If you have a dog with Exocrine Pancreatic Insufficiency (EPI), you are in tune with the concept, "What goes in must come out." A lack of digestive enzymes produced by the pancreas is at the heart of EPI. If a dog doesn’t have the enzymes necessary to digest food, he or she can’t absorb it, which leads to some serious digestive problems.
This is a roundabout way of saying that dogs with EPI tend to produce a lot of feces — often in the form of greasy, soft stools or diarrhea. Other common symptoms include dry, flaky skin and a ravenous appetite paradoxically accompanied by weight loss. Most cases of EPI are caused by an abnormal immune reaction. This reaction attacks and destroys the pancreatic cells responsible for producing digestive enzymes while leaving the ability to produce insulin intact. An especially severe or chronic case of pancreatitis can also be to blame.
EPI cannot be cured, but in many cases it can be managed successfully enough that affected dogs live long and relatively symptom-free lives. Owners and veterinarians do this by closely controlling two aspects of the "what goes in" part of the equation, both of which are outlined below.
Because the pancreas is no longer making adequate amounts of digestive enzymes, we must provide them as a supplement to the diet. Manufacturers give these medications different trade names, but they all contain amylase, lipase, and protease – enzymes needed to break down carbohydrates, fats, and proteins, respectively. Research has shown that the best way to use these supplements is to mix the powdered form with the food right before offering it to your dog. Feeding raw beef or lamb pancreas is another option, but in most cases the risks associated with handling and eating raw animal products outweighs any benefits. Some dogs with EPI also have a small intestinal bacterial overgrowth and require antibiotic therapy and vitamin B12 (i.e., cobalamin) injections.
Even with pancreatic enzyme supplementation, dogs with EPI are still somewhat restricted in their ability to digest food. Therefore, feeding a diet that is highly digestible and made from quality ingredients is vitally important. The last thing you want to do is to make your dog’s digestive tract work harder than necessary breaking down ingredients of questionable value. The general recommendation is to feed a diet that is low in fat and high in carbohydrates and protein. Fats are harder to digest than carbohydrates and proteins, so this makes sense, but in my experience there is no one best food for dogs with EPI. Some dogs seem to do better with a little more fat than you’d expect, others need a little less protein, and so forth.
What holds true in all cases, however, is that dogs with EPI should not eat foods made from low-quality ingredients that offer a questionable balance of nutrients. Of course, I’d argue against feeding these products to any dog, but optimal nutrition is especially important for dogs with impaired digestive function.
Dr. Jennifer Coates