ISSN 2398-2950      

Exocrine pancreatic insufficiency

ffelis

Synonym(s): EPI


Introduction

  • Much rarer in cats than in dogs but a few reports of exocrine pancreatic insufficiency (EPI) exist in cats.
  • Cause: absence of pancreatic exocrine secretion   →   maldigestion.
  • Signs: weight loss, diarrhea and steatorrhea and polyphagia.
  • Diagnosis: low trypsin-like immunoreactivity (TLI), not well documented.
  • Treatment: enzyme replacement, low fat, low fiber diet, +/- H2 antagonists or proton pump inhibitors, +/- antibiotics and vitamin supplementation.
  • Prognosis: reasonable with lifelong treatment but guarded if seen in association with diabetes mellitus.
    Print off the owner factsheet on Exocrine pancreatic insufficiency (EPI)  Exocrine pancreatic insufficiency (EPI) to give to your client.

Pathogenesis

Etiology

Pathophysiology

  • Chronic pancreatitis   →   loss of 90% of exocrine pancreatic tissue   →   lack of pancreatic digestive enzymes   →   maldigestion, particularly of fat (pancreatic lipase).
  • Malabsorption of fat soluble vitamins, eg vitamin K   →   weight loss, polyphagia, diarrhea and coagulopathies in some cases.
  • Also malabsorption of vitamin B12   →   metabolic consequences of vitamin B12 deficiency.

Timecourse

  • Gradual weight loss over months.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Toresson L, Steiner J M, Olmedal G, Larsen M, Suchodolski J S, Spillmann T (2017) Oral cobalamin supplementation in cats with hypocobalaminaemia: a retrospective study.J Feline Med Surg 19(12),1302‐1306 PubMed.
  • Thompson K A, Parnell N K, Hohenhaus A E et al (2009) Feline exocrine pancreatic insufficiency: 16 cases (1992-2007). J Feline Med Surg 11 (12), 935-940 PubMed.
  • Steiner J M & Williams D A (1999) Feline exocrine pancreatic disorders. Vet Clin North Am Small Anim Pract 29 (2), 551-575 PubMed.
  • Browning T (1998) Exocrine pancreatic insufficiency in the cat. Aust Vet J 76 (2), 104-106 PubMed.
  • Steiner J M & Williams D A (1997) Feline exocrine pancreatic disorders - insufficiency, neoplasia and uncommon conditions. Comp Cont Ed 19 (7), 836-48 VetMedResource.

Other sources of information

  • Simpson J W & Else R W (1991) Diseases of the exocrine pancreas. In: Digestive Disease in the Dog and Cat.pp 198-303. Oxford. Blackwell Scientific Publications.

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