Exocrine Pancreatic Insufficiency

Typical Signalment

• Most common in dog:
  • German Shepherd Dogs
  • Rough Collie
• Occurs occasionally in other species including calves with pancreatic hypoplasia and in cats (chronic pancreatitis)
• In contrast, horses with very little pancreatic tissue develop hypoinsulinism but rarely EPI

Description

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
• In dog it is mostly caused by pancreatic atrophy or Pancreatic Acinar Atrophy (PAA)
• In the cat it is usually associated with chronic pancreatitis

Diagnosis

History

• Weight loss with or without polyphagia (usually ravenous with scavenging)
• Coprophagia and pica
• Polyuria and polydipsia due to Diabetes Mellitus
• Varible diarrhoea (large volumes of semi-formed faeces)
• Vomiting
• Borborygmus and flatulance

Clinical Signs

• Steatorrhoea
• Diarrhoea
• Mild to marked weight loss
• Muscle wastage
• Polyphagia
• Poor haircoat
• Flatulance

References

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

Merck & Co (2008) The Merck Veterinary Manual