Pancreatic Insufficiency
Submitted
by Caroline Hunt, Professor of English, College of Charleston
(South Carolina). E-mail: huntc@cofc.edu Voice: 803 953-5649 Fax: 803 953-3160
Copyright
©1996, 1997 HomeVet
This disorder
of the digestive system is potentially life threatening
(particularly in its acute form) but often responds
well to treatment. It is more common in some breeds
than others and is frequently seen in German Shepherd
Dogs. Successful treatment of pancreatic problems requires
close cooperation between owner and veterinarian, as
well as a certain flexibility in working with changes
in the animal's condition.
The pancreas
serves two separate functions, endocrine and exocrine.
The endocrine gland secretes hormones, notably insulin,
and the most feared pancreatic malfunction seen by endocrinologists
(human and veterinary alike) is of course diabetes.
The exocrine gland secretes enzymes into the small intestine,
aiding digestion. Pancreatic insufficiency in dogs is
not, thus, an endocrine problem like diabetes but rather
an exocrine problem, referring to the organ's failure
to produce digetive enzymes. The condition is therefore
properly referred to as Exocrine Pancreatic Insufficiency,
often shortened in the veterinary field to EPI.
Typically, the
exocrine functions of the pancreas can malfunction in
either of two ways. In acute pancreatitis, the dog's
pancreas becomes inflamed, causing vomiting and loss
of appetite with resulting dehydration. This requires
immediate veterinary attention (with inpatient care
and intravenous rehydration/feeding). What is actually
happening is that the digestive enzymes are digesting
the pancreas itself--hence the need to stop all oral
food and water and to trick the body into reducing the
production of pancreatic enzymes. The dog that survives
an attack of this kind may recover completely or may
be subject to chronic pancreatitis thereafter. This
chronic irritation of the pancreas can then lead to
EPI. In a different scenario, a previously healthy animal
begins to exhibit some or all of the following symptoms:
ravenous appetite, excessive water-drinking, and very
soft "cow patty" stools. No matter how much the dog
eats, it is hungry soon after and begins losing weight
(often rapidly).
Some authorities
note that pancreatitis (the acute form) is particularly
common in spayed, overweight females in middle age,
and most agree that excessive amounts of fat in the
diet are likely to trigger this form. As to animals
suffering from EPI that have not previously had pancreatitis,
some sources designate an onset by the age of two to
three years in previously healthy animals, but seldom
later. The prevalence of the chronic disease in German
Shepherd Dogs has led to speculation about genetic links.
The treatment
of exocrine pancreatic problems depends on the severity
of clinical signs, and status of the patient. Full-blown
pancreatitis, as indicated above, is a life-threatening
emergency. EPI, however, is treated along a gradual
spectrum involving food, medicine, and schedule. Blood
tests showing the dog's ability to produce digestive
enzymes (lipase, protease, amylase) are the usual place
to start. It may be possible to regulate the condition
by feeding a bland low-fat, low-fiber diet with an over-the-counter
enzyme supplement. Some veterinarians recommend rice
and boiled chicken in the early stages of treating an
animal that has already lost a lot of weight; others
prefer a high-protein premium food, or like to move
to this after the rice-and-chicken stage.
For the severely
affected animal, whose pancreas has basically ceased
to produce one or all of the required enzymes, a more
stringent regime is required. Despite the apparently
identical composition of the various enzyme supplements
on the market, they are not all equally effective. The
use of "prescription" or especially prepared bland,
easily digestible food is also sometimes initially indicated.
The owner of
a dog with EPI needs to be constantly attentive to the
animal's condition. After establishing the amount and
balance of enzyme(s) needed to produce relatively normal
stools, the owner can usually feed enough so that the
dog regains any lost weight. It is important to watch
for any relapses, shown either in the return of diarrhea
or in resumed weight loss. Some dogs with EPI dogs may
also go on to develop diabetes due to dysfunction of
the endocrine pancreas. In general however, as long
as owner and vet are willing to work together in fine-tuning
the diet and medicine, the dog with EPI can live a happy
and relatively normal life.
Please note:
The information provided here is meant to supplement
that provided by your veterinarian. Nothing can replace
a complete history and physical examination performed
by your veterinarian. - Dr. Jeff
I greatly value your feedback. Please let me know what
you think of this site and what you would like to see
on it. drjeff@homevet.com
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