Difference between revisions of "Exocrine Pancreatic Insufficiency"

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{{OpenPagesTop}}Also known as: '''''EPI — Pancreatic Exocrine Insufficiency'''''
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{{unfinished}}
  
==Introduction==
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<big><center>[[Pancreas Developmental - Pathology|'''BACK TO PANCREAS - DEVELOPMENTAL''']]</center></big>
'''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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<big><center>[[Pancreas Degenerative - Pathology|'''BACK TO PANCREAS - DEGENERATIVE''']]</center></big>
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<big><center>[[Pancreas Inflammatory - Pathology|'''BACK TO PANCREAS - INFLAMMATORY''']]</center></big>
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<big><center>[[Pancreas Hyperplastic and Neoplastic - Pathology|'''BACK TO PANCREAS - HYPERPLASTIC AND NEOPLASTIC''']]</center></big>
  
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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*'''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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*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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*Most common in dog - usually associated with [[Pancreas Degenerative - Pathology|pancreatic atrophy]] or [[Pancreas Inflammatory - Pathology#Chronic Pancreatitis|chronic pancreatitis]]
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*Occurs occasionally in other species, esp. calves with [[Pancreas Developmental - Pathology#Pancreatic hypoplasia|pancreatic hypoplasia]] and in cats
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*'''Clinical signs'''
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**Steatorrhoea
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**Diarrhoea
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**Weight loss
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**Increased appetite
  
==Signalment==
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*In contrast, '''horses''' with very little pancreatic tissue develop '''hypoinsulinism''' but rarely EPI
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 [[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.
 
 
 
<big>'''[[Exocrine Pancreatic Insufficiency - Dog|Exocrine Pancreatic Insufficiency in the dog]]
 
 
 
'''[[Exocrine Pancreatic Insufficiency - Cat|Exocrine Pancreatic Insufficiency in the cat]]</big>
 
 
 
 
 
 
 
 
 
{{Learning
 
|Vetstream = [https://www.vetstream.com/felis/search?s=exocrine Exocrine pancreatic insufficiency (EPI)]
 
|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]
 
}}
 
 
 
==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.
 
 
 
 
 
 
 
 
{{review}}
 
 
 
{{OpenPages}}
 
[[Category:Pancreas_-_Pathology]]
 
[[Category:Pancreatic Diseases - Cattle]]
 
[[Category:Expert_Review]]
 

Revision as of 11:24, 7 August 2009



BACK TO PANCREAS - DEVELOPMENTAL
BACK TO PANCREAS - DEGENERATIVE
BACK TO PANCREAS - INFLAMMATORY
BACK TO PANCREAS - HYPERPLASTIC AND NEOPLASTIC
  • Exocrine pancreatic insufficiency (EPI) is a syndrome caused by insufficient synthesis and secretion of digestive enzymes by the exocrine portion of the pancreas
  • Leading to insufficient activity of digestive enzymes in the lumen of the small intestine
  • Pancreas has considerable functional reserve, large proportion needs to be non-functional to show signs of EPI
  • Most common in dog - usually associated with pancreatic atrophy or chronic pancreatitis
  • Occurs occasionally in other species, esp. calves with pancreatic hypoplasia and in cats
  • Clinical signs
    • Steatorrhoea
    • Diarrhoea
    • Weight loss
    • Increased appetite
  • In contrast, horses with very little pancreatic tissue develop hypoinsulinism but rarely EPI