for the production of insulin to regulate blood
sugar levels and digestive enzymes to digest starches, proteins
and fats from the diet. When the pancreas does not produce
sufficient digestive enzymes, the dog is unable to digest the
food.Many dog owners fail to realize the effects of the
disease, as a result of which, dogs with EPI starve to death
without getting proper treatment. There have been many cases
where EPI took a toll on the lives of dogs such as German
Shepherd and Shiloh Shepherd. However, the incidence of EPI,
albeit rare, does not depend on the breed, and this
life-threatening dog disease has affected dogs across the
What are the symptoms of
As mentioned earlier, many dog owners fail to identify the
disease and give appropriate veterinary care to their dogs.
Unfortunately, many vets also fail to understand the disease
because of its uncommon nature. However, an understanding of
the symptoms may help in giving proper veterinary care to your
dogs before it becomes too late. The following are few of the
symptoms seen in dogs with EPI:
- Orange, yellow, gray or pale-colored stool.
- Uncontrollable diarrhea that doesn't go away.
- Rapid and excessive weight loss.
- Polyphagia, which is caused due to increase in appetite.
- Abnormal stool.
- Burping as a result of gas.
- Dry and dull coat.
- Intake of non-food items.
- Changes in mood and temperament.
Diagnosis and treatment of
Diagnosis of EPI in dogs include the following:
- Determining the levels of digestive enzymes in the blood
- Measuring chymotrypsin activity
- Determining the levels of digestive enzymes in fecal matter
- Stool examination under a microscope.
The treatment of EPI in dogs can be an expensive and lengthy
process, but it can be accomplished easily. The process
involves replacing the pancreatic enzymes of the dog with EPI
with enzymes from other sources, such as freeze-dried,
ground-up pancreatic tissue from a hog or cow. Although an
expensive process, enzyme replacement is a large part of the
treatment, and the dog begins to improve rapidly once the
supplementation begins.The supplement powders are usually mixed
with the dog's food, while tablets are given half an hour
before meal. The supplement powder should be mixed properly
with the food and hydrated with water. It is recommended that
the enzyme replacement is allowed to incubate for a few minutes
prior to eating. The treatment is seen to provide beneficial
results by restoring the dog's ability to produce digestive
enzymes, but the number of successful cases has been less.
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