How is Exocrine Pancreatic Insufficiency diagnosed and treated?
Exocrine Pancreatic Insufficiency (EPI) is diagnosed by a blood test (TLI). The TLI test looks for trypsin-like enzymes in the bloodstream. An EPI affected dog will have almost no TLI in the bloodstream. The dog must be fasted before the blood is drawn but unlike the faecal test only one blood test is required to make a diagnosis. Another popular test is a faecal protease test. A stool sample is taken and tested for protein digesting enzymes. Fasting is not required for this test but three consecutive samples are required to obtain a consistent result due to the large variability in faecal enzyme activity. Another faecal test, tests for elastase. Only one sample is required. However, sometimes normal dogs will test negative for elastase. This means that EPI can be ruled out when the elastase test is positive but not confirmed when the elastase test is negative.
Generally treatment for EPI involves supplementation of the dog with digestive enzymes, this is an effective treatment. Generally, treatment continues for the rest of the dogs life or symptoms are likely to return. A change in diet may also be a good idea. Generally, in EPI patients, a diet with foods that are low in fibre and fat are useful for dogs that have trouble gaining weight. EPI dogs commonly have a secondary condition - a bacterial overgrowth in their intestines. This usually results in a vitamin B-12 deficiency as the bacteria consume this vitamin before the animal can. A course of antibiotics usually corrects the overgrowth problem along with vitamin B-12 supplementation.