Exocrine pancreatic insufficiency
Exocrine pancreatic insufficiency (EPI) is a common condition in dogs, resulting from inadequate functional reserve of pancreatic acinar tissue.
Clinical signs only develop when a critical mass (e.g. >90%) of exocrine tissue has been lost, and result from maldigestion and subsequent malabsorption.
Clinical signs are characterized by chronic intermittent diarrhea, often with large bulky stools. Weight loss and compensatory polyphagia are commonly observed in older dogs. The feces are usually pale and malodorous, and the high fat content of the feces can lead to a greasy appearance of the hair coat.
Diagnosis is based on evaluation of serum trypsin-like immunoreactivity (TLI) concentration, which in affected dogs is usually ≤2.5 µg/L. Fecal elastase in dogs has been developed but appears less reliable than serum TLI concentration.
Treatment of EPI in dogs usually involves various enzyme replacement therapies with the addition of highly digestible food and vitamin supplementation.
Recovery from this condition is rare due to the underlying loss of viable pancreatic tissue. However, clinical normality is usually achieved with appropriate therapy and most dogs gain weight and pass normal stools.
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