EXOCRINE PANCREATIC INSUFFICIENCY (EPI) IN THE DOG

We think of the pancreas as the producer of insulin, and we understand  that a lack of insulin leads to Type 1 Diabetes. The pancreas, however, has another important glandular function; it also produces acinar enzymes which allow dogs (and us) to digest food. The enzymes break down food in the intestine into small molecules. The major digestive enzymes are protein molecules that are produced and stored in the pancreas. They include trypsin, chymotrypsin, amylase, and lipase. The trypsin and chymotrypsin break down protein molecules, amylase breaks down starches, and lipase does the same for fats.

     The process of digestion begins when the dog eats his meal.  Breaking down the molecules of food into smaller sizes is an important part of the process of digestion and allows nutrients to be absorbed by the cells that line the intestine. The nutrients are then passed from those cells into the bloodstream and from the blood to the tissues. When a dog eats, the enzymes are released; they flow from the pancreas into the anterior small intestine through the pancreatic duct. Only after they reach the lumen (centre of the intestine) do they begin their work digesting food.

A loss (partial or complete) of these enzymes is called Exocrine Pancreatic Insufficiency (EPI) or sometimes Maldigestion Syndrome.  When dogs have this disorder, the proteins, starches, and fats found in their diet cannot be broken down into small enough pieces that allow them to be absorbed through the intestinal wall. The food stays in the digestive tract and is passed out chewed but not digested.  The affected dog, without treatment will soon die of starvation even though it may be ravenously hungry and eating consistently..Large dogs, especially German Shepherds sometimes have a genetic predisposition to this disorder.

 A dog with severe EPI will lose weight rapidly, body fat will soon disappear, muscle will atrophy, bones will become porous, the hair will be dull, and the dog will have diarrhoea with the stools usually looking like mashed banana- yellow or clay-colored, due to lack of bile. If the deficiency is severe the stools may even have the consistency of very thin custard.

There are diagnostic tests ranging from sophisticated to simple. Ask your veterinarian about them. Once it is established that the dog has EPI the pancreatic enzymes must be replaced with enzymes from other sources. At present there are no synthetic enzymes.  Pancreatic enzymes are made through an expensive process, using freeze-dried and ground-up extracts of pig and cattle pancreases. These glands are harvested in meat plants and then processed solely for this purpose. They are made into tablets or powder and go under different trade names. The tablets are given before each meal while the powder is usually mixed with food and allowed to set 30 minutes before feeding.   Plant based enzymes are available. They are also very expensive, they will help, but are not likely to be strong enough on their own except in very mild cases.

Response to accurate and sufficient therapy is immediate and the dog will usually return to near normal health. The first thing you will notice is the stool and bowel control becoming more normal.  There is no cure- only control,  so unfortunately, cost becomes the major hurdle in treating pancreatic insufficiency, many dogs with this condition are put down Some good news is that the products sold for humans are essentially the same as the veterinary supplements and for some reason in most countries are quite a bit cheaper. These can be given to a dog with no problems.

There is a much cheaper option even again.  Raw pig pancreas can be used. There may be a slight risk of disease transmission from pig to dog depending on regulations in different countries ensuring the health of the slaughtered pig.

Dosing is more difficult with the raw pancreas, but in general, a 20 kilo or 45 pound dog would need to receive half a cup chopped pancreas. It’s an experiment – your dog would maybe need more to start with. Raw pancreas can be frozen at -4ºF (-20c) for up to 3 months and still retain its enzyme activity. It can probably be refrigerated for a few days. Some people blend this into a liquid for better absorption. Chopped up in small pieces it can be mixed into the meal.

Right diet is just as important, my personal preference would be raw lean protein (for natural enzymes) and low fibre. A highly digestible diet is possibly cooked yam, sweet potato, or carrot with lean raw meat, fish, cottage cheese or eggs. Many dogs with EPI can never digest grains. Grain based kibble should be avoided.  Medium chain triglycerides may be added as fat sources since as the molecules are so tiny they do not require breakdown by pancreatic enzymes, (coconut oil or palm oil) Fresh coconut may provide enough fat – especially in a milder case or after the dog improves, and multiple vitamin and mineral supplements B12 deficiency should be checked for by your vet.

All the fat soluble vitamins will need to be added – A,D, E, K.

If you have a dog with this illness and you are contemplating euthanasia because of the ongoing expense, do what you can to source raw pancreas, or failing that enzymes prepared for people. There are some pictures on the Internet of amazing transformations, so please don’t give up hope.

 

31 Mar 2011

Last Update: 6 Apr 2011

Diana Thurbon Profile | Email | Website Diana Thurbon - Keysborough Clinic - Victoria Cost Effective and Confidential Consultations. Naturopath, Nutrition, Stress management, Lifestyle Advice Specialising in Female Health: Pre-Conception - Fertility - Chronic Conditions I can help you balance hormones, lose weight, have a healthy family, enjoy vibrant health; and get the most out of your life. Keysborough Keysborough VIC Australia 3000 03 9798 6862 - 0400 979 868