Exocrine Pancreatic Insufficiency in Dogs

icon June 26, 2024

Exocrine Pancreatic Insufficiency (EPI) is a serious condition that affects a dog’s ability to digest and absorb nutrients from food. This condition, which results from a deficiency of digestive enzymes produced by the pancreas, can lead to significant health issues if not properly managed. In this article, we will explore EPI in dogs in detail, including its causes, symptoms, treatment options, and dietary management, along with the life expectancy of dogs diagnosed with this condition.

Exocrine Pancreatic Insufficiency in Dogs

Exocrine Pancreatic Insufficiency in Dogs

EPI is a condition where the pancreas fails to produce enough of the digestive enzymes necessary for the proper digestion of food. These enzymes include lipase (for fat digestion), amylase (for carbohydrate digestion), and protease (for protein digestion). Without these enzymes, dogs cannot properly break down and absorb nutrients, leading to malnutrition and a variety of health problems.


Exocrine Pancreatic Insufficiency (EPI) is diagnosed through blood tests measuring trypsin-like immunoreactivity (TLI) levels, fecal elastase testing, and sometimes imaging studies to assess pancreatic structure and function. A low TLI level is indicative of EPI.

Exocrine Pancreatic Insufficiency Life Expectancy

The life expectancy of a dog with EPI can vary greatly depending on the severity of the condition, the dog’s overall health, and how well the condition is managed. With proper treatment and dietary management, many dogs with EPI can live normal, healthy lives. Early diagnosis and consistent treatment are critical to improving the prognosis and quality of life for affected dogs.

EPI in Dogs: Symptoms

The symptoms of EPI in dogs can be quite pronounced and may include:

1. Weight Loss:
Despite having a normal or increased appetite, dogs with EPI often lose weight due to malabsorption of nutrients.

2. Diarrhea:
Frequent, loose, and foul-smelling stools are common in dogs with EPI.

3. Increased Appetite:
Dogs with EPI are often very hungry and may eat voraciously due to their inability to absorb nutrients properly.

4. Steatorrhea:
Stools may appear greasy or oily, indicating undigested fat.

5. Flatulence:
Excessive gas can be a symptom of improper digestion.

6. Poor Coat Condition:
The inability to absorb nutrients can lead to a dull, dry coat and skin issues.

7. Lethargy:
Lack of proper nutrition can cause fatigue and decreased energy levels.

8. Coprophagia:
Dogs with EPI may eat their own feces or other non-food items in an attempt to gain nutrients.

Exocrine Pancreatic Insufficiency Causes

EPI can be caused by several underlying issues, including:

1. Pancreatic Acinar Atrophy (PAA):
This is the most common cause of EPI in dogs, particularly in certain breeds. PAA is a progressive condition where the enzyme-producing cells of the pancreas gradually degenerate.

2. Chronic Pancreatitis:
Repeated bouts of inflammation of the pancreas can damage the enzyme-producing cells, leading to EPI.

3. Genetic Factors:
Some breeds are genetically predisposed to EPI, including German Shepherds and Rough Collies.

4. Pancreatic Hypoplasia:
This is a congenital condition where the pancreas is underdeveloped and unable to produce sufficient enzymes.

EPI in Dogs: Treatment

While EPI is a lifelong condition, it can be effectively managed with proper treatment, which typically includes:

1. Enzyme Replacement Therapy:
The cornerstone of EPI treatment is the administration of pancreatic enzyme supplements with each meal. These supplements provide the necessary enzymes for proper digestion.

2. Dietary Management:
Feeding a highly digestible, low-fiber diet helps to ensure that the nutrients in the food are more easily absorbed. Some dogs may also benefit from a diet that is moderate in fat.
→Low Fat Dog Food for Pancreatitis

3. Antibiotics:
In some cases, secondary bacterial overgrowth in the intestines can occur due to undigested food. Antibiotics may be prescribed to address this issue.

4. Vitamin Supplements:
Dogs with EPI often require supplementation of fat-soluble vitamins (A, D, E, and K) and vitamin B12 (cobalamin), which are poorly absorbed due to the condition.

EPI in Dogs: Treatment

What is the Best Food to Feed a Dog with EPI?

The best food for a dog with EPI is one that is easily digestible and nutritionally balanced. Key considerations include:

1. Highly Digestible Proteins:
Foods with high-quality animal proteins are easier for dogs to digest and absorb.

2. Low to Moderate Fat:
While some fat is necessary, too much can be difficult for dogs with EPI to digest. A diet with moderate fat content is often recommended.

3. Low Fiber:
High-fiber diets can interfere with the absorption of nutrients, so low-fiber options are preferable.

4. Grain-Free Options:
Some dogs with EPI do better on grain-free diets, although this is not universally necessary.

Commercial diets specifically formulated for dogs with digestive issues, such as prescription gastrointestinal diets, are often recommended. Home-cooked diets can also be an option but should be formulated under the guidance of a veterinary nutritionist to ensure they meet all nutritional needs.

What Foods Aggravate EPI?

Certain foods can aggravate EPI symptoms and should be avoided:

1. High-Fat Foods:
Foods high in fat can be difficult for dogs with EPI to digest and may exacerbate symptoms.

2. High-Fiber Foods:
Excessive fiber can interfere with nutrient absorption and worsen digestive issues.

3. Table Scraps and Human Foods:
These can be difficult to digest and may contain inappropriate levels of fat and fiber.

4. Grains:
Some dogs with EPI may have difficulty digesting grains, leading to increased symptoms.

Are Dogs with EPI Always Hungry?

Dogs with EPI often exhibit an increased appetite and may seem constantly hungry. This is because their bodies are not absorbing the nutrients from their food properly, leading to a state of malnutrition despite adequate food intake. Enzyme replacement therapy and proper dietary management typically help to alleviate this symptom by improving nutrient absorption.


Exocrine Pancreatic Insufficiency in dogs is a manageable condition that requires lifelong treatment and careful dietary management. Understanding the causes, symptoms, and treatment options is crucial for pet owners to provide the best care for their affected dogs. With proper enzyme replacement therapy, a well-balanced diet, and regular veterinary care, many dogs with EPI can lead healthy and fulfilling lives. By staying informed and proactive, pet owners can ensure their dogs receive the necessary support to thrive despite this challenging condition.

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