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What is Maldigestion Disorder?

Maldigestion disorder in dogs, a condition also known as exocrine pancreatic insufficiency (EPI), is a relatively common disorder in canines.  The associated malabsorption of nutrients causes a loss in body condition of the host while the canine continues to remain hungry and eats ravenously.  

While this condition can occur in any canine breed, it is more common in German Shepherds, Collie breeds and English Setters and is believed to be genetic in nature.  The condition is treatable.

Maldigestion disorder, also known as exocrine pancreatic insufficiency (EPI), is defined as reduced secretion of pancreatic digestive enzymes by the exocrine portion of the pancreas into the intestines, reducing the appropriate digestion and absorption of food.

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Symptoms of Maldigestion Disorder in Dogs

As noted above, dogs afflicted with maldigestion disorder or exocrine pancreatic insufficiency cannot digest foods because they lack certain enzymes.  Here are some of the symptoms you would likely notice in your canine family member:

  • Diarrhea - often foul smelling
  • Fatigue
  • Flatulence (gas)
  • Increased appetite
  • Weight loss
  • Poor hair coat
  • Undigested fat in stools
  • Color and consistency of feces - usually an oily yellow-gray consistency


While there are a variety of malabsorption syndromes in small animals, maldigestion disorder or exocrine pancreatic insufficiency has two types.  

  • Inherited - The genes are a gift from their parents; the condition usually begins to show up between 1 and 4 years of age
  • Grumbling pancreatitis - Results from low grade, long-term pancreatic inflammation and usually shows up in older dogs ranging from approximately 4 to 8 years of age

As noted above, this condition can affect any canine breed but is more commonly found in German Shepherds, Collie breeds and English Setters and is believed to have a genetic basis with no gender predisposition.  The cause for EPI is the same in both types.

Causes of Maldigestion Disorder in Dogs

The cause of maldigestion disorder in dogs, as well as exocrine pancreatic insufficiency, is the lack of certain digestive enzymes secreted by the pancreas into the intestinal system where they are needed to properly digest food and absorb the needed nutrients.  The lack of these certain digestive enzymes is caused by damage to certain types of pancreatic cells, reducing their ability to manufacture the required digestive enzymes.  Certain enzymes responsible for controlling digestion of the various categories of nutrients in foods are:

  • Lipase - An enzyme which controls the digestion of fats  
  • Amylase - An enzyme which controls the digestion of starches
  • Trypsin and Chymotrypsin - Enzymes which control the digestion of proteins

If any of these enzymes are missing in your pet’s gut, then there will be undigested remains in the feces of the host.

Diagnosis of Maldigestion Disorder in Dogs

In order to arrive at an accurate diagnosis, your veterinary professional will need a good, thorough history from you.  This history should include:

  • Dietary regimen (food offered, snacks offered, frequency of feeding, amounts of feeding)
  • Report any changes in appetite and eating behaviors and duration of those changes
  • List the symptoms noted along with their severity and duration 
  • Health history and vaccinations if not readily available to your current treating vet
  • Any changes noted in the activity/energy levels of your pet. 

Your vet will do a physical examination and will order blood, urine and fecal sample testing.  There are many other health conditions and diseases which can have similar symptoms and your vet will need to rule them out to isolate the root or underlying cause. In this vein, he may wish to get imaging studies like radiography (x-rays), CT or MRI imaging to rule out other possible causes of the symptoms of which your canine family member is suffering.  Once he has collected and analyzed the results of his exam, your history and the testing modalities he has ordered, an appropriate treatment plan will be developed and initiated.

Treatment of Maldigestion Disorder in Dogs

The treatment plan will likely consist of a multi-level approach which will include:

  • Need to address the actual enzymes identified as missing in your pet’s digestive process 
  • Dietary changes which will include the type of food being given to your pet 
  • Perhaps the frequency of feeding that food.  

Once the missing enzymes have been identified, replacement of those missing enzymes will need to be implemented.  This can be done with a supplement which is available as powder, capsule and tablet forms.  Mixing the supplement with the food is the best way to get it into your pet’s system - this makes the powder the most convenient but the tablets can also be crushed and mixed with the food and the capsules can be opened and the contents sprinkled into the food - your vet will advise you of the appropriate dosing and method of infusing it into the dietary regimen.

An appropriate food will be recommended to be fed. This dietary change will be based upon the enzyme and the nutrient type which is not being digested; you might have to change to a low fat, or a low carb, or a lower fiber diet for example.

Smaller and more frequent meals may be required to ease the load on the digestive system and to get the supplements into the system more efficiently. For example, you might have to feed your pet three times a day instead of once a day, being sure to include the supplement with each meal.

Recovery of Maldigestion Disorder in Dogs

Recovery and prognosis for your pet diagnosed with and suffering from maldigestion disorder in dogs is generally good if the condition is identified and treated appropriately and in a timely manner.  The vet will be concerned about improving the malnutrition condition of your pet, bringing him back to a relatively normal level of nutritional health.  This will likely be done with dietary changes, the addition of enzyme supplementation and home routine changes.  

Over time, your pet’s condition should improve and you should begin to see a healthier version of your doggy family member return to you. Be prepared for the supplementation of the pancreatic digestive enzymes and the dietary changes to become a “new normal” for your pet for the rest of his life.

Maldigestion Disorder Questions and Advice from Veterinary Professionals

Catahoula mix
13 Years
Moderate condition
0 found helpful
Moderate condition

Has Symptoms

blood & mucus in stool, diarrhea ga
blood & mucus in stool, diarhea gas
blood & mucus in stool, diarhea ga

We have an older dog, a catahoula mix, age 13. Not sure if it's possible to develop this at such a late age?

He's a hound so has and is always ravenous for any possible food, ha! But for the past two months, he's had horrible gas. The gas disappears and it's diareah with straining. We have had him tested for giardia and other parasites. He has been on flagyl and had W/D diet. His stools firm up a LITTLE, but still the next day he'll have diarrhea. It is mucousy and sometimes has blood. We also had bloodwork done, and all came back well. He has sore hips and I gave him the supplment Duralactin, but not for over a month. I thought maybe it was a lactose thing...he does have a sensitive the fact that this is still happening makes me think this couldn't be lactose sensitivity. I just want to get to the bottom of what is causing this. We hadn't changed his diet at all before this. (Nutro all natural). After, we tried cooking for him (sweet potatoes, chicken, rice, etc). It didn't make a difference. We are down to his last day of W/D and no answers or real improvement. PLEASE HELP!!

Dr. Michele King, DVM
Dr. Michele King, DVM
1093 Recommendations
Given Bocephus's age, it might be a good idea to have an ultrasound done to evaluate his intestinal tract for signs of inflammation or thickening that may indicate disease or cancer. Since he has not responded to any common treatments that should help, it might be time to start looking for uncommon things. I hope that he does well.

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Border collie/ golden retriever mix
4 Months
Mild condition
0 found helpful
Mild condition

Has Symptoms

Soft stools/liquid stools

I have a 4mo old border collie/golden retriever mix. He and his litter mates were dumped and on the streets until we adopted him.

He’s had loose stools to diarrhea since we got him a month ago. They won’t firm up. We’ve changed his food, a vet friend of mine put him on flagyl a week ago with no real change.

She said it could be maldigestion and recommended another dietary change to gastro medicine that cost $75 a bag. OUCH!!

Based on the description on this website (usually begins 1 year or older, fatigue, ravenous eating, etc...).

Those don’t sound like my puppy. He has crazy energy, grazes when eating food (the only ravenous eating is socks and paper), he passes gas the same as my other dogs, and his diarrhea comes on he schedule of normal excretion. He doesn’t randomly poop like he can’t hold it. He is on the thin side but not losing weight. i would attribute that to his activity level.

Could this still be maldigestion? Do you see maldigestion in 4 mo old puppies?

Dr. Michele King, DVM
Dr. Michele King, DVM
1093 Recommendations
I see parasites more commonly in puppies than maldigestion, for sure. A fecal test and a test for Giardia would be a good idea to rule out any parasites that are common in puppies, including Coccidia. I hope that all goes well for him.

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Labrador Retriever
7 Years
Moderate condition
0 found helpful
Moderate condition

Has Symptoms

fatty stools
Weight Loss
Increased Appetite
Hair Loss

My vet believes our dog has maldigestion disorder. She wants us to do a blood test that costs $220. My dog has every symptoms of this disorder and my question is whether or not it is necessary to complete the $220 test? Can't we just treat her for this disorder and rule out this disorder through changes in symptoms in response to supplements?

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
2507 Recommendations
Your Veterinarian is looking to confirm the diagnosis before managing the maldigestion disorder, whilst it is possible to to give the digestive enzymes and monitor for improvement it seems that your Veterinarian is looking for confirmation. I cannot speak on their behalf and you should discuss with them about it. Regards Dr Callum Turner DVM

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