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Exocrine pancreatic insufficiency in dogs
Elias Westermarck1, Maria Wiberg
1Department of Clinical Veterinary Sciences, Faculty of Veterinary Medicine, University of Helsinki, P.O. Box 57, 00014 Helsinki, Finland. elias.westermarck@helsinki.fi
The Veterinary Clinics of North America. Small Animal Practice
|October 14, 2003
Summary
Canine exocrine pancreatic insufficiency (EPI), caused by pancreatic acinar atrophy (PAA), can now be diagnosed in its early stages. Early diagnosis aids in understanding the autoimmune nature of PAA and managing EPI in dogs.
Area of Science:
- Veterinary Medicine
- Immunology
- Gastroenterology
Background:
- Pancreatic acinar atrophy (PAA) is the leading cause of canine exocrine pancreatic insufficiency (EPI).
- Understanding PAA in its subclinical phase is crucial for studying its pathogenesis.
- Evidence suggests an autoimmune basis for PAA, leading to the term autoimmune-mediated atrophic lymphocytic pancreatitis.
Purpose of the Study:
- To investigate the diagnostic markers for subclinical and clinical canine exocrine pancreatic insufficiency (EPI).
- To explore the autoimmune nature of pancreatic acinar atrophy (PAA).
- To evaluate treatment responses for EPI.
Main Methods:
- Analysis of serum canine trypsin-like immunoreactivity (cTLI) concentrations.
- Correlation of cTLI levels with clinical signs of EPI and pathological findings of PAA.
- Assessment of treatment outcomes with pancreatic enzyme supplementation.
Main Results:
- Abnormally low cTLI (< 2.5 mg/L) is diagnostic for clinical EPI in dogs with maldigestion.
- Subnormal cTLI values (2.5-5.0 µg/L) in asymptomatic dogs indicate subclinical EPI and partial PAA.
- Treatment response to nonenteric-coated enzyme supplements for EPI varies, with approximately 50% showing good long-term results.
Conclusions:
- Canine EPI, linked to PAA, can be identified in subclinical stages using cTLI levels.
- PAA exhibits characteristics of an autoimmune disease.
- Pancreatic enzyme supplementation is the primary treatment for EPI, but efficacy varies.