Left Untreated, This Wasting Disease Can Lead to Organ Failure and Death

In the article “Left Untreated, This Wasting Disease Can Lead to Organ Failure and Death” by Dr. Karen Shaw Becker, canine Exocrine Pancreatic Insufficiency (EPI) is explored as a disorder that can have serious consequences if left untreated. EPI is characterized by the pancreas not producing enough digestive enzymes, leading to poor digestion and absorption of food. While it is more common in German Shepherds, it can occur in any breed of dog. The article discusses the symptoms of EPI, the damage it can cause to a dog's body, the diagnosis process, treatment options, and the best diet for EPI dogs. With helpful insights and recommendations, this article provides valuable information for dog owners to ensure the well-being of their canine companions.

Symptoms of EPI

Exocrine Pancreatic Insufficiency (EPI) in dogs can present with several symptoms that may vary in severity. If you notice any of the following signs in your furry friend, it may be an indication of EPI:

• Significant weight loss despite constant hunger: Dogs with EPI are often hungry all the time, but they continue to lose weight. This can be confusing and distressing for both you and your dog.

• Pooping more frequently with large, yellowish or greyish stools: EPI can cause dogs to have frequent bowel movements, and the stools may be abnormally large and discolored.

• Coprophagia (poop eating) and/or pica (eating nonfood items): Due to the poorly digested food in their intestines, dogs with EPI may resort to eating their own feces or other nonfood objects in an attempt to obtain the nutrients they require.

• Noisy digestion and flatulence: EPI can result in loud digestive noises and increased flatulence as the food remains undigested in the gut.

• Intermittent watery diarrhea or vomiting: Dogs with EPI may experience episodes of watery diarrhea or vomiting, indicating a compromised digestive system.

It's important to note that not all dogs will exhibit all of these symptoms. Even if your dog displays just one or a few of these signs, it's still worth discussing EPI with your veterinarian to get a proper diagnosis.

EPI Can Cause Tremendous Damage to a Dog’s Body

If left untreated, EPI can lead to significant damage throughout a dog's body. Some of the potential complications and conditions that can arise from EPI include:

• Muscle wasting and difficulty maintaining or gaining weight: Dogs with EPI struggle to absorb and utilize nutrients, resulting in muscle wasting and an inability to maintain a healthy weight.

• Developmental abnormalities: For young dogs with EPI, the lack of proper nutrient absorption can lead to developmental issues. Smaller than average teeth and a higher risk of hip dysplasia are some examples of these abnormalities.

• Damage to the nervous system and brain: Malnutrition associated with EPI can have adverse effects on the nervous system and brain. This can manifest as abnormal behaviors like anxiety, fear, and food aggression.

• Skin and coat issues: Dogs with EPI may experience problems with their skin and coat, such as excessive shedding, flaking, and thin hair. These issues are often related to nutritional deficiencies caused by poor digestion and absorption.

Diagnosing Exocrine Pancreatic Insufficiency

Unfortunately, EPI is often misdiagnosed or overlooked by veterinarians, especially if the symptoms are not severe or present in every affected dog. However, early diagnosis is essential for effective treatment. Here are some important factors to consider when diagnosing EPI:

• Misdiagnosis and unnecessary prescriptions for antibiotics: Since chronic loose stools are a common symptom of EPI, veterinarians may mistakenly prescribe antibiotics to address the symptom without identifying the underlying cause. This can lead to temporary relief but does not address the root issue.

• Importance of the trypsin-like immunoreactivity (TLI) test: The TLI test is a blood test that measures a dog's ability to produce digestive enzymes. A TLI value below 2.5 micrograms per deciliter is considered diagnostic for EPI. It's crucial to get an accurate diagnosis through this test to ensure appropriate treatment.

• Cobalamin test to check for vitamin B12 deficiency: Dogs with EPI often have low levels of vitamin B12 due to malabsorption. A cobalamin test can help determine if your dog requires additional supplementation to address the deficiency.

EPI Treatment Options

EPI is a manageable condition, and with the right treatment, dogs can lead healthy lives. Here are some treatment options commonly used for dogs with EPI:

• Enzyme supplementation with pancreatin-containing supplements: Enzyme supplementation is crucial to provide the digestive enzymes that are lacking in dogs with EPI. Pancreatin-containing supplements, which provide protease, lipase, and amylase, can help improve food digestion and absorption.

• Predigestion of food with enzymes before feeding: To optimize digestion, it's recommended to mix the enzyme supplements with the dog's food and let it sit for approximately 20 to 30 minutes before feeding. This allows the enzymes to start breaking down the food before it reaches the dog's digestive system.

• Importance of probiotics and cobalamin injections for dogs with low vitamin B12 levels: Probiotics play a crucial role in restoring the gut microbiome and preventing further complications like small intestinal bacterial overgrowth (SIBO). Cobalamin (vitamin B12) injections may also be necessary to address deficiencies.

Best Diet for EPI Dogs

Diet plays a significant role in managing EPI in dogs. Here are some considerations for choosing the best diet for your dog:

• Switching to a fresh, nutritionally balanced, home-cooked diet or a commercially available, human-grade, gently cooked diet: Highly processed kibble and canned foods can exacerbate pancreatic inflammation, so transitioning to a fresh, balanced diet is highly recommended. Home-cooked diets or commercially available gently cooked diets that are free from unnecessary fillers and preservatives can provide the necessary nutrients for your dog's well-being.

• Transitioning from cooked to raw food for improved digestion: As your dog's gut health improves, transitioning to a raw food diet can provide additional enzymes naturally present in raw food, further aiding digestion.

• Importance of a low-fiber diet for better enzyme function and nutrient absorption: High-fiber diets can interfere with the function of digestive enzymes and inhibit the absorption of certain nutrients. Opting for a low-fiber diet (less than 4 percent) can improve enzyme function and nutrient absorption.

• Ensuring the diet is nutritionally complete: Dogs with EPI are often malnourished, so it's crucial to choose a diet that is nutritionally complete. Work with a veterinarian to ensure the diet meets all the nutritional requirements for your dog's specific needs.

Supplementation

In addition to enzyme supplementation and a balanced diet, additional supplements can benefit dogs with EPI:

• Probiotics for restoring the microbiome and preventing SIBO: Probiotics help restore the balance of beneficial bacteria in the gut, which is important for overall digestive health and preventing small intestinal bacterial overgrowth.

• Additional supplements like fish oil, krill oil, and coconut oil for gut health: Fish oil, krill oil, and coconut oil can provide essential fatty acids and offer additional gut health benefits for dogs with EPI.

• Maintenance of supplement protocols for long-term bowel health: Once symptoms improve, it's important to continue the recommended supplement protocols to maintain long-term bowel health.

• Adjustments to the protocol for optimal symptom resolution and identification of food intolerances: Each dog may respond differently to treatment, so it's crucial to make adjustments to the supplement protocol to achieve optimal symptom resolution. Additionally, some EPI dogs may develop food intolerances, which can be identified through testing and may require adjustments to their diet.

Efficient management of EPI involves a combination of enzyme supplementation, a balanced diet, and appropriate supplementation. Regular veterinary care and monitoring are essential to ensure proper treatment and optimal quality of life for dogs living with EPI.