Difference between revisions of "Exocrine Pancreatic Insufficiency"

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{{unfinished}}
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{{OpenPagesTop}}Also known as: '''''EPI — Pancreatic Exocrine Insufficiency'''''  
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==Typical Signalment==
 
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*Most common in dog:
 
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**German Shepherd Dogs
 
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**Rough Collie
 
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*Occurs occasionally in other species including calves with [[Pancreas Developmental - Pathology#Pancreatic hypoplasia|pancreatic hypoplasia]] and in cats ([[Pancreas Inflammatory - Pathology#Chronic Pancreatitis|chronic pancreatitis]])
 
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*In contrast, '''horses''' with very little pancreatic tissue develop '''hypoinsulinism''' but rarely EPI
 
  
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==Description==  
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==Introduction==  
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'''Exocrine pancreatic insufficiency (EPI)''' is a syndrome caused by insufficient synthesis and secretion of digestive enzymes by the exocrine portion of the pancreas
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'''Exocrine pancreatic insufficiency (EPI)''' is a syndrome characterised by insufficient secretion of digestive enzymes by the exocrine portion of the pancreas. Most commonly EPI occurs following the progressive reduction in pancreatic mass caused by pancreatic acinar atrophy or chronic pancreatitis. EPI may also occur secondary to excessive gastric acid secretion (excess acid affects the activity and production of the pancreatic enzymes) or severe protein malnutrition (decreased synthesis of pancreatic enzymes). Concurrent diabetes mellitus and pancreatic hypoplasia have also been documented as causes in the dog.
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*Leading to insufficient activity of digestive enzymes in the lumen of the small intestine
 
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*Pancreas has considerable functional reserve, large proportion needs to be non-functional to show signs of EPI
 
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*In dog it is mostly caused by [[Pancreas Degenerative - Pathology|pancreatic atrophy]] or Pancreatic Acinar Atrophy (PAA)
 
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*In the cat it is usually associated with [[Pancreas Inflammatory - Pathology#Chronic Pancreatitis|chronic pancreatitis]]
 
  
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==Diagnosis==
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The Pancreas has a considerable functional reserve and a large proportion needs to be non-functional to show signs of EPI. In the dog EPI is mostly caused by [[Pancreatic Atrophy, Exocrine| Exocrine Pancreatic Atrophy]] or [[Pancreatic Atrophy, Exocrine|Pancreatic Acinar Atrophy (PAA)]]. In the cat EPI is usually associated with [[Pancreatitis|chronic pancreatitis]].
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===History===
 
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*Weight loss with or without polyphagia (usually ravenous with scavenging)
 
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*Coprophagia and pica
 
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*Polyuria and polydipsia due to Diabetes Mellitus
 
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*Varible diarrhoea (large volumes of semi-formed faeces)
 
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*Vomiting
 
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*Borborygmus and flatulance
 
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===Clinical Signs===
 
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*Steatorrhoea
 
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*Diarrhoea
 
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*Mild to marked weight loss
 
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*Muscle wastage
 
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*Polyphagia
 
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*Poor haircoat
 
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*Flatulance
 
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===Laboratory Tests===
 
  
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==Treatment==
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==Signalment==
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===Enzyme replacement===
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EPI is most common in the dog, German Shepherd dogs and rough collies are over-represented.  Many other breeds however can also be affected by EPI.
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===Dietary modification===
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===Vitamin supplementation===
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EPI can occur in cats as a result of [[Pancreatitis|chronic pancreatitis]] and also occasionally in calves with [[Pancreatic Hypoplasia|pancreatic hypoplasia]]. In contrast, '''horses''' with very little pancreatic tissue develop '''hypoinsulinism''' but rarely EPI.
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===Antibiotic therapy===
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===Glucocorticoid therapy===
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<big>'''[[Exocrine Pancreatic Insufficiency - Dog|Exocrine Pancreatic Insufficiency in the dog]]
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==Prognosis==
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'''[[Exocrine Pancreatic Insufficiency - Cat|Exocrine Pancreatic Insufficiency in the cat]]</big>
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{{Learning
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|Vetstream = [https://www.vetstream.com/felis/search?s=exocrine Exocrine pancreatic insufficiency (EPI)]
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|literature search = [http://www.cabdirect.org/search.html?rowId=1&options1=AND&q1=%22Exocrine+Pancreatic+Insufficiency%22&occuring1=title&rowId=2&options2=AND&q2=&occuring2=freetext&rowId=3&options3=AND&q3=&occuring3=freetext&x=37&y=15&publishedstart=yyyy&publishedend=yyyy&calendarInput=yyyy-mm-dd&la=any&it=any&show=all Exocrine pancreatic insufficiency publications]
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}}
  
 
==References==
 
==References==
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Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA''
 
Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA''
  
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Merck & Co (2008) '''The Merck Veterinary Manual'''
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Ettinger, S.J, Feldman, E.C. (2005) '''Textbook of Veterinary Internal Medicine''' (6th edition, volume 2)
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Sturgess, K. (2003) '''Notes on Feline Internal Medicine''' Blackwell Publishing.
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Tams, T.R. (2003) '''Handbook of Small Animal Gastroenterology''' (2nd edition) Saunders.
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{{review}}
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{{OpenPages}}
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[[Category:Pancreas_-_Pathology]]
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[[Category:Pancreatic Diseases - Cattle]]
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[[Category:Expert_Review]]

Latest revision as of 19:05, 12 April 2022


Also known as: EPI — Pancreatic Exocrine Insufficiency

Introduction

Exocrine pancreatic insufficiency (EPI) is a syndrome characterised by insufficient secretion of digestive enzymes by the exocrine portion of the pancreas. Most commonly EPI occurs following the progressive reduction in pancreatic mass caused by pancreatic acinar atrophy or chronic pancreatitis. EPI may also occur secondary to excessive gastric acid secretion (excess acid affects the activity and production of the pancreatic enzymes) or severe protein malnutrition (decreased synthesis of pancreatic enzymes). Concurrent diabetes mellitus and pancreatic hypoplasia have also been documented as causes in the dog.

The Pancreas has a considerable functional reserve and a large proportion needs to be non-functional to show signs of EPI. In the dog EPI is mostly caused by Exocrine Pancreatic Atrophy or Pancreatic Acinar Atrophy (PAA). In the cat EPI is usually associated with chronic pancreatitis.

Signalment

EPI is most common in the dog, German Shepherd dogs and rough collies are over-represented. Many other breeds however can also be affected by EPI.

EPI can occur in cats as a result of chronic pancreatitis and also occasionally in calves with pancreatic hypoplasia. In contrast, horses with very little pancreatic tissue develop hypoinsulinism but rarely EPI.

Exocrine Pancreatic Insufficiency in the dog

Exocrine Pancreatic Insufficiency in the cat




Exocrine Pancreatic Insufficiency Learning Resources
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(CABI log in required) 		Exocrine pancreatic insufficiency publications


References

Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition) BSAVA

Ettinger, S.J, Feldman, E.C. (2005) Textbook of Veterinary Internal Medicine (6th edition, volume 2)

Sturgess, K. (2003) Notes on Feline Internal Medicine Blackwell Publishing.

Tams, T.R. (2003) Handbook of Small Animal Gastroenterology (2nd edition) Saunders.



This article has been peer reviewed but is awaiting expert review. If you would like to help with this, please see more information about expert reviewing.



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