Vet Buzz from Erin Troy, DVM, CCRP,
Muller Veterinary Hospital, Walnut Creek, CA
Exocrine pancreatic insufficiency or EPI can be thought of as a type of maldigestion. The problem starts in the pancreas, which is an important organ that sits near the stomach and small intestine. The pancreas has multiple functions including making and storing enzymes needed for digesting starches, fats, and proteins. Without these important enzymes, as occurs in EPI, proper absorption of food is impaired.
There is thought to be a genetic basis to EPI and while it can develop at any age it is usually seen before the age of 4. The incidence is reportedly much higher in German Shepherd Dogs and Rough-Coated Collies but it has been diagnosed in many other breeds.
The main symptoms of EPI include weight loss or the lack of weight gain and soft stools or diarrhea. Diagnosis is based upon physical exam, pertinent historical information and a serum blood test for a specific enzyme. The test is called the TLI or trypsin like immunoreactivity test. There have been other tests used in the past but they are not as accurate as the TLI test. Keep in mind that dogs with EPI can have other concurrent medical issues so it is always a good idea to have a full work up done including a general health screen blood panel, urinalysis, fecal parasite check and the levels of folate and cobalamin measured.
If a dog is diagnosed with EPI then treatment is centered on supplementing for the missing enzymes. There are a variety of choices of enzyme replacements available so discuss with your veterinarian about cost, form and quality. You should also discuss the manner in which the supplement is given to your dog. If other medical issues are discovered then additional medications or a diet change may be indicated.
While this is not a curable disease and does require life long medication it can be managed so your dog can have an active healthy life.