Dogs with undiagnosed exocrine pancreatic insufficiency are typically brought to the veterinarian for chronic diarrhoea and weight loss despite having a ravenous appetite and consuming large amounts of food. Once diagnosed, a dog needs pancreatic replacement enzymes added to frequent small meals of highly digestible, grain-free food for the rest of its life. Most dogs with EPI respond positively to this regimen and live full, happy lives. For some dogs, however, no known treatments seem to work.
Identifying Exocrine Pancreatic Insufficiency
A healthy pancreas produces enzymes that break down food so nutrients can be utilised. EPI occurs when the pancreas no longer produces adequate amounts of these essential enzymes. Because dogs with EPI cannot digest food or use nutrients, they lose weight, have frequent, loose, foul-smelling stools containing undigested fat and exhibit other symptoms, both physical and psychological.
Diagnosis and Treatment
Some veterinarians have little experience with EPI, so a diagnosis may take awhile to emerge. In most cases, once diagnosed, dogs with EPI respond well to being treated with a combination of diet and replacement enzymes. With sufficient enzyme supplementation, symptoms usually begin to resolve within weeks, followed by gradual weight gain. For some dogs, enzyme replacement and other treatments do not succeed, and these dogs cannot gain weight or thrive.
Pancreatic enzymes are essential for treating and controlling EPI. Replacement enzymes do not have a cumulative effect; they only work for the one meal on which they are applied. Start with one teaspoon of powdered enzymes added to approximately one cup of “room temperature” food. After thoroughly mixing the enzymes and food together, let the concoction sit for 20 to 30 minutes before serving it. Once the dog eats the partially digested food, the enzymes continue to work internally to aid digestion.
EPI can also be treated with raw cow or pig pancreas instead of powdered enzymes, but finding raw pancreas may be difficult because of restrictive agricultural laws. If used, raw pancreas may be chopped into bite-size bits, frozen in freezer bags for up to three months, and thawed naturally at room temperature, never heated or microwaved. After thawing the pancreas, mix with high-protein, low-fat, low-fibre food.
Raw, Cooked, Canned or Kibble?
Some EPI dogs respond best to raw food diets and others do well eating grain-free dry kibble or canned food. Some people give dogs a combination of meat and dry food, but dry and raw foods are digested at different rates so feed only one kind of food at a time to prevent overwhelming your dog’s system. If possible, give the newly diagnosed EPI dog three to four small meals a day. Once the EPI is more under control, you may reduce feeding frequency.
Kibble and Canned Food
Foods with grains contain more fibre than EPI dogs can tolerate so if you choose to feed dry or canned food, use a grain-free food containing protein and sweet potato, potato, or, if necessary, brown rice. Try grinding hard kibble, before softening it with warm water before adding the enzymes and soaking for 20 to 30 minutes. This will allow the enzymes to cover and penetrate more of the food.
Raw Meat, Bone and Vegetables
For many EPI dogs, a homemade raw diet is a good choice. Introduce only one meat/protein at a time and to make sure the food is being digested, check stool formation. Ongoing loose stools may indicate food intolerance, so eliminate that protein and try another. EPI dogs need less bone in their raw diets than is customary, so if stool becomes white and crumbly, reduce bone content. Recommended vegetables are sweet potatoes, turnips, beets, carrot, squash and pumpkin. They should be steamed and finely mashed. Meats should be ground, combined with other ingredients such as vegetables and bone matter, and then incubated with enzymes for 20 to 30 minutes.
Premade Raw Meals
Pet food stores now sell prepared frozen raw meals. This makes it easier and less time-consuming, though more costly, to feed raw. Another option is dehydrated raw dog food from The Honest Kitchen, whose certified organic foods are made at an FDA-approved, human-food-producing facility.
Omega 3 Oils
Because some EPI dogs cannot tolerate a lot of fat, their skin and coats become dry and itchy. Wild Salmon Oil is used by many EPI dog owners who alternate between that and cold pressed, unrefined coconut oil.
Checking Poop to Measure Improvement
Finding out what can or cannot be fed is based on trial and error with each unique dog. In the end, it is all about poop because checking your dog's faeces is how you measure the progress your dog is making. How the poop is formed will let you know if treatment and diet are working to counteract the EPI.