So, Your Dog Has Been Diagnosed With Exocrine Pancreatic Insufficiency (EPI)
We assume that you’re visiting this page because your dog is suspected to have or has recently been diagnosed with Exocrine Pancreatic Insufficiency (EPI). It’s likely that you’ve been going through a worrisome time as your furry companion has been displaying symptoms that made you think the worst. We understand how you feel.
Molly is our Bernese Mountain Dog. One day a few years ago, I noticed that she had lost a little bit of weight. At the time, I didn’t think much of it as she had become more active as we entered cooler temperatures of the Fall season (Berners hate the heat, LOVE the cold). Fast forward a couple of weeks… one night we were all in the family room watching TV when Molly started whining out of the blue, a behavior very out of the ordinary. I figured she just needed to go out and do her business (although normally she would just stand at the back door). Outside we went when I noticed she had a very loose and pale-colored stool. Once again, I didn’t think much of it as I thought she had an upset tummy after eating something she shouldn’t (also typical of Berners!). Shortly thereafter, she started to become very restless and would meander around the house without purpose. It was at that point we decided to take her to the vet to see what was going on.
How is EPI Diagnosed?
After a couple of misdiagnoses (another story!), and us at our wits’ end, the vet recommended we conduct a serum trypsin-like immunoreactivity (TLI) blood test. A TLI test checks for the presence of trypsin, an enzyme that helps digest protein in the bloodstream. Naturally we agreed and, sure enough, the test showed that Molly’s blood contained very low levels of trypsin. Molly had EPI.
What is EPI?
After hearing the diagnosis, we heard the full explanation of what EPI is, how dogs get it, and how to treat it. Basically, the pancreas has two purposes: The first is to produce insulin to remove sugars from the blood and transfer to cells. When this process is performed poorly, the dog may have diabetes. The second is to produce hormones to breakdown fat, protein, starch, and carbohydrates in cells. When the pancreas fails to accomplish this effectively, the dog will more than likely have EPI.
Symptoms of EPI
Although Molly experienced most, but not all, of the classic symptoms of EPI, it only takes a few to cause concern and lead to a diagnosis by your vet.
- Gradual weight loss
- Ravenous appetite
- Eats own feces
- Soft stool or diarrhea that is yellow or pale in color
- Eats unusual things
- Excessive gas
- Whining
- Restlessness
- Meandering about
- Flaky skin/rough coat
What Causes EPI in Dogs?
There’s no definitive method of determining exactly how or why any particular dog develops EPI. Basically, there are three reasons leading to the diagnosis: present at birth (congenial); hereditary (genetics); or the result of a pancreas injury, infection, or inflammation. For us, we suspect Molly got this disease from the time we lived in the Pittsburgh area. We had a very large backyard that was frequented by deer, a lot of deer…. looked like a petting zoo out there sometimes. Unbeknownst to us, Molly enjoyed snacking on deer droppings. It was a regular deer poop smorgasbord! This, we think, led to her ingesting giardia (to which she was diagnosed), a single-celled microscopic parasite that causes severe gastrointestinal distress. We’ll never know for sure, but we have our suspicions that the giardia disease caused damage to Molly’s pancreas.
How is EPI in Dog Treated?
Here’s the “oh thank goodness” moment. EPI in dogs can be treated with pancreatic enzyme supplements or fed a diet of pancreas meat of other animals. Not a big fan of the latter as pancreas meat is only available from butchers, is sometimes hard to find, expensive over time (especially with large dogs), and the prospect of handling raw organ meat may not be the most appealing to many people. So, we went the supplement route. The enzyme supplement must be prescribed by your vet and comes in two forms, pill and powder. We initially tried the pill option but didn’t have much success as the pill didn’t break-down fast enough in Molly’s system. The vet then recommended we try the powder option and we had immediate positive results. The deal with the powder is that it has to be sprinkled on the dog food, moistened with water, then must sit for at least 15 minutes prior to consumption. Small price to pay for a happy, healthy dog.
Dogs with EPI may experience an associated vitamin deficiency. In Molly’s case, she was deficient in vitamin B12 (cobalamin) but other dogs may experience low levels of folate and/or vitamin K as well.
To complement EPI treatments, there are times when vets will prescribe a diet that is highly digestible, low in fat and low in fiber. As each dog is different, I highly recommend speaking with your vet before making any dietary changes. The less you affect your dog’s already compromised digestive system, the better.
Conclusion
Molly was diagnosed with EPI about six years ago. At this writing she’s over 10 years old when Berners only typically live no more than eight. She is proof that, with the right plan and care from their owners, dogs with this disease can live full and happy lives.
