jpy
08-09-2001, 11:29 AM
LAST EDITED ON Aug-09-01 AT 01:02PM (PST)[p]This post could as well go in H&W as well as diet, but since it's about changing diets when there is an lack of enzymes I thought it might get read more often here. The below is a short summary of what exocrine pancreas insufficiency (EPI) looks like, which seems to be more common in Danes than may often be recognized (by vets, breeders & owners). Two other related problems are PPA: Pancreatic Acinar Atrophy, particularly common in GSD(Shepherds) and CSID: Small Intestinal Disease, a sort of in-between/less severe problem from pancreas and/or small intestine dysfunction.
SYMPTOMS of EPI/PPA/CSID: A history of weight loss and/or poor weight gain in a puppy. Soft voluminous stools are common, sometimes combined with on-n-off again unformed stools & even diarrhea (watery, even explosive). Vomiting,a "rumbly" gut and flatulence (farting) are not uncommon. The dogs often appear extremely hungry and may be described as a food thief, but can have an appetite that comes & goes. Dogs with EPI may eat stools & other non-food items. Many are called "thirsty" (especially when diabetes develops, which it can in dogs with chronic pancreas problems). There is often a poor haircoat & the dog is at least mildy underweight. It's typically something diagnosed when a young adult.
AT THE VET's: The usual bloodwork is normal & the above history doesn't translate into any obvious illness (many problems have some of the above symptoms with very different causes), so it's not an "obvious" diagnosis. It might be that lipids (e.g.cholesterol) may be LOW. There is a specialty test that can confirm severe (established) cases of EPI called the TLI (Trypsin-Like Immunoreactivity) test. It's a blood test (serum) that looks for a protein (trypsinogen) that is exclusively made by the pancreas & a lack of this substance indicates a diagnosis of canine EPI. (Note: some false positive occur; that is some dogs will have "bad gut days" where they have a low TLI score, but a repeat test on a normal dog would be in normal ranges.) Food should be withheld prior to the test. There is also a fecal test (fecal proteolytic activity) but the reliability varies, but dogs with EPI will have low activity.
WHAT TO DO: Get a veterinarian's assessment. Dogs with EPI/PAA/CSID are usually treated with vitamin//mineral & enzyme supplements. Kzymes & PetTabs for example are simply added to the diet & diet is assessed. A good quality, highly digestible, low-fiber diet is recommmended. This is usually combined with a quality enzyme & vitamin supplement. This dietary regime results in control of the diease & therefore usually results in improved overall health. Note that high-fiber diets should be avoided and that dogs with EPI, et. al. can have severe deficiencies of cobalamin (B12) & tocopherols (like vitamin E), and even Vit K, which is why some sort of vitamin/mineral supplement is usually necessary. Antibiotics may be necessary as these dogs commonly have an overgrowth of bacteria in the small intestine, which can, from time to time, cause obvious illness. Flagyl or Albon are typically prescribed until diet changes can help regulate the underlying problem.
WHAT THIS IS: This is a problem of the dog's own pancreas not producing enough of the proper varieties of digestive enzymes necessary to break down food products into forms usuable to enter thru the gut & be used by the body. The symptoms vary with diet fed (amount, kind, etc.) as the kind & amount of enzymes not only vary from dog to dog, but time to time. The lack of proper food absorption results in the typical symptoms of poor weight, poor haircoat & voluminous stools. Since severe cases respond to treatment with steroid & the problem results from a loss of (exocrine)glands, the cause may be related to immune dysfunction & be autoimmune in nature. Autoimmune diseases are genetically based and commonly become clinical problems thru various enviromental triggers. These sorts of pancreatic problems appear to be familial, although the inheritance mode is currently unknown.
SYMPTOMS of EPI/PPA/CSID: A history of weight loss and/or poor weight gain in a puppy. Soft voluminous stools are common, sometimes combined with on-n-off again unformed stools & even diarrhea (watery, even explosive). Vomiting,a "rumbly" gut and flatulence (farting) are not uncommon. The dogs often appear extremely hungry and may be described as a food thief, but can have an appetite that comes & goes. Dogs with EPI may eat stools & other non-food items. Many are called "thirsty" (especially when diabetes develops, which it can in dogs with chronic pancreas problems). There is often a poor haircoat & the dog is at least mildy underweight. It's typically something diagnosed when a young adult.
AT THE VET's: The usual bloodwork is normal & the above history doesn't translate into any obvious illness (many problems have some of the above symptoms with very different causes), so it's not an "obvious" diagnosis. It might be that lipids (e.g.cholesterol) may be LOW. There is a specialty test that can confirm severe (established) cases of EPI called the TLI (Trypsin-Like Immunoreactivity) test. It's a blood test (serum) that looks for a protein (trypsinogen) that is exclusively made by the pancreas & a lack of this substance indicates a diagnosis of canine EPI. (Note: some false positive occur; that is some dogs will have "bad gut days" where they have a low TLI score, but a repeat test on a normal dog would be in normal ranges.) Food should be withheld prior to the test. There is also a fecal test (fecal proteolytic activity) but the reliability varies, but dogs with EPI will have low activity.
WHAT TO DO: Get a veterinarian's assessment. Dogs with EPI/PAA/CSID are usually treated with vitamin//mineral & enzyme supplements. Kzymes & PetTabs for example are simply added to the diet & diet is assessed. A good quality, highly digestible, low-fiber diet is recommmended. This is usually combined with a quality enzyme & vitamin supplement. This dietary regime results in control of the diease & therefore usually results in improved overall health. Note that high-fiber diets should be avoided and that dogs with EPI, et. al. can have severe deficiencies of cobalamin (B12) & tocopherols (like vitamin E), and even Vit K, which is why some sort of vitamin/mineral supplement is usually necessary. Antibiotics may be necessary as these dogs commonly have an overgrowth of bacteria in the small intestine, which can, from time to time, cause obvious illness. Flagyl or Albon are typically prescribed until diet changes can help regulate the underlying problem.
WHAT THIS IS: This is a problem of the dog's own pancreas not producing enough of the proper varieties of digestive enzymes necessary to break down food products into forms usuable to enter thru the gut & be used by the body. The symptoms vary with diet fed (amount, kind, etc.) as the kind & amount of enzymes not only vary from dog to dog, but time to time. The lack of proper food absorption results in the typical symptoms of poor weight, poor haircoat & voluminous stools. Since severe cases respond to treatment with steroid & the problem results from a loss of (exocrine)glands, the cause may be related to immune dysfunction & be autoimmune in nature. Autoimmune diseases are genetically based and commonly become clinical problems thru various enviromental triggers. These sorts of pancreatic problems appear to be familial, although the inheritance mode is currently unknown.