Exocrine Pancreatic Insufficiency in Dogs

Exocrine Pancreatic Insufficiency in Dogs - Symptoms, Causes, Diagnosis, Treatment, Recovery, Management, Cost

What is Exocrine Pancreatic Insufficiency?

The condition EPI is best explained as a lack or absence of vital enzymes in your dog’s digestive system that would usually break down the food eaten into small enough pieces to allow smooth digestion. Without these vital enzymes, the food is not broken down small enough to be absorbed through the intestinal wall. As a result, the undigested food is excreted in the feces and your dog literally starves. Even though your dog may be constantly eating, he is getting no nourishment at all from the food.

Due to the lack of cellular functioning within the pancreas to produce enzymes to break down your dog’s food for absorption, your dog risks starving. This condition is known as exocrine pancreatic insufficiency.

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Symptoms of Exocrine Pancreatic Insufficiency in Dogs

  • This condition causes digestive and stomach problems leading to intestinal overgrowth of bacteria 
  • Weight loss even though your dog seems to eating plenty or has an increased appetite
  • Coprophagia which is a condition which causes your dog to eat its own stool
  • Chronic diarrhea
  • Weight loss
  • Lethargy
  • Loud rumbling sounds from the stomach
  • Frequent bowel movements
  • Frequent gas 


  • Exocrine pancreatic insufficiency in your dog is a result of the pancreas’ failure to produce the digestive enzymes need for proper food digestion 
  • For digesting starches and sugars an enzyme called amylase is needed 
  • These enzymes are lipases which digest fats 
  • Proteases enzyme is needed for proteins
  • Without enough of these vital enzymes, your dog will starve as the food will pass through him without the vital nutrients being used as the enzymes break down the food in order for the nutrients to be absorbed

Causes of Exocrine Pancreatic Insufficiency in Dogs

The causes can be traced to several potential elements. 

  • Inflammation of the pancreas (chronic pancreatitis) is one common cause
  • At a young age (up to 2 years old) in some cases,the pancreas just stops producing cells and decreases functionality – the reason has not yet been determined as to why
  • While no one is really sure of the reason, it has been suggested that it is an inherited condition
  • It seems to be more common in large dog breeds such as German Shepherds

Diagnosis of Exocrine Pancreatic Insufficiency in Dogs

Diagnosis is hard to pin point for this condition. Often it takes up to 90% of the pancreas to be destroyed before this condition is diagnosed. If your dog is eating feverishly yet starting to look gaunt, their body and muscle tone is slack, and your dog has very loose, often cow-patty style stools, then those symptoms need to be heeded. Your veterinarian will examine your dog and there are a number of tests that he can do to determine the cause of your dog’s ill health. 

These tests include blood tests, chymotrypsin activity measurement, analysis of the digestive enzymes levels that are present in the feces, and analysis of the feces under a microscope. The most effective test is the blood test which will show the level of enzymes present in the blood and is the best way to diagnose this condition. While the cause of this disease or condition is not really understood, and there is no cure as such for this problem, there are treatment measures that will help to balance your dog’s digestion and return him to good health.

Treatment of Exocrine Pancreatic Insufficiency in Dogs

While there is no cure for this condition, there is help available to assist your pet to overcome this debilitating disease. Your veterinarian is your first port of call and he will assist you to treat your dog. Usually the treatment includes supplements of pancreatic enzymes that you can add to your dog’s food. These targeted supplements can be in a powder form or come in capsules or tablets. The enzymes will start to assist your dog to break down the food he eats to get the much-needed nutrients. 

Because of your dog’s condition, your specialist may change the dietary components for your dog. The digestive system has been under a lot of stress, so replacing the high fat diet to an easy to assimilate diet will allow healing to occur. A low fat and low fibre diet will help your dog to digest the food and an antibiotic will control the bacteria that has been thriving in the gut. As the treatment takes effect, you will notice a change in your dog’s behavior as he is now getting the nourishment he needs, and he will lose that almost desperate driven behavior to fill his dietary needs.

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Recovery of Exocrine Pancreatic Insufficiency in Dogs

Ongoing management of this condition is vital to the health of your dog. A diet that is easy to digest and yet provides sufficient nourishment is essential. Your veterinarian will advise of ongoing treatment, and will need to check your dog’s progress from time to time. Once the treatment is administered and has taken effect, your dog’s behavior will become calmer and quieter. As vital nutrients are finally getting into his system, your dog will lose that gaunt look and his body will fill out and look healthier.

The problems with loose stools and stomach grumbles will cease and your dog’s hair coat will soon recover from dry and brittle to a shiny healthy look. With your dog now getting nourishment, he will stop eating everything in sight. With your veterinarian checking your dog’s progress, and adjusting the supplements, life will return to normal for your canine friend.

Paying to treat EPI out of pocket can be a major financial burden. Fortunately, most pet insurance companies reimburse claims within 3 days, putting 90% of the bill back in your pocket. In the market for pet insurance? Compare leading pet insurance companies to find the right plan for your pet.

Exocrine Pancreatic Insufficiency Questions and Advice from Veterinary Professionals


Labrador Retriever




9 Years


2 found this helpful


2 found this helpful

My pet has the following symptoms:
Not Eating
Sleeps Alot
Weigh Loss
Bleeding Gum
Jaw Paralysis
Hi iv been reading all these stories and they are all very familiar with my dog. I have a 9 year old lab mix. Although we have been to the vet numerous times finally diagnosed her with epi few weeks ago. I haven’t seen much improvement. She stopped eating so it’s hard to get her to eat the enzymes. Even have offered table food to get her to eat something but she started bleeding a lot from her gums recently and it’s really scary. She has filled an entire food bowl of just blood. I checked her mouth and saw her gums were inflamed so I assume that’s where the blood is coming from. She has been on every medication that could be prescribed for epi on top of weekly b12 shots. She has also developed jaw paralysis so she can’t close her jaw and drools a ton! She was a 50 lbs dog and now weighs under 30 lbs. it’s been a rough few months with her and all I see is her declining. I feel as though shes too far gone for her to make a dramatic recovery. Iv asked her vet what she thought we should do next and she suggested bringing her in again. My gut feeling says that I should put her down and stop the suffering. She can barely walk, eat, can barely get up and down stairs. It hard to see her this way and it’s hurts to see. My question is, could she make a complete recovery from this or should I go with my gut feeling. How anyone experienced there dog making a huge recovery from this?! I haven’t read a case that is as bad as mine. I’m so torn and I can’t stand seeing her this way. I know she’s uncomfortable and not happy!

April 6, 2018

2 Recommendations

Each case is different and without examining TK I cannot say how severe her case is; if she isn’t wanting to eat the digestive enzymes you can try to give some chunks of raw pancreas which you should be able to get from a local butcher to see if there is any improvement and whether she takes to it more. I understand she is weak, but it is one last thing to try before returning to your Veterinarian. Regards Dr Callum Turner DVM

April 6, 2018

My vet ex my dog with EPI, today. What is the life expectancy of my GSP?

April 17, 2018

Laura E.

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Australian Shepherd


Harry Potter


13 Years


0 found this helpful


0 found this helpful

My pet has the following symptoms:
Severe Diarrhea Gas Stomach Grumble
My Australian Shepherd has been struggling with intermittent diarrhea with gas and stomach upset since the end of October. There has not been vomiting. We have seent the vet several times. We have completed abdominal X-rays, blood chem panel, cell count, in office feces tests and recently sent a feces test off to the lab for further in depth analysis. Every test is negative and within normal range. He was slightly anemic ( 1% below normal) and his glucose level was slightly up-however our vet felt it was so minimal and typical due to general vet visit anxiety. We have had him on cimetidine, sucralate, metronidazole and Fortiflora in this food. At that pint the diarrhea and stomach upset seemed to subside. After the 2 week treatment ended the diarrhea was back. We tried just the cimetidine and sucralate with Fortiflora or kefir on his good thinking possible ulcer or stomach issue but the diarrhea would come back intermittently every few days. While sending the fecal test out we want back to the metronidazole and FortiFlora. Immediately, the diarrhea has cleared its now been several days. It has cleared three times when the metronidazole is given but I fear it may come back when this round of treatment ends. He typically eats well. If the diarrhea is about to start he will be cautious. He will eat poop if I don’t watch him. He has been a begger his entire life although rarely given scraps and never since this has started. I’m am concerned this could be the issue. What specific tests should we try next? Is there an antibiotic treatment that could be given longer term. The vet is leary of continuing metronidazole after this round which he wants to extend another two weeks to a full 21 days. Any suggestions or insight would be so appreciated. When the diarrhea is under control he is is normal self.

Jan. 4, 2018

0 Recommendations

This is not a simple case of switching to a different antibiotic for a long term solution, if an infection is suspected a sample should be taken for culture and sensitivity so that we know what we are working with specifically; metronidazole is an antibiotic and antiprotozoal medication so identification of a specific bacteria or parasite is important to assist with an effective treatment. Offering digestive enzymes or giving a few chunks of fresh pancreas each day may help if pancreatic disorders are suspected, however a more long term solution to antibiotic therapy needs to be found. Regards Dr Callum Turner DVM

Jan. 4, 2018

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