Changes

==Treatment==

==Treatment==

===Enzyme replacement===

===Enzyme replacement===

EPI can be managed with the supplementation of pancreatic enzymes from dried pancreatic extracts. A starting dose of 2 teaspoons per 20Kg of bodyweight per meal is usually effective. Meals should be fed twice a day to allow weight gain. Many clinical signs resolve within 5 days. Doses can then be lowered to a minimum effective dose which is different for each animal. Cheaper alternatives include chopped raw cow or pig pancreas (100-150g/20Kg bodyweight).  

EPI can be managed with the supplementation of pancreatic enzymes from dried pancreatic extracts. A starting dose of '''2 teaspoons per 20Kg of bodyweight per meal''' is usually effective. Meals should be fed '''twice a day''' to allow weight gain. Many clinical signs resolve within 5 days. Doses can then be lowered to a minimum effective dose which is different for each animal. Cheaper alternatives include chopped raw cow or pig pancreas ('''100-150g/20Kg bodyweight''').  

===Dietary modification===

===Dietary modification===

*Diets containing high volumes of non-fermentable fibre should be avoided

*Diets containing high volumes of non-fermentable fibre should be avoided

===Vitamin supplementation===

===Vitamin supplementation===

Levels of vitamin B12 (cobalamin) and vitamin E (tocopherol) are often found to be low.  

Levels of vitamin B12 (cobalamin) and vitamin E (tocopherol) are often found to be low.  

*Tocopherol should be supplemented for 1 month (5-25IU/Kg bodyweight orally)

*Tocopherol should be supplemented for 1 month ('''5-25IU/Kg bodyweight orally''')

*Cobalamin weekly for several weeks (100-250µg i.m. or s.c.). Long term monitoring should be carried out in cats.                                                                                                                          ===Antibiotic therapy===

*Cobalamin weekly for several weeks ('''100-250µg i.m. or s.c.'''). Long term monitoring should be carried out in cats.                                                                                                                          ===Antibiotic therapy===

Dogs with EPI often have Small Intestinal Bacterial Overgrowth (SIBO). This can be treated with oral oxytetracycline, tylosin or metronidazole.

Dogs with EPI often have Small Intestinal Bacterial Overgrowth (SIBO). This can be treated with oral oxytetracycline, tylosin or metronidazole.

===Glucocorticoid therapy===

===Glucocorticoid therapy===

This is a last line treatment.

This is a last line treatment.

*Oral prednisolone at 1-2mg/kg bid for 1-2 weeks. Long term treatment is usually not needed

*Oral prednisolone at '''1-2mg/kg bid for 1-2 weeks'''. Long term treatment is usually not needed

==Prognosis==

==Prognosis==