The pancreas lies beside the duodenum, the first part of the small intestine. Its vital role in digestion is to secrete digestive enzymes, via pancreatic ducts into the intestines. These powerfully destructive enzymes break down protein, fat and carbohydrate. Not enough digestive enzymes leads to poor digestion and malabsorption conditions. Seepage of enzyme anywhere other than through the pancreatic duct directly into the lumen of the intestine causes intense and painful inflammation. The pancreas has additional hormonal roles secreting a variety of hormones including insulin into the blood stream.
While the exact causes of pancreatitis remain a mystery there is certainly a direct relationship between the severity of an attack and a high fat, low protein diet. There is also circumstantial evidence that certain drugs, including corticosteroids, diuretics and H-2 receptor antagonists such as cimetidine are associated with pancreatitis. Trauma to the pancreatic duct from physical injury may also cause enzyme seepage and painful, local inflammation. We see more cases in West Highland White Terriers than other breeds. Affected pets suffer extreme pain, tuck-up their bellies, vomit and develop signs of shock. In less severe instances an affected dog drops its front half into a resting position but is reluctant to drop its hind quarters, assuming a "prayer position". Milder pancreatitis causes lethargy, occasional vomiting and diarrhea.
The aim of treatment is to control pain, overcome the consequences of shock and reduce pancreatic activity. The latter is done by withholding food for a short period of time, feeding intravenously as a safe alternative. Unlike in people, antibiotics are rarely used in pets with pancreatitis. Corticosteroids are used only if there is clinical shock. When vomiting is controlled a low fat maintenance diet is given, usually in small frequent meals. High fat diets are avoided.
Exocrine Pancreas Insufficiency In Dogs - Epi
For still unknown reasons the pancreas may lose its ability to manufacture digestive enzymes. It is likely that this is an auto-immune condition in which the immune system attacks its own tissue. This is the most common cause of canine diabetes, in which the immune system destroys the ability of the pancreas to produce insulin.
Exocrine pancreas insufficiency is a particular problem in families of German Shepherds where it occurs as an inherited condition, beginning at less than two years of age. Scar tissue from previous episodes of pancreatitis may also trigger pancreas insufficiency. Affected dogs eat voraciously but lose weight. They become industrial-strength scavengers. They pass copious quantities of grey, cow-manure-like diarrhea.
Affected dogs are treated with commercially produced dried pancreatic extracts. Dogs with EPI should be fed supplements of fat soluble vitamins, especially vitamin E. In some circumstances antibiotics (metronidazole, oxytetracycline) and corticosteroids may be used.