Disorders of the exocrine pancreas consist mainly of loss of functional mass of the pancreas in exocrine pancreatic insufficiency, or due to inflammation or pancreatitis. Clinical signs in cases of pancreatic insufficiency occur when there is a loss of at least 90% of the mass of the exocrine pancreas. This damage may be due to atrophy or chronic inflammation and results in a decrease in pancreatic enzymes in the intestine, which causes malabsorption and poor digestion of nutrients, in specifically fats, proteins and carbohydrates.
The treatment consists of the administration of pancreatic enzymes that fulfill the function of those that would normally be produced by a he althy pancreas. Keep reading this article on our site to learn everything about Exocrine pancreatic insufficiency in dogs, its symptoms and treatment.
What is exocrine pancreatic insufficiency?
Exocrine pancreatic insufficiency is called the inadequate production and secretion of digestive enzymes in the exocrine pancreas, that is, the pancreas does not have the ability to secrete enzymes in the right amount for proper digestion.
This leads to malabsorption and poor assimilation of nutrients in the intestine, causing an accumulation of carbohydrates and fats in it. From here, bacterial fermentation, fatty acid hydroxylation and bile acid precipitation can occur, which makes the medium more acidic and causes bacterial overgrowth
Symptoms of exocrine pancreatic insufficiency
Clinical signs occur when there has been damage greater than 90% of the exocrine pancreatic tissue, and the most frequently found in cases of exocrine pancreatic insufficiency in dogs are:
- Frequent bulky stools.
- Diarrhea.
- Flatulence.
- Steatorrhea (fatty stool).
- More appetite (polyphagia) but weight loss.
- Vomiting.
- Hair bad appearance.
- Coprophagia (stool swallowing).
During palpation you can feel the dilated bowel loops, with borborygmus.
Causes of exocrine pancreatic insufficiency in dogs
The most common cause of exocrine pancreatic insufficiency in dogs is chronic acinar atrophy, followed by chronic pancreatitis. In the case of cats, the latter is more common. Other causes of exocrine pancreatic insufficiency in dogs are tumors of the pancreas or outside of the pancreas causing an obstruction in the pancreatic duct.
Genetic predisposition of the disease
This disease is hereditary in the following dog breeds:
- German shepherd.
- Long-haired border collie.
Instead, it is more frequent in:
- Chow chow.
- English Setter.
The age of greatest risk for it is between 1 and 3 years of age, while in English setters in particular it is a 5 months.
Diagnosis of exocrine pancreatic insufficiency
In the diagnosis, in addition to taking into account the dog's symptoms, non-specific or general tests and other more specific ones must be carried out.
General Analytics
Within the general analyses, the following will be carried out:
- Blood tests and biochemistry: generally no significant changes will appear, and if they do appear they are mild anemia, cholesterol and low protein.
- Coprological exam: should be performed serially and with fresh stools to detect the presence of fat, undigested starch granules and muscle fibers.
Specific tests
Specific tests include:
- Measurement of serum immunoreactive trypsin (TLI): which measures trypsinogen and trypsin entering the circulation directly from the pancreas. In this way, the exocrine pancreatic tissue that is functional is indirectly evaluated. Canine species-specific tests are used. Values less than 2.5 ng/mL are diagnostic of exocrine pancreatic insufficiency in dogs.
- Fat absorption: it will be done by measuring the lipemia (fat in the blood) before and for three hours after administering vegetable oil. If lipemia does not appear, the test is repeated but incubating the oil with pancreatic enzyme for up to one hour. If lipemia appears, it indicates poor digestion, and if not malabsorption.
- Absorption of vitamin A: it will be performed by administering 200000 IU of this vitamin and it is measured in the blood between 6 and 8 hours after. If there is an absorption of less than three times the normal value of this vitamin, it indicates malabsorption or poor digestion.
Whenever this disease is suspected, you should measure vitamin B12 and folate. High levels of folate and low levels of vitamin B12 confirm an overgrowth of bacteria in the small intestine possibly related to this disease.
Treatment of exocrine pancreatic insufficiency
Treatment of exocrine pancreatic insufficiency consists of administration of digestive enzymes throughout the dog's life. These can come in powder, capsules, or tablets. However, once they improve, the dose can be lowered.
On some occasions, despite the administration of these enzymes, the absorption of fats does not take place correctly due to the pH of the stomach, which destroys them before acting. If this occurs, a stomach protector such as omeprazole should be given once daily.
If there is a vitamin B12 deficiency, it should be supplemented appropriately according to the dog's weight. Whereas in a dog under 10kg you would need up to 400mcg. If you weigh between 40 and 50 the dose will amount to 1200 mcg of vitamin B12.
Before, a low-fat, highly digestible, low-fiber diet was recommended, but today it is enough for it to be a digestible dietLow fat would only be recommended if the enzymes are not enough. Rice, as a source of easily digestible starch, is the cereal of choice in dogs with exocrine pancreatic insufficiency.
