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Exocrine Pancreatic Insufficiency in Dogs and Cats

Exocrine Pancreatic Insufficiency in Dogs and Cats

The Functions of the Pancreas

An animal’s pancreas has two functions within the body—exocrine and endocrine functions. The endocrine pancreas secretes hormones and insulin, while the exocrine pancreas contains acinar cells that secrete zymogens and digestive enzymes, which are crucial for proper digestion.

Digestive enzymes are responsible for breaking down food so that the body can use those nutrients. In addition to helping produce digestive enzymes, the exocrine pancreas produces essential substances that help with absorption and other important digestive system functions, such as neutralizing gastric acid.

Exocrine Pancreatic Insufficiency - What Is EPI in Dogs & Cats?

Exocrine pancreatic insufficiency (EPI) is a disease that is characterized by the inadequate production of digestive enzymes from pancreatic acinar cells. Without an adequate amount of enzymes, the body isn’t able to digest or absorb food. This leads to maldigestion and the malabsorption of nutrients.

In addition, EPI can lead to bacterial overgrowth in the intestines. Undigested food and unabsorbed nutrients end up feeding the bacteria living in the intestines, which leads to an overpopulation of bacteria and nutrient deficiencies. This often results in a vitamin B12 (also known as cobalamin) deficiency. If left untreated, EPI will deprive the body of the nutrients needed to survive.

What Causes Pancreatic Insufficiency?

The most common cause of EPI in dogs and cats is pancreatic acinar atrophy, which is a disease that destroys the acinar cells in the pancreas. Other causes include chronic pancreatitis, pancreatic neoplasia, and pancreatic hypoplasia.

Which Breeds Are Predisposed to EPI?

Some breeds have a higher risk of developing EPI. Many studies have shown that this disorder occurs more frequently in German Shepherd Dogs (GSD) than other breeds. GSD are known to be predisposed to pancreatic acinar atrophy, the most common cause of EPI.

Another breed that is predisposed to EPI are German Shepherds and 20% are Rough Collies. About 70% of dogs with exocrine pancreatic insufficiency are German Shepherd Dogs and 20% are Rough Collies (Wendy Brooks, DVM, DABVP). The disorder is inherited in an autosomal recessive manner and is assumed to be an autoimmune disease in both GSD and Rough Collies.

Exocrine Pancreatic Insufficiency Symptoms

Diagnosing EPI in cats and dogs can be difficult because visible symptoms may not appear for months or even years. The most common clinical signs of EPI include:

  • Diarrhea
  • Increased fecal volume
  • Polyphagia (excessive hunger and an abnormally large intake of food)
  • Weight loss
  • Dry coat and dandruff due to the inability to absorb dietary fats
  • Stool eating due to malnutrition
  • Anemia (from vitamin B12 deficiency)

EPI Treatment

EPI in dogs and cats can usually be successfully treated and regulated with pancreatic enzyme supplements. Enzyme supplementation will be needed for the rest of the pet’s life. Freeze-dried, powdered porcine enzymes are common and usually successful, rather than plant enzymes. However, every situation is different, so what works for one animal might not work for the next.

VCA Hospitals points out that highly digestible, low fat diets can also help stabilize the condition.

Because vitamin B12/cobalamin deficiencies are common with EPI, it’s important to consult with your veterinarian if you think your pet has a vitamin B12 deficiency. Symptoms of vitamin B12 deficiency include weakness, lack of energy, lack of appetite, diarrhea, and weight loss.

If your pet has a vitamin B12/cobalamin deficiency, your veterinarian may prescribe antibiotics for the bacterial overgrowth in the intestines. Many pets will also need vitamin B12 supplementation. In the past, it was recommended to give vitamin B12 supplementation through injection, but studies have shown that pets have good results from oral vitamin B12 supplements.

According to Texas A&M University, recent studies in humans, dogs, and cats suggest that oral cobalamin supplementation is as equally effective as parenteral supplementation.

Thomas Pet Bio Case Plus: Pancreatic Enzymes for Dog & Cats

If your pet requires pancreatic enzyme supplementation, consider Bio Case Plus from Thomas Pet! Bio Case Plus is a high potency, pancreatic enzyme powder designed to support the breakdown of carbohydrates, proteins, and fats. This digestive enzyme supplement assists in nutrient absorption, which is essential for proper digestion.

Plus, Bio Case Plus contains L-glutamine, vitamin B12, intrinsic factor, probiotics, and digestive enzymes.

  • The addition of vitamin B12 is important for pets that have a vitamin B12/cobalamin deficiency, which is a common secondary condition of EPI.
  • Intrinsic factor is a protein that is made by cells in the stomach lining. It helps the body absorb vitamin B12, which helps support pets in need of B12 supplementation. It plays a crucial role in the transportation and absorption of vitamin B12 by binding with vitamin B12 so that it can travel to the intestines and be absorbed in the bloodstream.
  • L-glutamine and the probiotic Lactobacillus Acidophilus help maintain the integrity of the gut flora and GI tract. Glutamine is an important energy source of immune and intestinal cells, making it essential for the immune system and intestinal health. It supports intestinal cells and is important for the normal growth and maintenance of the cells in the intestine.
  • Digestive enzymes are crucial for proper digestion. They are responsible for breaking down food so that the body can use those nutrients. They also support the immune system, improve the skin & coat, and provide energy. Bio Case Plus contains digestive enzymes that your pet needs to thrive: amylase, protease, and lipase.

Although exocrine pancreatic insufficiencies may seem overwhelming, most pets do well with enzyme supplementation. Finding a high-quality supplement that works for your pet is key!


The materials and information provided on this website are not intended to replace the medical advice or services of your veterinarian or other pet healthcare professional. Consult your own veterinarian if you have medical questions concerning diagnosis, treatment, therapy, or medical attention.

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