Exocrine Pancreatic Insufficiency (EPI) Dogs

The pancreas is a v-shaped gland lying close to the stomach and small intestine. Secretions from the pancreas are carried to the small intestine by the pancreatic duct.

The pancreas has two separate and distinct functions which are its endocrine and exocrine functions. The pancreas produces enzymes that digest fats, carbohydrates, and proteins. This is the exocrine function of the pancreas.

Exocrine pancreatic insufficiency (EPI) is the inability to produce sufficient pancreatic enzymes to digest fats, carbohydrates, and proteins. This difficulty in digestion leads to poor absorption of nutrients which commonly causes weight loss despite a normal or increased appetite.

Affected dogs often have large volumes of pale, fatty feces. This condition is called steatorrhea or fat in the stool.

The causes can be congenital (present from birth), inherited (genetic), or acquired as the result of pancreatic infection, inflammation, or injury. The condition is seen more commonly in Chow Chows, Cavalier King Charles Spaniels, Rough-Coated Collies, and German Shepherd Dogs.

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 very soft, bulky, fatty looking feces, excessive appetites, occasional vomiting, and gradual weight loss over a period of months.

Highly digestible, low fat diets together with pancreatic enzyme replacement (Viokase®, Pancreazyme®, Pank-Aid) will usually stabilize the condition. Cobalamin (vitamin B12) supplementation may be considered by your veterinarian when hypocobalaminemia is documented. Treatment is usually for the rest of the dog's life. If elevated folate levels are detected indicating an overgrowth of bacteria in the small intestine, then an antibiotic called tylosin (brand name Tylan®) may be prescribed.

Rarely, in cases that are the result of chronic pancreatitis, the endocrine cells that produce insulin can also be affected. In these cases, diabetes mellitus (sugar diabetes) may also be present.

Once an accurate diagnosis has been established, most pets do well with treatment.

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.