In order to fully understand the nature of the condition known as Exocrine Pancreatic Insufficiency (EPI)—also known as maldigestion—it is necessary to first learn what role the pancreas plays as a vital organ in our bodies. Understanding EPI will also be clearer if the meanings of enzymes, atrophy and autoimmune are first learned.
The pancreas is a glandular organ located under to the stomach and next to the upper portion of the small intestine (duodenum). The pancreas is responsible for two major functions crucial to the digestion of the food we eat. The first function is performed by the endocrine pancreas. The endocrine pancreas secretes the hormones insulin and glucagon which are constantly regulating the levels of sugar in the bloodstream. The exocrine pancreas produces and excretes enzymes used for digestion. Enzymes are proteins that help break down the food we eat so it can then be absorbed by our intestines. For example, lactose is the sugar found in milk. Lactase is the enzyme needed to break lactose into two simpler sugars (galactose and glucose) that can now be absorbed into our body and utilized. People with low levels of lactase are called “lactose intolerant,” a term familiar to most people due to all the television commercials pushing lactose-free milk and dairy products.
When a dog suffers from the condition Exocrine Pancreatic Insufficiency, its pancreas fails to excrete enough of the digestive enzymes needed for proper digestion of food. Some of the enzymes are: lipases, to digest fats; amylase, to digest starch/sugars; and proteases, to digest proteins. Even though the dog is eating enough food, and in many cases much more than enough, it is literally starving. Without enzymes to break down the food eaten, nutrients cannot be absorbed. If they can’t be absorbed, they can’t be utilized by the body. Owners are feeding their dog plenty of food so they can’t imagine why the dog is severely malnourished and wasting away.
The most common cause of EPI is pancreatic atrophy. Atrophy is wasting, or a decrease in size of an organ or tissue. Pancreatic atrophy is when this wasting away happens to the pancreas. It is thought to be an inherited condition, but is not present at birth, or congenital. It usually appears in young adult dogs, ages 4-5.
Since pancreatic atrophy is thought to be genetic, it is the responsibility of the breeder to not breed a dog known to have it. EPI is only one problem that occurs with a shrinking pancreas, and there is no cure, only lifelong treatments and expenses.
Another cause of EPI can be from recurring bouts of pancreatitis, or inflammation of the pancreas. Each time the dog gets pancreatitis, small portions of the pancreas can become permanently damaged from scarring or necrosis (tissue death). The more damage done, the greater the risk of EPI occurring.
There is no cure for Exocrine Pancreatic Insufficiency, but there are treatments. The first thing an owner must do when suspecting EPI is to take the dog to the vet. The treatment will be to include pancreatic enzyme supplements added to the food, usually in the form of a powder, but it comes in capsules and tablets too.
It is also sometimes recommended to keep the dog on a low fat, low fiber diet to aid in easier digestion, so owners most likely will need to change their pet’s food. An antibiotic may also be prescribed since lack of enzymes in the digestive tract cause an overgrowth of bacteria in the gut. One or all of the above may be advised.