An assay that measures fecal elastase in dogs has been validated. Unfortunately, some healthy dogs or dogs with chronic small-intestinal disease may have a severely decreased fecal elastase concentration, making this test much less reliable than serum TLI concentration.
Most dogs and cats with exocrine pancreatic insufficiency can be successfully treated by supplementation with pancreatic enzymes. Powder is more effective than tablets, capsules, and especially enteric-coated products. Once the clinical signs have completely resolved, the dose can be slowly decreased until the lowest effective dose has been reached.
However, it should be noted that the lowest effective dose can vary between enzyme batches. Oral bleeding has been reported in 3 of 25 dogs with EPI treated with pancreatic enzyme supplements; the bleeding stopped in all three dogs after a dose reduction.
Moistening the food and pancreatic powder mix may also decrease the frequency of this adverse effect. Fresh pancreas may be a viable alternative to the use of powder; 1—3 oz 30—90 g of raw chopped pancreas can replace 1 teaspoon of pancreatic extract.
Raw pancreas can be kept frozen for several months without loss of enzymatic activity. Preincubation of the food with pancreatic enzymes or supplementation with bile salts is not necessary. Even though pancreatic enzyme supplementation decreases the clinical signs in almost all animals, nutrient absorption, especially that of fats, is not normalized. Some types of dietary fiber interfere with pancreatic enzyme activity, and a diet low in insoluble or nonfermentable fiber should be fed.
In contrast, fermentable fiber eg, FOS, beet pulp, or similar can be given. Enzyme supplementation alone may not lead to complete resolution of clinical signs; cobalamin deficiency should be considered as a possible cause. Cobalamin absorption depends on adequate synthesis and secretion of intrinsic factor. In both dogs and cats, the majority of intrinsic factor is synthesized and secreted by the exocrine pancreas The Exocrine Pancreasin Dogs and Cats The pancreas has both endocrine and exocrine functions.
The exocrine pancreas is made up of pancreatic acinar cells and a duct system that opens into the proximal duodenum. Pancreatic acinar Also, cobalamin deficiency was the only independent risk factor for poor outcome in a study of dogs with EPI.
Thus, serum cobalamin and folate concentrations should be routinely evaluated in small animals with suspected EPI. Dogs and cats with cobalamin deficiency, suggested by a severely decreased serum cobalamin concentration, should be supplemented with cobalamin, either parenterally or orally.
Other hypovitaminoses have also been reported in animals with EPI. For example, vitamin K deficiency leading to a coagulopathy has been reported in some cats with EPI. Some animals may not respond to enzyme supplementation and cobalamin therapy and likely have concurrent small-intestinal disease. Animals with EPI commonly have concurrent small-intestinal dysbiosis and may benefit from antibiotic therapy eg, tylosin.
Inflammatory bowel disease Chronic Enteropathies in Small Animals Chronic enteropathies last 3 weeks or longer and include GI signs such as vomiting, anorexia, and diarrhea. She loved going to the nursing home and always knew which patients needed a little extra time or doggie kisses.
Over time, she developed multiple health conditions in addition to EPI, but had such a positive spirit that she not only survived she flourished through it all. Until last week, when the light went out of her eyes and I knew it was time to let her go. We had a vet come to the house Feb 13 th and Izzy passed quietly in my arms in our home. But even before she left this earth, she still managed to help one more dog, by giving her remaining enzymes to the vet that helped her cross over, to help another client that was struggling.
She was my best friend, my all-time companion, once in a life-time heart dog, who taught me so much. She literally changed the course of my life. So many have said that I took such good care of her and gave her so much of my time… but they all had it backwards, I was the lucky one to have had Izzy in my life! God Speed Sweet Girl. I had no idea what this condition was. Izzy was a Spanish Water Dog! And then when I found out how expensive the enzymes were.
I was in shock. But how could we put her down, she was such a sweet little being. So, I started researching the internet. Luckily, I eventually connected with Enzyme Diane. Thank Goodness… because of Enzyme Diane we were able to afford the enzymes for Izzy and I will forever be grateful to her!
So, Epi4Dogs was born. The objective of Epi4Dogs was and continues to be to bring better awareness to the condition and to help those struggling with EPI. And finally, EPI is now recognized in all breeds. Over the years, Epi4Dogs has connected with some of the best veterinarian researchers and veterinarian universities worldwide.
We have collaborated with some on research, and some have advised and guided us. Others have sought us out for advice and information.
We have been published multiple times and have presented at many seminars and conferences through the years. I would like to acknowledge and thank those that have helped us accomplish so much. First, I am forever thankful to:. Penny Watson UK. Johnny: a young St. Bernard mix born in El Paso, TX in There are a lot of words to describe him: fluffy, freckled, goofy, sweet, clever.
I have struggled with chronic illness for most of my life. When I was younger, it was mostly clinical depression and social anxiety. I take medications daily. But as of last year I was still seriously struggling, and my disabilities were impacting my ability to function and perform the basics of life day to day. In , an adoption counselor at an animal shelter in Utah recommended Johnny — at the time known as Scotty — to me based on my living situation and lifestyle.
The leash was handed to me, and it was instantly over for me. This was my dog, and he was going to change my life, and I knew it right then and there. EPI requires lifelong treatment — much like my own conditions, it was lifelong, irreversible, and would need to be managed for the rest of his life.
Johnny had been diagnosed with EPI at the shelter but was still in the beginning phases of his treatment, and it showed. He was emaciated, his ribs and all his joints sharp and pointy underneath thin skin; he was ravenous, eating and eating but never satiated; and he was lethargic, unable to go out and walk for more than ten minutes at a time. Johnny immediately started to blossom — he not only put on all the weight he had lost, but kept growing, and growing, and growing, and it soon became apparent he must have a giant dog breed somewhere in his lineage!
As Johnny became healthy and his temperament began to truly shine through, it quickly became apparent that he had all the qualities that make for a competent service animal. He was laid back, but motivated; even-keeled; friendly to everyone and anyone, but not overly enthusiastic with strangers. I was fortunate to have a background in animal training, and started working with him — he surpassed my greatest expectations, and took to service work like a fish to water.
Producing digestive hormones, including lipase to break down fat, proteases to break down protein, and amylase to break down starch. When enough insulin-producing cells are damaged, dogs develop Type I diabetes. Once the pancreas is damaged to the point that symptoms of EPI develop, you will need to give your dog pancreatic enzyme supplements and possibly other treatments for the rest of their life. However, with proper management, your dog can live a healthy and happy life.
Eat feces coprophagia. Eat other unusual things pica. Other symptoms may be present in severe cases or if a dog is suffering from another condition in addition to EPI.
This is especially true when EPI is diagnosed in a relatively young dog less than four years old. The primary risk factor for PAA in dogs is genetic, which is why EPI is seen more frequently in certain breeds of dogs. German Shepherd dogs are most at risk, but studies have shown that these breeds also have an increased incidence of EPI 1,2,3 :. Cavalier King Charles Spaniels. West Highland White Terriers. Cardigan Welsh Corgis. Australian Heelers. Australian Shepherds.
Shetland Sheepdogs. A veterinarian may suspect that a dog has EPI based solely on their symptoms and breed or history of health problems, but lab tests are still necessary because other diseases can have similar clinical signs. Here are several tests that can help diagnose EPI in dogs. However, they may be appropriate under some circumstances.
Vitamin B12 cobalamin deficiencies, are common in dogs with EPI. Folate another type of B vitamin levels can be normal, high, or low.
In severe cases of EPI, dogs may become deficient in vitamin K, which can lead to bleeding. In theory, treatment for EPI in dogs is fairly straightforward: Dogs eat the missing pancreatic digestive enzymes with their meals, and any other abnormalities, like low cobalamin levels, are addressed. You can purchase the organ meat from butchers, raw pet food suppliers, and other sources, but handling and feeding raw animal products increases the risk of food-borne illnesses like salmonellosis for everyone in the house.
You can grind up and freeze pancreas meat in the appropriate portions and then thaw it before mixing it thoroughly with each meal. Medication that decreases stomach acid secretion, like omeprazole, may be used if this is a concern. Some dogs with EPI develop an overgrowth of bacteria in their intestinal tract , which can be managed with antibiotics often Tylosin. Many dogs only require antibiotic treatment for a month or two as their condition improves, but some may benefit from long-term treatment.
After proper treatment is started, most dogs with EPI quickly start to feel better.
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