Exocrine Pancreatic Insufficiency (EPI) in Dogs

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3 min read

Key takeaways

Exocrine pancreatic insufficiency (EPI) is a condition where the pancreas fails to produce sufficient enzymes for food digestion. 

  • EPI results from a lack of the pancreatic cells that are responsible for releasing digestive enzymes
  • Chronic pancreatitis, immune-mediated disorders, congenital underdevelopment, and cancer are potential underlying causes
  • Sometimes the underlying cause cannot be determined
  • Symptoms of EPI include weight loss despite a good appetite, foul-smelling greasy feces, diarrhea, flatulence, poor hair coat, and sometimes lack of appetite and vomiting
  • Diagnostics include physical examination and bloodwork (specifically enzyme and vitamin testing)
  • Treatment requires lifelong daily oral supplementation of pancreatic enzymes, and sometimes additional vitamin supplementation
  • Prognosis is typically good with appropriate treatment
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A closer look: Exocrine Pancreatic Insufficiency (EPI) in Dogs

The pancreas is an organ responsible for secretion of digestive enzymes into the intestine. It is also involved in production and secretion of insulin, which regulates blood sugar. If the pancreatic cells are damaged, these processes are interrupted, resulting in gastrointestinal symptoms which may progress into more severe disease if left untreated.

Most dogs affected by EPI have a good prognosis with appropriate treatment. Some dogs may have concurrent diabetes mellitus and have a poorer prognosis. Prompt veterinary consultation is advised for dogs showing symptoms consistent with EPI, as the prognosis may worsen over time.

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Risk factors

EPI is an uncommon condition in dogs, although German Shepherds and rough coated collies are most commonly affected.

Dogs with EPI may also have concurrent diabetes mellitus. These dogs may also have the following symptoms:

  • Increased thirst
  • Increased urination

The following factors are associated with EPI:

  • Immune mediated destruction of the pancreas
  • Chronic pancreatitis
  • Pancreatic hypoplasia (congenital underdevelopment of the pancreas)
  • Pancreatic cancer
  • Idiopathic (the cause cannot be determined)
  • Genetic predisposition

Possible causes

The cause of EPI is insufficient production of pancreatic digestive enzymes.These enzymes are secreted into the intestine to facilitate digestion, so poor digestion and inefficient nutrient absorption result.

Main symptoms

Testing and diagnosis

EPI is diagnosed via physical examination, medical history, bloodwork, and pancreatic function tests. Some of the specific lab tests used for diagnosis include a serum trypsin-like immunoreactivity, pancreatic lipase immunoreactivity, and evaluation of cobalamin (vitamin B12) and folate (vitamin B9) levels.

Steps to Recovery

Following a diagnosis of EPI, dogs require life-long, daily dietary supplementation of pancreatic enzymes. Typically the response to treatment is rapid (resolution of some symptoms within days to weeks of starting treatment).

Dogs that do not initially respond to treatment may require antibiotics, antacids, vitamin supplementation, and a special diet.

EPI is a lifelong condition requiring daily management. Prognosis is good with treatment, although some dogs may not respond to dietary supplementation alone and may require further treatment.

Dogs with concurrent diabetes mellitus often have a poorer prognosis.


EPI is not a contagious condition.

As EPI is associated with genetics and chronic pancreatitis, preventive measures include:

  • Avoid breeding dogs with EPI
  • Avoid fatty foods that may lead to pancreatitis

Staying up to date with routine exams and vaccinations increase overall health and improve the likelihood of early detection and treatment.

Is Exocrine Pancreatic Insufficiency (EPI) in Dogs common?

EPI is uncommon in dogs.

Typical Treatment

  • Dietary supplementation of pancreatic enzymes
  • Antibiotics
  • Diet change
  • Antacids
  • Vitamin supplementation


Jörg M. Steiner, Med Vet, Dr Med Vet, PhD, DACVIM-SAIM, DECVIM-CA, AGAF - Writing for Merck Veterinary Manual
Timoleon S. Rallis, DVM, PhD; Professor K. Adamama-Moraitou, DVM, DrMedVet - Writing for Veterinary Information Network®
Wendy Brooks, DVM, DABVP - Writing for Veterinary Partner
Jessica A. Morgan, DVM, Lisa E. Moore, DVM, DACVIM - Writing for dvm360®

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