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Exocrine Pancreatic Insufficiency (EPI)
GastrointestinalCanineFelineNew
Key Points
  • Exocrine pancreatic insufficiency (EPI) is caused by a loss of functional exocrine pancreatic tissue, resulting in insufficient digestive enzyme production and maldigestion
  • Dogs are most commonly affected but EPI also occurs in cats
  • The most common causes are pancreatic acinar atrophy (dogs) and chronic pancreatitis (cats)
  • Typical clinical signs include weight loss despite polyphagia, chronic diarrhoea and large-volume, greasy stools
  • Serum trypsin-like immunoreactivity (TLI) is the diagnostic test of choice
  • Treatment is lifelong and centred on pancreatic enzyme replacement therapy (PERT)
  • Cobalamin deficiencies are common in patients with EPI, so levels should be assessed and supplemented as needed
Differential Diagnoses
  1. Chronic inflammatory enteropathies (CIE)
  2. Gastrointestinal dysbiosis
  3. Protein-losing enteropathy (PLE)
  4. Intestinal lymphoma
  5. Hypoadrenocorticism
Overview
Aetiology
Clinical Signs
Diagnosis
Treatment
Prevention
Resources
Overview

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Aetiology

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Clinical Signs

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Diagnosis

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Treatment

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Prevention

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Resources

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Educational content only. This factsheet is for general veterinary education and is not a substitute for professional veterinary advice, diagnosis, or treatment. Not for use in an emergency — contact a veterinarian or emergency service. Full disclaimer →