Changes

===Vitamin supplementation===

===Vitamin supplementation===

Cats are particularly susceptible to deveelopment of severe cobalamin deficiency and hence should be supplemented every two weeks to maintain normal serum cobalamin levels. Long term monitoring of serum cobalamin is advised. Similarly cats with EPI may also have subnormal Vitamin E levels which should be measured and corrected.  A vitamin K- responsive coagulopathy has been reported in cats and hence it is sensible to examine the vitamin K status of cats with EPI.  

Cats are particularly susceptible to development of severe cobalamin deficiency and hence should be supplemented every two weeks to maintain normal serum cobalamin levels. Long term monitoring of serum cobalamin is advised. Similarly cats with EPI may also have subnormal Vitamin E levels which should be measured and corrected.  A Vitamin K responsive coagulopathy has been reported in cats and hence it is sensible to examine the vitamin K status of cats with EPI.  

===Glucocorticoid therapy===

===Glucocorticoid therapy===

Oral prednisolone may be useful in animals that do not respond to the above treatment. This is normally only required for a short period.

Oral prednisolone may be useful in animals that do not respond to the above treatment. This is normally only required for a short period.

Cats that do not respond well to the treatment listed above may have small intestinal disease causing malabsorption despite adequate pancreatic enzyme replacement, these cases usually require further investigation of the small intestine.

Cats that do not respond well to the treatment listed above may have small intestinal disease causing malabsorption despite adequate pancreatic enzyme replacement. These cases usually require further investigation of the small intestine.

==Prognosis==

==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.

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.