41 Exocrine Pancreatic Insufficiency
Exocrine pancreatic insufficiency (EPI) is a condition in which the pancreas no longer produces adequate amounts of digestive enzymes. This usually will not occur until more than 90% of the exocrine pancreas has become nonfunctional. Most cases in dogs are caused by pancreatic acinar atrophy, though some may also develop because of chronic pancreatitis. Clinical signs develop because digestion no longer occurs properly, leading to malabsorption with weight loss and diarrhea. Maldigestion and malabsorption does not just result from the enzyme deficiency. The disease also leads to changes in small intestinal digestive processes. Small intestinal bacterial overgrowth (SIBO) is also frequently seen and can contribute to the diarrhea. Low cobalamin levels also occur, which also may play a role with small intestinal disease in these dogs.
Pancreatic acinar atrophy is a condition in which a normal pancreas undergoes atrophy. A familial predisposition in German Shepherds and rough-coated collies has been established. It can, however, occur in any breed, with large-breed dogs being more commonly affected.
Because pancreatic acinar atrophy is the most common cause of EPI many of the dogs are German Shepherds. They tend to be young animals, usually younger than 2 years.
