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Exocrine Pancreatic Insufficiency - Dog (view source)
Revision as of 14:55, 6 July 2010
, 14:55, 6 July 2010no edit summary
The most sensitive and specific test for the diagnosis of EPI is the '''TLI''' serum assay. The values are greatly reduced as compared to normal animals. Values '''<2µg/l''' in dogs are considered diagnostic. This test must be carried out after withdrawing food for several hours.
The most sensitive and specific test for the diagnosis of EPI is the '''TLI''' serum assay. The values are greatly reduced as compared to normal animals. Values '''<2µg/l''' in dogs are considered diagnostic. This test must be carried out after withdrawing food for several hours.
==Radiography==
===Other===
Atrophy of the pancreas seen via exploratory laparotomy or laparoscopy
==Treatment==
==Treatment==
===Enzyme replacement===
EPI can be managed with the supplementation of pancreatic enzymes from dried pancreatic extracts. 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.
===Dietary modification===
*Diets containing high volumes of non-fermentable fibre should be avoided and Low fat diets should not be fed
*Certain studies show that:
**animals may do better with a highly digestible diet
**the animals may also benefit from readily hydrolysed and absorbed medium chain triglycerides within the diet
===Vitamin supplementation===
Levels of vitamin B12 (cobalamin) and vitamin E (tocopherol) are often found to be low.
*Tocopherol should be supplemented for 1 month
*Cobalamin weekly for several weeks. 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.
===Glucocorticoid therapy===
This is a last line treatment.
*Oral prednisolone. Long term treatment is usually not needed
==Prognosis==
==Prognosis==
EPI is a life-long condition and so is the treatment. However recoveries have been reported. The prognosis is generally good so long as the owner understands the longevity of the disease and the cost involved with treating it.