Exocrine Pancreatic Insufficiency (EPI) in Cats

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Last updated on
2 min read

Key takeaways

Exocrine pancreatic insufficiency (EPI) is a disorder in which there is insufficient synthesis or secretion of digestive enzymes from the pancreas to the intestine. 

  • In cats, this is most commonly caused by damage to the pancreatic glands from chronic inflammation (pancreatitis)
  • Symptoms include loose, greasy, and mucousy stools, weight loss, and excessive appetite
  • Diagnostics include physical examination, blood work, pancreatic enzyme assessment, and cobalamin and folate level testing
  • Treatment primarily involves oral pancreatic enzyme supplementation and cobalamin supplements if B12 levels are low
  • EPI is an uncommon condition which has a good prognosis
  • If diabetes is also present, the prognosis is poor
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A closer look: Exocrine Pancreatic Insufficiency (EPI) in Cats

Exocrine pancreatic insufficiency is usually a secondary condition that develops as a result of ongoing inflammation in the pancreas (pancreatitis). Prolonged inflammation leads to tissue damage which prevents the pancreatic glands from effectively secreting digestive juices into the intestine.

Additional symptoms may be associated with chronic pancreatitis, since it’s the most common cause of EPI.

These symptoms are often vague, subtle, and intermittent.

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Risk factors

This condition is uncommon in cats but is the second most common pancreatic disorder.

Symptoms usually develop gradually over time and do not present an emergency.

Management of associated conditions is critical for successful treatment of EPI.

Possible causes

The primary cause of EPI is destruction of the pancreatic glands secondary to chronic inflammation (pancreatitis).

Main symptoms

Testing and diagnosis

After a physical examination and medical history, a number of blood tests are ordered, typically followed by diagnostic imaging in order to diagnose EPI.

Steps to Recovery

Once EPI is confirmed, treatment includes

  • Oral supplementation of pancreatic enzymes for the remainder of life
  • Cobalamin supplementation in the case of lowered B12 levels
  • Dietary modification

Conditions contributing to a good prognosis include:

  • Early diagnosis
  • Compliance with treatment recommendations
  • Aggressive management for chronic pancreatitis

EPI occurring along with diabetes mellitus has a poor prognosis.


Monitoring for symptoms of pancreatitis and treating early symptoms is the best way of preventing EPI formation. EPI is not contagious. Maintaining a healthy diet and weight management also help reduce occurrence of associated nutritional and metabolic disorders.

Is Exocrine Pancreatic Insufficiency (EPI) in Cats common?

EPI is uncommon in cats.

Typical Treatment

  • Supplementation of pancreatic enzymes
  • Cobalamin supplementation
  • Dietary modification


Jörg M. Steiner - Writing for Merck Veterinary Manual
Timoleon S. Rallis, Adamama-Moraitou - Writing for Veterinary Partner
Wendy Brooks - Writing for Veterinary Partner
Jessica A. Morgan - Writing for dvm360®

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