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| : Item 2[[Category:To_Do_-_Caz]] | | : Item 2[[Category:To_Do_-_Caz]] |
| ==Description== | | ==Description== |
| + | A rare disease in cats but can occur following [[Pancreatitis, Chronic Interstitial|chronic pancreatitis]]. |
| + | ==Diagnosis== |
| + | ===History=== |
| + | Cats with EPI have a history of chronic small bowel diarrhoea and weight loss combined with a ravenous appetite. |
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| + | ===Clinical signs=== |
| + | Weight loss and muscle wastage are usually seen in assosiation with EPI. Diarrhoea and steatorrhoea are also common. Hair coat is often in a poor condition and Cats presenting with EPI may also have concurrent Diabetes mellitus. |
| + | |
| + | ===Laboratory Tests=== |
| + | Routine hamatology and biochemistry are often unremarkable in cats with EPI. |
| + | Serum concentrations of cobalamin are often decreased. Serum folate concentrations may also be decreased due to concurrent inflammatory bowel disease or intestinal lymphoma. |
| + | 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. |
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| + | ===Other=== |
| + | Atrophy of the pancreas seen via exploratory laparotomy or laparoscopy |
| + | |
| + | ==Treatment== |
| + | ===Enzyme replacement=== |
| + | Pancreatic enzyme replacement, raw pancreas (10-20g/feed is generally more effective than dried enzyme replacment and can be stored frozen for at least three months. |
| + | |
| + | ===Dietary modification=== |
| + | A fat restricted diet is advised. |
| + | |
| + | ===Vitamin supplementation=== |
| + | Levels of vitamin B12 (cobalamin) and vitamin E (tocopherol) are often found to be low and hence should be supplemented. Similarly Cobalamin supplementation is often required. |
| + | |
| + | ===Antibiotic therapy=== |
| + | Dogs with EPI often have Small Intestinal Bacterial Overgrowth (SIBO). This can be treated with oral oxytetracycline, tylosin or metronidazole. |
| + | |
| + | ===Glucocorticoid therapy=== |
| + | Oral prednisolone may be useful in animals that do not respond to the above treatment. |
| + | |
| + | |
| + | ==Prognosis== |
| + | EPI is generally irreversible and hence life-long treatment is needed. The prognosis is generally good as long the owner is aware of the longevity of the disease and the cost involved with treating it. |
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| ==Signalment== | | ==Signalment== |