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{{OpenPagesTop}}Also known as: '''''EPI — Pancreatic Exocrine Insufficiency'''''
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==Introduction==
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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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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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==Signalment==
*Leading to insufficient activity of digestive enzymes in the lumen of the small intestine
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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.  
*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
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*In contrast, '''horses''' with very little pancreatic tissue develop '''hypoinsulinism''' but rarely EPI
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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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<big>'''[[Exocrine Pancreatic Insufficiency - Dog|Exocrine Pancreatic Insufficiency in the dog]]
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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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}}
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==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''
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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]]