Feline Exocrine Pancreatic Insufficiency – NAVLE Study Guide

Overview and Clinical Importance

Exocrine Pancreatic Insufficiency (EPI) is a maldigestive and malabsorptive syndrome caused by insufficient synthesis and secretion of digestive enzymes from pancreatic acinar cells. While historically considered rare in cats, EPI is now recognized as more common than previously thought, with diagnosis rates increasing significantly since the introduction of the feline trypsin-like immunoreactivity (fTLI) assay in 1995. Unlike dogs where pancreatic acinar atrophy (PAA) predominates, chronic pancreatitis is believed to be the most common cause of EPI in cats.

Understanding feline EPI is essential for the NAVLE because the clinical presentation differs substantially from dogs, concurrent diseases are common, and early recognition with appropriate treatment results in excellent outcomes for most patients.

Pathophysiology

Normal Pancreatic Function

The exocrine pancreas produces digestive enzymes essential for nutrient breakdown. The major enzymes include lipase (fat digestion), amylase (carbohydrate digestion), and proteases (trypsin, chymotrypsin) for protein digestion. Clinical signs of EPI only develop when greater than 90% of pancreatic exocrine function is lost, reflecting the enormous functional reserve of the pancreas.