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Exocrine Pancreatic Insufficiency

Being able to eat as much as you like may sound like a dream situation to many of us as our girth seems to inexorably increase with our age but for some of our canine friends it can be a real problem.

Prince moved into our area a few months ago and had come up from the tropical county of Kent to the crisp cold of Yorkshire and didn’t seem to be taking to it at all well. Since his arrival his owners gradually noticed that he was looking worse and worse and started to lose weight. His coat looked dull and he has started eating his own faeces, which he had never done as a puppy. Their first thought was that maybe he had picked up some worms and he hadn’t been done for a while because of the move. As time went by, though, it became obvious that there was more going on.

When I first saw Prince he didn’t look too bad but you could tell that his condition was not what it should be and his fur was very dry to touch. Being a German shepherd dog did immediately give me an idea as to what was going on. Incredibly these days, breed type can be one of our most useful diagnostic tools and it was certainly true in Prince’s case.

A relatively common cause of poor condition and weight loss in adult German shepherds is a condition called EPI or exocrine pancreatic insufficiency. The pancreas is an organ that sits nestled in the small intestine and has two main sections. One is the endocrine portion and these cells control things such as insulin production. The exocrine portion produces many of the enzymes required for proper digestion, especially when it comes to digesting fat.

In EPI the cells that produce these enzymes are destroyed. The result of this is that no matter how much the dog eats the nutrition cannot be accessed and just goes straight through. Dogs with EPI often defecate large amounts because they are not using their food and because of the high fat content in the stools they often have a very strong odour. Over time the dogs can become properly malnourished and tend to develop ravenous appetites because they are losing weight.

Prince had started to eat his own stools and this is also a common finding in these dogs. Partly it is because they are so hungry that anything becomes a meal and also it is because their faeces have not been processed much and have a high fat content so will become more and more appealing. The dull coat was also probably related. As with any source of malnourishment often one of the first body systems to suffer is the coat and skin as the body prioritises where the available nutrients are needed the most.

Prince’s owners were very upset and understandably so because they had heard someone making a comment about the state of their beloved pet as if they had been starving him themselves but they just couldn’t seem to get weight onto him at all.

A thorough clinical examination revealed the fact that he was grossly underweight but little else. We decided that by far the most important thing to do was to take a blood sample for a full battery of tests including pancreatic activity. As with all these things even when you have a pretty good idea of what the problem is you easily miss the rarer causes and should never fall into the trap of being complacent.

Luckily for Prince we were right and the bloods showed that besides an overgrowth of bacteria in his ailing gut his only problem seemed to be his poorly functioning pancreas. I say luckily because the other causes of weight loss and poor condition such as liver disease, bowel disease and cancer can all be much more serious and may not be so amenable to treatment.

Exocrine pancreatic insufficiency has an excellent outlook in nearly all cases. The treatment is to replace the enzymes needed for digestion in a powered form mixed with a good balanced diet. These enzymes are readily available and make a fairly remarkable and massive difference to the dogs concerned. They can be incredibly satisfying cases for us too because the dogs look so dreadful and are in a genuinely bad way and the recovery is an amazing thing to be privy to. Prince did need a decent course of antibiotics too because of his bacterial overgrowth and he also needed extra rations to start with.

These dogs, at the start of treatment, are in a very similar situation to rescue dogs that have been deliberately starved, because of their level of malnutrition. Prince was started on his supplements and we put him onto three meals a day. We had him in every two weeks for weight checks and his owners kept an eye on his newly acquired and fairly revolting habit! Happily after just a couple of weeks his coprophagia was the first sign of his illness to go. His coat became the beautiful example of German shepherd lustre that it had been previously and his ribs gradually got covered as his strength returned.

German shepherds are very beautiful dogs in my opinion and unfortunately for them they are prone to numerous possible problems. Fortunately for Prince we were able to return him completely to his former glory and it was a pleasure to see. It would seem that Prince is also aware of just how gorgeous he is and is willing to exploit it as much as possible every time he comes to the surgery and charms everyone he meets into giving him just a little treat!

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