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Looking at dogs with Exocrine Pancreatic Insufficiency


The pancreas is an organ in the body who's job is to make insulin and digestive enzymes. These two functions are sometimes referred to as the endocrine and exocrine pancreata. The insulin is what controls the blood sugar levels in the dog's body and the digestive enzymes help in digesting fats, starches and proteins that he eats. When the pancreas does not produce enough digestive enzymes EPI develops (Exocrine Pancreatic Insufficiency. In this article we look at what the causes and symptoms are of EPI, how it is diagnosed and what can be done to treat or manage it.

Symptoms of EPI


In dogs with EPI the lack of digestive enzymes can lead to problems linked to poor absorption of essential nutrients and maldigestion. With food left undigested in the small intestine can come an overgrowth of bacteria which can then adversely affect how the intestine functions. The good news is the pancreas is able to reserve the enzyme at a high capacity so that it has to be at 90% loss of function for maldigestion symptoms to occur. The common symptoms of Exocrine Pancreatic Insufficiency include;

Weight loss

Chronic diarrhea


Increased appetite

More stool or more frequent stool


Coprophagia (the dog eats its own stool)

What Causes Canine Exocine Pancreatic Insufficiency

In German Shepherds the condition is believed to be hereditary. If you are purchasing a German Shepherd from a breeder be sure to look at the health background of its parents and include a check on whether they had EPI. There is no way to prevent it apart from making sure not breed animals with it.

PAA (pancreatic acinar atrophy) is the most common cause of canine EPI. Cells in the pancreas called pancreatic acinar cells are what make the enzymes to help digest food. When a dog has PAA it then leads to EPI.

Another cause of Exocine Pancreatic Insufficiency in dogs is pancreatitis (chronic inflammation of the pancreas). When a dog gets pancreatitis it is often due to diabetes so this underlying condition will also need to be managed and treated.

Diagnosing a Dog with EPI

After looking at the symptoms your dog is experiencing your vet will also carry out a number of diagnostic tests to look for a definite diagnosis. There are several pancreatic function tests that can be carried out. The most reliable is taking a serum sample to look at the levels of TLI (trypsinogen) the pancreas releases into the blood as this indicates whether it is functioning correctly or not. They may also look at the levels of chymotrypsin. As well other tests will be performed like stool analysis looking for levels of digestive enzymes and examining under a microscope and urine analysis to rule out something like a gastrointestinal infection which can present similar symptoms.

Treating Dogs with EPI

When you have a confirmed diagnosis in your dog, treatment usually involves supplementing your dog's food with a replacement pancreatic enzyme. It comes as a powder prescribed by your vet and you just mix it in with his food. If the EPI has lead to malnutrition your dog may also be put on vitamin supplements for a time to give him a boost.

As well as the above treatment there may also be additional treatment for the underlying cause of EPI. In many cases the underlying cause is itself irreversible so this means the dog will need to be on medication and enzyme supplements for the rest of his life.

While treatment is fairly easy to carry out it can be expensive as the pancreatic enzyme replacements are expensive to produce. They have to come from other sources like freeze dried and ground up cattle or hog extracts which have the same naturally occurring enzyme as your dog. These pancreases are gotten from meat packing plants just for this use then turned into powders or pills. Commonly prescribed trade names include Pancrezyme or Viokase. When mixed with food you usually have to leave it for 30 minutes before feeding your dog.

Your dog will show improvement very quickly and return to almost normal health. Do not feed your dog foods that are high in fiber or fat as they are harder to digest. Track your dog's progress each week. After the first week the diarrhea symptoms should have passed then stools should normalize and he should regain lost weight.

Long Term Prognosis

On the above course of treatment, as long as the underlying condition can be treated too, your dog can still live a long life and happy life. However the cost will be around $60 to $100 a month just for the EPI treatment. Hopefully at some point researchers will be successful in their development of synthetic digestive enzymes which will cost less.

If digestive enzymes in their food does not work, which for some dogs it does not, a diet change is needed, one that is highly digestible with fat sources added that do not need the pancreatic enzymes to break them down. Supplements will also be needed. As your dog's health improves the dosage of enzymes may be lowered.


It is important to stick to known methods of treatment from your vet rather than resorting to trying to fill the deficiency yourself. There are foods and products that advertise themselves as containing natural enzymes. For a normal dog these are helpful as supplements but for a dog with EPI these are not the right kind of enzymes. In some dogs the disorder actually resolves itself somehow after 6 to 8 months of treatment but this is not common. It is thought this happens in rare cases where the cells that produce the enzymes have just been irritated somehow, but that damage heals itself and is not permanent. Once the dog recovers the EPI goes away and they can produce the enzymes normally once more.