What is Exocrine Pancreatic Insufficiency (EPI).
The pancreas is a vital organ that lies on the right side of the abdomen adjacent to the stomach. The pancreas produces enzymes to assist in food digestion and hormones such as insulin, which regulates blood sugar or glucose metabolism. If the pancreas fails to produce enough of these digestive enzymes, exocrine pancreatic insufficiency, or EPI, develops. it is a disease of maldigestion and malabsorption, which when left untreated eventually leads to starvation. One of the major difficulties with this disease is in the prompt and accurate diagnosis.
Astonishingly, visible symptoms may not appear until 80 to 95 percent of the pancreas has atrophied.
There are three major groups of enzymes critical to efficient digestion:
What is the cause of Exocrine Pancreatic Insufficiency?The general cause of Exocrine Pancreatic Insufficiency (EPI) is insufficient cells that are responsible for the production of these enzymes. This can be the result of destructive inflammation such as severe pancreatitis or can be an immune based condition. German shepherd may be predisposed but any breed can be affected. Pancreatic cancer is a very uncommon, but possible,
The main cause appears to be a progressive loss of pancreatic cells but chronic pancreatitis can also result in EPI.
Young adult dogs are often affected and have chronic diarrhea or a very soft, bulky, fatty looking feces which looks like cow’s dung (Gober) and excessive appetites, occasional vomiting and gradual weight loss over a period of months. weight loss despite a normal or increased appetite is the typical sign of the disease. Coprophagia, a condition which causes an animal to eat its own stool is also seen in most of the affected dogs.
What are the causes of EPI?
The causes can be congenital (present from birth), inherited or acquired as the result of pancreatic infection or injury. The main cause appears to be a progressive loss of pancreatic cells but chronic pancreatitis (inflammation of pancreas) also result in EPI.
How the disease diagnosed?
Most of the time the sign are obvious and clear cut. But for the accurate and confirmed diagnosis many test is carried out by the Vets. 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. However gastrointestinal infections or inflammations may be among the other problems responsible for symptoms similar to those of EPI which may confuse the Vets.similarly Vitamin B12 and folate level tests give us the best assessment of your pet’s pancreatic function.
What is the treatment of EPI?
Most dogs with EPI can be successfully treated by supplementation with pancreatic enzymes. Powder is more effective than tablets, capsules. Avoid high-fat and high-fiber diets, which are more difficult for digestion .Highly digestible, low fat diets together with pancreatic enzyme replacement will usually stabilize the condition. Cobalamin (Vitamin B12) supplementation should be considered when hypocobalaminemia is documented. Treatment is usually for the rest of the dog’s life.
EPI due to chronic pancreatitis will sometimes resolve as the pancreas heals. However, the most common cause of EPI is the progressive destruction of the exocrine cells of the pancreas. This cannot be cured, only managed with medications and diet.
Written by Dr Pratik Man Pradhan B.V.Sc &A.H
Mount Everest Kennel Club