Exocrine Pancreatic Insufficiency in Dogs

Dr. Lera talks about exocrine pancreatic insufficiency with Milky Way, a six-year-old Maltese Mix.
Exocrine pancreatic insufficiency (EPI) is the inability to produce sufficient pancreatic enzymes to digest fats, carbohydrates, and proteins. This difficulty in digestion leads to poor absorption of nutrients which commonly causes weight loss despite a normal or increased appetite. Affected dogs often have large volumes of pale, fatty feces. This condition is called steatorrhea or fat in the stool.
The causes can be congenital (present from birth), inherited (genetic), or acquired as the result of pancreatic infection, inflammation, or injury. The condition is seen more commonly in Chow Chows, Cavalier King Charles Spaniels, Rough-Coated Collies, and German Shepherd Dogs. The main cause appears to be a progressive loss of pancreatic cells but chronic pancreatitis can also result in EPI. (source: VCA Hospitals)
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[@Pathologymadesimple]

When an astrophysicist names his dog It has to be Milky Way 😁😁😆 I still remember the poop of EPI dogs😂 No words to describe

[@claudiamolina6623]

Very informative

[@DrLera]

Glad you think so, thanks for watching!

[@dawn881]

excellent video for any one who is dealing with a pupp or dog that has chronic diarrhea and you are unclear where its coming from. will go to my vet fully loaded with questions and information. thank you so much

[@joseandiel1586]

Wish we had vets like this in my area where we live, my dog has lost so much weight, he went from 78lb to 66LB and now he is 70LB but now he is eating twice as more(6cups) a day and extra calorie supplements. Ridiculous. Vets said there’s nothing he has. You can still see his ribs and spine.

[@Bmount_35]

How did you fix this?

[@ch39547]

He is remarkably calm and well-behaved for a dog at the vets.

[@DrLera]

We strive to make all of our patients comfortable every time they come in =)

[@tracievaughn9092]

My German Shepherd has it and we discovered that the enzymes needs some sort of liquid to help make it stick to the food because when we tried it without it would just go to the bottom of the bowl and he won’t absorb it.

[@harrietmaclean3149]

looking for advice...my 7month old puppy has just started to limp when he wakes up and then he is fine after a few steps he is absolutely fine through out the day full of energy not limping at all but it seems to be at night

[@mareelewis7639]

It weird these videos you are doing as my baby has been in 2 hospitals and they are still not sure what he has and i am away with work so he is seeing different vets and in the end they gave him 4 needles and also some stuff to stop him been sick that i give him before meals and also antibiotics. I thought he was going to die as he was stiff and he could not move or eat or drink as he would just throw up none stop and a hour before that he was running around. I am thinking it could be stress as he is a service dog. I wish you where in Australia as you have a heart and you care. It is hard to find vets like you. Thank you.

[@DrLera]

Is he still doing poorly

[@mareelewis7639]

@@DrLera He is starting to get a little sparkle in his eyes and he can walk again. I was so scared. I have never been so scared in my life. He is only 3 years old.

[@t.s.7082]

What do you do if the vet drew a fasting blood sample, but it isn't viable due to being too lipemic (too much fat in blood)? Trying switch from Hills Rx i/d lowfat canned food to chicken and rice for 5 days before giving it another try. If that doesn't work, then I have no idea what's next in order to get PLI and TPI???

[@aswang7890]

Thank you for this video. Very informative! Is it possible to get a transcript of this video? I couldn't catch all the tests and parameters you mentioned following blood work done on Milky Way. Or all the tests that confirmed that Milky Way did have EPI. I think our Jack Daniel Terrier-Sharpei mix has EPI but right now, his vet has him trying a new diet and is on pancreatic enzyme concentrate tablets. It's been a couple of months and he hasn't really gained weight. This is the first time I've heard of adding enzymes directly to food so I wanted to explore that and ask our vet his thoughts. But how long would you try to let Pancreatic Enzyme concentrate tablets work before you try the enzymes that are added directly to the food? Or do you do that immediately? Hopefully, you can share a transcript of this video or a list of the test and parameters that confirmed EPI in Milky Way. Thanks so much!

[@alessandraforlani152]

Hi. My older dog has been suffering with this disease for a very long time. You must, as my vet did, get a complete blood test. This is the confirmation you need. I give my dog the enzyme powder. I am on the fence about this powder. Early in the disease process, b4 diagnosis, his stools were very yellowish and grayish. Now after using the powder , they are more normal colored. He has not gained any weight. The reason I am unsure about this powder is I googled it and it states it causes mouth sores and vomiting, two things my poor dog has been exhibiting. He has vomited after his evening meal, whole food, not bile, and he is having trouble chewing - maybe mouth sores? he never had this problem before. Just wanted to share my experience. Please consult your vet and research the meds for yourself, something I did not do.

[@valeriehutchinson863]

Go see another Vet. That is what I would do. He can not give you that dogs medical records/test that would be unprofessional

[@lissettegonzalez1059]

Hi. My pups have EPI but they can’t have the blood test due their anemia becaise kidney also. Is Epizyme a good digestive enzyme for this situation. My pup from 5 pounds is 3 pounds and 1/8 teaspoon in each meal is not helping. Have a nice day 🐾🐾❤️❤️🙏🏼

Hello! what are the name of the tests to diagnose that disease? My vet is suspecting that but we want a second opinion or doing the tests by a different lab we assume that he is taking advantage by the price.

[@joseandiel1586]

Same thing is happening with me, it’s so ridiculous

[@nomancave591]

​@@joseandiel1586mines trying to charge $330 and also is dissmissing my concern

[@bsnofficial363]

hello sir my 11 month old Rottweiler is suffering from pancreatitis he weighs only about 15 kg but my local vets are not able to help him out could you please help me out in this situation as his health is deteriorating really fast

[@sandymauch6938]

I’m sure he would have to see your dog, to give you a set evaluation. Hope he gets feeling better.

[@bsnofficial363]

@@sandymauch6938 he passed away one month after i posted this comment he must be at a better place now

[@nomancave591]

My vet is trying to change me $330 for the TLI test. Is this Normal, research found the avg cost for the test is around $100 dollars.

[@DrLera]

The malabsorption panel is a very expensive panel. I don't know what his or her expenses are at their clinic and so you have to take into consideration those kinds of things when looking at the actual price that you're being charged. Sometimes I have clients that are looking for the cheapest veterinarian when they come to me and I tell them that's not me. I give them recommendations if they're looking for the cheapest. And I have no qualms. I run my practice a certain way and spend a lot of time with clients so I'm limited on the number of appointments I can see in a day.

[@nomancave591]

@@DrLera I appreciate your answer. I I paid for the test along with some other test to rule out any other gastrointestinal issues, in all honesty I probably wouldn't have had an issue with the cost except for the fact that the vet I had gone to originally gave me antibiotics and a probiotic when I brought my dog in for chronic diarrhea, this was after speaking to a vet tech for 30 minutes and having him come in for 5 and asked all the questions I had already answered for the tech, after I gave my dog the meds it exacerbated the diarrhea and introduced vomiting, told him she has every symptom listed I could find of EPI and also SIBO he completely dismissed what I was saying and wanted to do a bunch of other tests first.

[@brookroberson6084]

The TLI is $400 + and yes very expensive

[@claudiamolina6623]

Hi there my dog is lately eating grass for 15 minutes and vomits for 4 days now. Is this normal? Do I have to get an ultrasound for his GI?

[@DrLera]

I wouldn't jump straight to an ultrasound. Normally we have to collected a detailed history to see ifnthere have been any changes within 7 days of the symptoms starting and basic questions like is the dog on heartworm prevention. Then I'm terms of testing we would at stool analysis and blood work. The next steps would be determined based on test results and response to empirical therapy. Hope this helps

[@claudiamolina6623]

@@DrLera Thank you!!!!

[@97warlock]

not normal. they are like us