Pancreatic insufficiency or exocrine pancreatic insufficiency (EPI) is "characterised by a decrease or absence of pancreatic enzymes in the dog," according to veterinarian Race Foster, DVM. When a dog has EPI, food cannot be absorbed or digested, remains in the gastrointestinal tract and is passed out undigested in the faeces. Without pancreatic enzyme replacement therapy, a dog can starve to death despite eating constantly. EPI dog has unique requirements and dietary needs that change over time. Managing pancreatic insufficiency requires enzymes, proper diet, trial and error, patience and support.
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Raw Diet and Home Cooked Meals
Many dogs with EPI thrive on raw diets and some owners find a raw diet is the only one that works for their dogs, however, other EPI dogs cannot tolerate a raw diet. You can prepare your own raw diet using any meat or poultry, plus organ meat, and finely ground or mashed vegetables. Always introduce only one change or addition at a time and monitor stool formation. If stool becomes loose, reduce or eliminate that particular protein, vegetable or ingredient from the diet. Some bone should be included, but according to EPI educator, Olesia Kennedy, "It's all about the poop! If the stools...have a lot of white to them, it means they are getting too much bone and cannot digest it."
You can also purchase frozen or fresh ready-made raw food diets at pet food stores, raw food coops or online.
Some veterinarians recommend an initial diet of a prescription or veterinary food, made with hydrolyzed ingredients, which are carbohydrates and proteins chemically broken down into tiny particles for easier absorption in the small intestine. These foods tend to be starch-based, and many EPI dog owners choose not to use prescription diets or to use them short-term, before switching to grain-free diets.
Many owners feed grain-free kibble and/or high quality canned dog food, some make home-cooked meals and others feed a combination of commercial and homemade. Pancreatic insufficiency diets require low fibre content, so EPI dogs do better on grain free commercial foods, whether dry kibble or canned dog food. When choosing a food, try to start with one that has around 4 per cent fibre and 12 per cent fat content, even though some dogs can tolerate more fat.
All dogs need some fat in their diet to properly maintain body and brain functions and keep their skin and coats from becoming dry, so once you establish that your EPI dog is receiving the proper amount of enzyme replacement in its diet, you may consider slowly increasing the fat content.
A recent change in feeding recommendations concerns dietary fat. In his 2003 EPI paper, Dr. Edward J. Hall stated that "there is experimental evidence to show that the percentage fat absorption increases the higher the percentage of fat that is fed. Therefore, current recommendations are merely to give a good quality food."
No matter how you decide to prepare your dog's food, it is best to thoroughly mix powdered pancreatic enzymes into the food and to soak the food and enzymes in warm water. This not only helps the enzymes penetrate all the food, it cuts down on painful mouth irritation experienced by dogs who come into direct contact with the dry enzymes.
Fresh porcine pancreas can also be used for the enzyme replacement therapy, but raw pancreas is not available or legal in all locations.
Wild salmon oil is used by many EPI owners to alleviate dry skin issues and because it is an excellent source of omega 3. Probiotics are another important addition to the EPI diet, especially since many EPI dogs have small intestinal bacteria overgrowth (SIBO) that is treated with antibiotics. Antibiotics destroy not only bad bacteria, but good bacteria and probiotics help maintain healthy intestinal flora.
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