Symptoms of Exocrine Pancreatic Insufficiency in Dogs

By Laura GarcĂ­a Ortiz, Veterinarian specialized in feline medicine. January 24, 2021
Symptoms of Exocrine Pancreatic Insufficiency in Dogs

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Exocrine pancreatic insufficiency mainly consists of loss of functional mass of the pancreas in exocrine pancreatic insufficiency, or due to inflammation or pancreatitis.

In this AnimalWised article we're going to explain the clinical symptoms of exocrine pancreatic insufficiency in dogs. We'll also explain the causes, diagnosis and treatment. Keep reading to learn more.

You may also be interested in: What Causes Pancreatitis in Cats?

What is exocrine pancreatic insufficiency?

Exocrine pancreatic insufficiency is when there is inadequate production and secretion of digestive enzymes in the exocrine pancreas. In other words, this occurs when the pancreas does not have the ability to secrete enzymes in their adequate quantity for digestion to proceed correctly.

This leads to a malabsorption and poor assimilation of nutrients in the intestine, causing an accumulation of carbohydrates and fats. From here on, bacterial fermentation, hydroxylation of fatty acids and precipitation of bile acids can occur, which makes the medium more acidic and causes an overgrowth of bacteria.

Symptoms of exocrine pancreatic insufficiency

The clinical signs occur when there has been more than 90% damage to the exocrine pancreatic tissue. Clinical symptoms of exocrine pancreatic insufficiency in dogs include:

  • Bulky and frequent stools
  • Diarrhea
  • Flatulence
  • Steatorrhea (fat in the stool)
  • More appetite (polyphagia) but weight loss
  • Vomiting
  • Poor coat condition
  • Coprophagia (ingestion of feces)
  • During palpation the loops of the intestine can be felt dilated
Symptoms of Exocrine Pancreatic Insufficiency in Dogs - Symptoms of exocrine pancreatic insufficiency

Causes of exocrine pancreatic insufficiency in dogs

The most common cause of exocrine pancreatic insufficiency in dogs is chronic acinar atrophy, and second is chronic pancreatitis. In the case of cats, the latter is more common. Other causes of exocrine pancreatic insufficiency in dogs are tumors of the pancreas or outside of it that cause an obstruction in the pancreatic duct.

Genetic predisposition of the disease

This disease is hereditary in the following breeds of dogs:

And it is more common in:

The age of greatest risk of suffering from exocrine pancreatic insufficiency in dogs is between 1 and 3 years of age, while in English Setters in particular it is 5 months.

Diagnosis of exocrine pancreatic insufficiency

In the diagnosis, in addition to taking into account the symptoms of the dog, non-specific or general tests and other more specific tests should be carried out.

General analysis

Within the general analyzes, the following exams will be carried out:

  • Blood and biochemical tests: generally no significant alterations will appear, and if they do appear they are mild anemia, cholesterol and low protein.
  • Stool examination: it should be performed serially and with fresh stools to detect the presence of fat, undigested starch granules and muscle fibers.

Specific tests

Specific tests include:

  • Measurement of serum immunoreactive trypsin (TLI): which measures trypsinogen and trypsin that enters the circulation directly from the pancreas. This way, exocrine pancreatic tissue that is functional is indirectly evaluated. Specific tests are used for the canine species. Values less than 2.5 ng / mL are diagnostic of exocrine pancreatic insufficiency in dogs.
  • Fat absorption: This is done by measuring lipemia (fat in the blood) before and for three hours after administering vegetable oil. If lipemia does not appear, the test is repeated but incubating the oil with pancreatic enzyme for up to one hour. If lipemia appears, it indicates poor digestion, and if not, malabsorption.
  • Absorption of vitamin A: it will be done by administering 200,000 IU of this vitamin and it is measured in the blood between 6 and 8 hours later. If there is an absorption less than three times the normal value of this vitamin, it indicates poor absorption or poor digestion.

Whenever this disease is suspected, vitamin B12 and folate should be measured. High folate levels and low vitamin B12 levels confirm an overgrowth of bacteria in the small intestine possibly related to this disease.

Symptoms of Exocrine Pancreatic Insufficiency in Dogs - Diagnosis of exocrine pancreatic insufficiency

Treatment of exocrine pancreatic insufficiency

The treatment of exocrine pancreatic insufficiency consists of the administration of digestive enzymes throughout the life of the dog. These come in powder, capsules, or tablets. However, once they improve, the dose can be lowered.

On some occasions, despite the administration of these enzymes, the absorption of fats is not carried out correctly due to the pH of the stomach that destroys them before acting. If this happens, a stomach protector such as omeprazole should be given once a day.

If the dog is deficient in vitamin B12, this vitamin must be adequately supplemented according to the dog's weight. Whereas in a dog under 10 kg it would need up to 400 mcg. If they weigh between 40kg - 50kg the dose will amount to 1200 mcg of vitamin B12.

Before, a diet low in fat, highly digestible and low in fiber was recommended, but today a digestible diet is recommended. Low fat would only be recommended if enzymes are not sufficient. Rice, as a source of easily digestible starch, is the cereal of choice in dogs with exocrine pancreatic insufficiency. Ask your veterinarian for more guidelines on which diet is best for your dog with exocrine pancreatic insufficiency.

Is exocrine pancreatic insufficiency in dogs curable?

EPI due to chronic pancreatitis will sometimes resolve as the pancreas heals. However, the most common cause of EPI is the progressive destruction of the exocrine cells of the pancreas. Unfortunately, this cannot be cured, only managed with medications and diet.

This article is purely informative. AnimalWised does not have the authority to prescribe any veterinary treatment or create a diagnosis. We invite you to take your pet to the veterinarian if they are suffering from any condition or pain.

If you want to read similar articles to Symptoms of Exocrine Pancreatic Insufficiency in Dogs, we recommend you visit our Other health problems category.

  • UranoVet. (2019). IPE (exocrine pancreatic insufficiency). Available at:
  • J. Cerón, MJ Fernández, C. García, M. Hervera, SM Angulo, D. Pérez, C. Pérez, G. Santamarina. (2016). Clinical Manual of Internal Medicine in Small Animals I. ESVPS, Ed. SM Publishing Ltd. Sheffield, UK.

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