Exocrine pancreatic insufficiency (EPI)

Exocrine pancreatic insufficiency is a congenital or acquired condition that can affect both dogs and cats, although it is more common in dogs. Young adult dogs, especially German Shepherds, are usually affected.

In dogs EPI is usually due to pancreatic acinar atrophy (PAA). It may be seen together with diabetes mellitus if there is damage to both the exocrine and endocrine pancreas.

Pathophysiology

• Digestive enzymes are not secreted normally by the pancreas
• Food is not sufficiently digested and processed
• Diarrhoea and weight loss in spite of a normal or increased appetite

Diagnosis and treatment

EPI is diagnosed on the basis of blood tests and is treated with pancreatic enzyme replacements, e.g. Tryplase (Intervet). Enzyme replacements usually result in improvement of the clinical signs, and dietary management. However, if EPI is due to chronic pancreatitis and accompanied by diabetes mellitus, it can be more difficult to treat successfully.