Exocrine pancreatic insufficiency

EPI, Exocrine Pancreatic Insufficiency, is the inability of the acinar cells of the exocrine pancreas to produce and secrete the necessary enzymes needed to digest food. These main enzymes are:.

  • Amylase for digestion of carbohydrates (sugars & starches in grains, fruits & vegetables),      
  • Lipases for digestion of fat.                                          
  • Trypsin and Proteases for digestion of proteins.

EPI, is sometimes referred to as Pancreatic Hypoplasia or Pancreatic Acinar Atrophy (PAA).  

Or EPI can also be the secondary condition of a chronic illness, such as chronic pancreatitis. 

EPI is when a dog’s exocrine part of the pancreas is atrophied and can no longer produce these  pancreatic digestive enzymes. Some food particles then remain undigested causing SIBO and unabsorbed resulting in a dog, who although is eating copious amounts of food, is constantly undernourished and can literally waste away. Without proper treatment, the EPI dog cansuffer greatly and even die a painful death from malnourishment, starvation or organ failure. 

With EPI, organ, immune, nervous and all other body systems may become compromised to one degree or another.   A lack of nutrients sometimes even results in temperament changes which may express themselves in fear and/or aggression. 

It is a devastating, frustrating disease that is all too often misdiagnosed. Symptoms usually do not appear until anywhere between 80% and 95% of the exocrine pancreas acinar cells are destroyed. What makes this disease even harder to diagnose is that not all dogs display any or all of the symptoms all of the time. Any breed can have EPI, not just GSDs… see

Common Symptoms

The most common symptoms are:

  • Gradual wasting away despite a voracious appetite
  • Eliminating much more frequently, sometimes every hour or two
  • Stools are greasy voluminous yellowish cow-plops, but sometimes grayish
  • Eating their own stools, or other inappropriate substances
  • Increased rumbling sounds from the abdomen
  • Increased passing amounts of flatulence
  • Some dogs do not show any typical signs
  • Some experience intermittent watery diarrhea or vomiting
  • Some dogs even display personality changes such as fearfulness or sudden aggression


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