Question of the Day

This dog has exocrine pancreatic insufficiency (EPI) due to pancreatic acinar atrophy (PAA). PAA is the most common cause of EPI in German shepherd dogs and is considered hereditary. It is also seen in rough-coated Collies and Eurasians.

In cats and older dogs EPI is most commonly caused by chronic pancreatitis.

Serum TLI is the best test for EPI in dogs and cats. A significantly low (< 2.5 µg/L) fasting TLI is diagnostic for EPI.

In EPI there is impaired synthesis and release of digestive enzymes by pancreatic acinar cells, resulting in maldigestion, weight loss/failure to gain weight, diarrhea, and polyphagia. Concurrent small intestinal dysbiosis and cobalamin deficiency are common.

Treat with oral enzyme replacement and cobalamin supplementation if deficient. Patients with EPI require life-long enzyme replacement. Prognosis is good with appropriate treatment.