When a dog or cat is afflicted with exocrine pancreatic insufficiency (EPI), the animal’s body is unable to break down and absorb the nutrients in the foods he or she eats. Affected animals will lose weight; have loose, foul-smelling stools; and have a much greater appetite. This is because the animal is, essentially, starving to death.
The main focus of treatment for this condition includes the life-long use of enzyme replacements in the animal’s food. Because multiple secondary issues could develop due to this disease condition, you and your veterinarian will need to closely monitor your pet for the remainder of his or her life.
One such potential problem in animals with EPI is a condition called small intestinal bacterial overgrowth (SIBO). It is commonly seen in dogs with EPI and can complicate treatment unless it is recognized and brought under control. Cats are more often afflicted with irritable bowl disease than SIBO.
What Causes SIBO?
Small intestinal bacterial overgrowth develops when the bacteria that are already present in the intestinal tract are given the opportunity to use the undigested material passing through the intestine as fuel to grow and thrive. The food that isn’t being absorbed by the animal is being “eaten” by the bacteria, which leads to a population explosion.
The overgrowth of “bad” bacteria in the gut of animals with EPI leads to even greater problems with the function of the intestinal tract. Motility is disrupted and watery (secretory) diarrhea can develop. Toxins are produced by the expanding numbers of bacteria, which can cause severe damage to the intestinal cells. If not treated rapidly, permanent digestive disorders and even food intolerances can result from SIBO.
Deficiencies with EPI and SIBO
If your pet has pancreatic insufficiency, he or she will eventually develop deficiencies in certain vitamins, especially the fat-soluble vitamins like A, D, E, and K. Because vitamin K is an important part of the mechanism that causes blood to clot, deficiencies in this particular vitamin can bring about bleeding problems in animals, particularly cats, with EPI. Cats are also prone to developing folate (a B vitamin) deficiencies.
Vitamin B12 (cobalamin) is commonly deficient in animals with SIBO. This is because the bacteria that build up in the small intestine are able to take in this particular vitamin easily and use it. In fact, a deficiency in B12 is one sign of secondary SIBO in animals already diagnosed with EPI. This particular deficiency must be corrected in order for an animal with EPI to respond to treatment and survive.