Exocrine pancreatic insufficiency (EPI) is a maldigestion syndrome that develops when the pancreatic acini can no longer make enough digestive enzymes. The textbook patient is a young German Shepherd that eats ravenously, passes large volumes of pale, soft feces and still loses weight. One fasted blood test, serum trypsin-like immunoreactivity (TLI), confirms it, and lifelong enzyme replacement with cobalamin supplementation usually gives the dog a normal life.
Key facts
Exocrine pancreatic insufficiency at a glance- Species and system: dog (also cat); exocrine pancreas, gastrointestinal system.
- Causes: pancreatic acinar atrophy (PAA) in German Shepherd Dogs, Rough Collies and Eurasiers; chronic pancreatitis in most other breeds; rarely, masses obstructing the pancreatic duct.
- Classic picture: weight loss with polyphagia and voluminous, pale, loose, often fatty feces in a young adult German Shepherd.
- Diagnosis: fasted serum canine TLI ≤5.5 µg/L (Texas A&M, 2024); always measure cobalamin and folate.
- Treatment: non-enteric-coated pancreatic enzyme powder (or raw pancreas) with every meal, cobalamin supplementation, a highly digestible diet that is not fat-restricted.
- Not zoonotic or reportable. Affected German Shepherds should not be bred.
What's inside
12 sections in the full guide- Key facts
- How the NAVLE tests this
- Cause and pathophysiology
- Clinical signs
- Diagnosis
- Differential diagnoses
- Treatment and management
- Prevention, control and public health
- Prognosis
- Quick review
- Test yourself
- References
The full guide also has 5 tables, 2 figures, 3 self-test questions and 11 references, available to NAVLE members.
Read the full study guide
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