Exocrine Pancreatic Insufficiency

Description

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 Pancreatic Atrophy, Exocrine 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.

For EPI in the dog see here

For EPI in the cat see here

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.