Exocrine pancreatic insufficiency in dogs symptoms. Inflammation of the pancreas in dogs: basic information about the disease and methods of diagnosis and treatment

Introduction
The most common cause of exocrine pancreatic insufficiency (EPPI) in dogs is atrophy of the secretory acini in the pancreas. Most often, this pathology is detected in German shepherds, but the disease can develop in dogs of other breeds, including mixed breeds. German Shepherds are known to have a genetic predisposition to NEFP, but the etiology of this phenomenon is unknown. The disease is progressive: at a young age, the exocrine function of the pancreas is normal, the first

Clinical signs of the disease begin to appear in animals between 1 and 5 years of age. In other cases, NEFP may be caused by chronic, recurrent inflammation (pancreatitis), as commonly seen in cats, and pancreatic hypoplasia. NEFP and diabetes mellitus often complicate the course of chronic pancreatitis in dogs.

The main exocrine function of the pancreas is the secretion of digestive enzymes and pancreatic juice that enters the duodenum both in the absence of food and during feeding.
Clinical signs
chronic diarrhea (of varying severity)
polyphagia
weight loss
Coprophagia or perverted appetite may also occur with this disease.
Most owners note that their pets have an increase in the volume of feces with a semi-formed consistency. Attacks of vomiting, flatulence, and abdominal pain may occur.
Externally, dogs with NEFP look emaciated, their muscle mass is reduced, their coat loses its shine and becomes unpleasant and greasy to the touch. However, animals are physically active and mobile. If your dog is lethargic, refuses food, and has a fever, another medical condition is likely causing the diarrhea.

Laboratory diagnostics
Overt pancreatic atrophy can be detected by exploratory laparotomy or laparoscopy. It is recommended to perform surgery only when we are not dealing with chronic pancreatitis.
The most reliable and widely used test is assessment of trypsin-like immunoreactivity (TPI) in blood serum.

Determination of pancreatic elastase in dog feces is one of the most common tests in Russia, but is not 100% reliable.
Other laboratory blood tests (biochemical or hematological) do not give a specific result, but they are necessary to identify concomitant diseases. If helminth infestation or bacterial contamination is suspected, feces are examined (for the presence of helminth eggs and for bacteriological cultivation).

Treatment
Most dogs and cats with NEFP have a good clinical response to enzyme replacement therapy.
(Dry pancreas extract).Twice feeding is usually sufficient for the animal to begin to gain weight.
After clinical improvement of the condition, owners will be able to select the minimum effective dose of drugs to prevent relapses.

Feeding
The ideal diet should be complete, and if the animal continues to lose weight during enzyme replacement therapy, it should be switched to a dietary diet (therapeutic dry and wet food)
For cats with NEFP, enzyme replacement therapy can be supplemented with parenteral administration of cobalamin, since this pathology impairs the absorption of vitamin B12 in the digestive tract.

Conclusion
Those animals that have an unsatisfactory response to the above treatment methods usually respond favorably to glucocorticoid therapy (oral prednisolone at a dose of 1-2 mg/kg every 12 hours for 7-14 days). Long-term use is not required.

The pathological processes that lead to NEFP are irreversible, so treatment must be carried out throughout life.

Veterinarian, Vinokurova M.V.

Many diseases of domestic animals arise as a result of improper feeding regime and diet. Hard-to-digest porridges made with fatty bone broths, tasty morsels from the master's table, low-quality ready-made food, and an uncontrolled amount of food with little physical activity contribute to the development of obesity in dogs. As a result organ functioning is impaired, ensuring normal digestion, which leads to serious illnesses in pets.

Pancreas in dogs

There are seven different glands in a dog’s body, the pancreas is one of the main ones, functionally necessary to provide the animal with vital energy. The enzymes it produces help digest food. In the endocrine system, it synthesizes insulin, a hormone that controls blood glucose levels for proper metabolism in cells and tissues.

Pancreatitis (Latin - Greek pancreat + itis)- inflammation of glandular tissues, which affects the production of pancreatic juice. The inflammatory process causes a narrowing of the gland ducts for the passage of enzymes that break down food into the duodenum; insufficient quantities of them negatively affect the gastrointestinal tract system.

In this case, stagnation of enzymes (enzymes that accelerate metabolism) occurs in the gland itself, their accumulation and activation leads to self-destruction of its tissues, provokes the release of the resulting toxins into the bloodstream, and harms other internal organs.

According to the rate of accumulation of symptoms of inflammation and the duration of its course, pancreatitis is divided into acute and chronic

Acute inflammation of the pancreas in dogs: symptoms, treatment

Acute pancreatitis occurs suddenly; the inflammatory process in dogs can be caused by poor-quality food, overeating fatty foods, intoxication of the body caused by exposure to chemicals and drugs, or toxic substances entering the stomach.

Initial signs of pancreatitis in dogs are similar to ordinary intestinal disorders or poisoning, then as they accumulate, a sharp deterioration occurs.

Experiencing pain, the dog rushes around restlessly, squealing.
Shows no interest in food, but greedily laps up water.
Frequent vomiting before and after feeding.
The mucous membrane of the mouth dries out, and dehydration occurs.
Feverish condition.
Severe skin itching occurs.

Chronic pancreatitis in dogs: symptoms

Chronic pancreatitis in dogs is also caused by congenital changes in the structure of the gland tissue, traumatic damage to it, and frequent exacerbations of the acute form of pancreatitis.

Chronic pancreatitis goes away for a long time without warning signs of the disease; over time, characteristic symptoms of prolonged inflammation appear.

The dog becomes lethargic, lies down most of the time, and is reluctant to go for a walk.
He eats little, sometimes does not touch food, and regurgitates food.
Urinary disorders, urinary incontinence.
A sharp decrease in weight is noticeable, the coat is dull, trembling appears in the limbs.
The consistency of stool changes.
The abdominal tone is tense, the stomach is swollen with gas.

Acute and chronic pancreatitis: treatment

A veterinarian makes an accurate diagnosis. During the clinical examination, the symptoms and treatment of pancreatitis in dogs are examined, the periumbilical region of the abdominal cavity is palpated, the necessary tests are taken (blood, urine, feces), an ultrasound and an x-ray are taken. Sometimes additional gastroscopy and biopsy are required.

Further treatment of pancreatitis at home is carried out based on the results of a complete examination. The identified causes of the disease show how to treat the pancreas in a dog.

In case of acute pancreatitis or exacerbation of the chronic form, subcutaneous injections are prescribed with drugs that eliminate the pain effect (Butorphanol, other analgesics); relieving spasms of the gland ducts (solution of No-shpa, Eufillin); They give tablets (Cerucal, Ondansetron) that stop vomiting. A dehydrated animal is given drips with sodium chloride (saline) to replenish the water-salt balance. All medications are taken in dosages prescribed by the veterinarian, strictly according to the instructions.

Treatment of pancreatic inflammation, diagnosed as a complication, should begin with therapeutic treatment of a possible infection, diseases of the internal organs, supplementing the listed drugs with injections of antibiotics.

Can a dog die from pancreatitis? When the disease is started at a certain stage of treatment, it causes pancreatic necrosis in dogs; the pathological process occurs in stages: consistent deformation of the pancreatic tissue and their slow death. Energy and chemical metabolic processes in the dog’s body are disrupted, which leads to death.

Pancreatin for dogs: pros and cons

The main active ingredient (Pancreatin) is a powder made from pancreatic enzymes taken from livestock. Necessary for the breakdown of fats, carbohydrates, proteins in the small intestine. Pale pink coated tablets, each containing 250 mg of pure pancreatin, also contain auxiliary components.

Can I give my dog pancreatin? The instructions contain instructions for use:

The number of tablets is calculated according to the following scheme: 25-50 mg of pancreatin is allowed per 1 kg of dog weight. Take during feeding, adding to food, 3-4 times a day. For puppies and small breed dogs, a single dosage is prescribed by a veterinarian.

Diet: regimen, diet for feeding dogs with pancreatitis

Regardless of the established form of pancreatitis, the animal is prescribed:

Therapeutic fasting lasts 1-3 days, while feeding the dog every hour in small portions (1-2 spoons).

Gradually fractional (5-6 times during the day) dietary meals are introduced at regular intervals (2-3 hours).

The dry food that the dog is accustomed to is replaced with special, medicinal, vitamin-enriched food or a temporary switch to a different diet.

With natural feeding, prepare porridge without broth, give boiled poultry breast or chopped fish, puree of green vegetables, carrots, low-fat cottage cheese.

Complications, consequences, prevention

The following complications are possible: inflammation in the abdominal cavity (peritonitis), development of diabetes mellitus, weakening of the heart muscle, shortness of breath, difficulty breathing.

The chronic form can cause exacerbations of the disease and persist in the animal throughout its life. The intestinal mucosa becomes vulnerable to various infections. Ulcerative or tumor (pseudocyst) neoplasms in the glandular tissues of the pancreas are possible; surgical intervention will be required to remove the affected areas of the gland.

For prevention, it is necessary to follow the composition and nutritional standards: fresh finely chopped lean meat or offal (beef liver, heart), cereal porridge in lean broth with the addition of vegetables, cottage cheese, eggs and other low-carbohydrate foods. The dog should receive the vitamins necessary for health, the required vaccinations, and the number and duration of walks should be increased. You also need to regularly conduct a medical examination of your pet to timely identify possible relapses.

Pancreatitis in Yorkshire Terriers: symptoms, treatment, feeding

Some breeds of dogs from birth have a high probability of developing pancreatitis at the level of genetic inheritance. Yorkshire Terrier dogs have a vulnerable digestive system; violations of the selected diet provoke inflammation of the pancreas at the age of 4-5 years.

High-calorie foods, excess weight, abuse of packaged foods, ill-considered transition from one type of feeding to another, drug and food poisoning lead to acute pancreatitis in Yorkies.

The main symptoms of the disease are: a sharp change in behavior, involuntary vomiting after feeding, sudden heavy shedding, frequent changes in bowel movements from diarrhea to constipation.

Diagnosis is carried out in a veterinary clinic, where clinical and biochemical tests (feces, blood, urine), X-rays and ultrasound examinations are performed.

Therapeutic treatment begins with injections to eliminate pain and vitamins that support the body; They give antiemetic tablets (coated), other necessary medications, and a portioned regimen of eating and drinking is prescribed.

During the recovery period, you should follow the instructions given by the veterinarian, especially regarding feeding rules: exclude raw meat and offal; It is forbidden to feed mixed food; you should use special food for Yorkshire terriers, including medicinal ones.

The occurrence of the disease in puppies

Predisposition to the disease in puppies can be transmitted along the hereditary line, from adult parents who have had hepatitis. Acquired pancreatitis in puppies (over 6 months old) is possible after an infectious or viral disease that has affected the functioning of internal organs.

The acute form of pancreatitis can be caused by unsystematic and uncontrolled feeding of the puppy - if they become overly fat, they are vulnerable to the disease. You should not give food prepared for adult dogs; it is difficult for their digestive system to digest and is poor in essential vitamins.

At the first symptoms of poor health in puppies (vomiting, severe diarrhea, fever), you should contact a veterinary hospital. Examinations by specialists, tests (blood, urine, feces), ultrasound will allow you to make the correct diagnosis, provide first aid with painkillers, antidiarrheal drugs, and prescribe the necessary therapeutic treatment.

The puppy’s fragile body can hardly tolerate the acute form of pancreatitis; the likelihood of it becoming chronic is very high. Therefore, it is so important to follow all the recommendations of the rehabilitation period: follow dietary feeding, using special food and products for puppies, do all necessary vaccinations, give vitamins and minerals necessary for growth.

Attention, TODAY only!

Abramova L.A., Derezina T.N.
Don State Agrarian University, veterinary clinic "Center", Rostov-on-Don

The pathophysiology of exocrine pancreatic insufficiency is still not fully understood. Acinous cells of a healthy pancreas secrete enzymes involved in the initial stage of digestion of food components; the products of their activity, relatively low-molecular compounds, are further destroyed by enzymes of the brush border of the cells of the mucous membrane of the small intestine (Gubergrits N.E., Klochkov D.E.) Pancreatic enzymes include lipase (the pancreas is the main source of this enzyme), a-amylase , phospholipase, proteolytic enzymes (elastase, chymotrypsin and trypsin).

Diagnosis and treatment of pancreatic diseases is the most complex section of clinical gastroenterology. As evidenced by the work of leading specialists - gastroenterologists, the prevalence of these diseases in recent times has a clear upward trend (Zhukova E.N., 1998; Niemand H.G., 2004; Westermarck E., 1980). The diversity and characteristics of the clinical manifestations of pancreatic diseases give rise to numerous diagnostic and tactical errors. In young animals, malformations of the pancreas are more often diagnosed, in older animals - acute and chronic pancreatitis due to various reasons. Information given in the literature on the frequency of NEFP and chronic pancreatitis in animals in the structure of diseases of the digestive organs is extremely contradictory (from 5% to 25% of the number of gastroenterological diseases). This is primarily due to the lack of a unified classification of pancreatic diseases in veterinary medicine and a unified diagnostic approach (Simpson J., 2003). The signs of exocrine pancreatic insufficiency are similar to diseases of the small intestine, which makes it very difficult to differentiate the two diseases on a clinical basis alone. Both diseases occur in the same breeds, which becomes a source of additional diagnostic problems. In addition, therapy for NEFP, even if a diagnosis has been made, is often limited only to enzyme replacement therapy, which does not always lead to positive results.

We were faced with the task of developing therapy for NEFP. After the diagnosis was made, 2 groups of animals of 20 animals each were formed - experimental and control, according to the principle of analogue pairs. As the most appropriate, the principle of complex therapy was chosen for both groups of animals. The basis of the complex of measures is enzyme replacement therapy. The primary aspect of the action of enzyme preparations is the basis for their prescription for late indications, that is, as replacement therapy for exocrine pancreatic insufficiency.

Animals in the control group (10 animals) were prescribed therapy according to the following regimen: panzinorm 1 tablet at each feeding; emulsified denatured placenta in a dose of 2 ml subcutaneously, a total of 7 injections with an interval of 36 hours, multivitamin in a dose of 1 ml per 10 kg of body weight once every 10 days, a total of 4 injections. Eubicor at a dose of 3 g 2 times a day and Bifiform 1 capsule 2 times a day with meals in the first 10 days of treatment. Feeding fractional 3-4 times a day with the Royal Canin INTESTINAL veterinary diet as a monoration.

The animals of the experimental group (10 animals) were prescribed therapy according to the following regimen: Creon 10,000 at a dose of 10,000 units. (1 capsule) at each feeding for 90 days; emulsified denatured placenta in a dose of 2 ml subcutaneously, a total of 7 injections with an interval of 36 hours, multivitamin in a dose of 1 ml per 10 kg of body weight once every 10 days, a total of 4 injections. Eubicor at a dose of 3 g 2 times a day and Bifiform 1 capsule 2 times a day with meals in the first 10 days of treatment. Diet therapy is identical to scheme 1.

Monitoring of the general condition of dogs in the control and experimental groups was carried out upon admission to treatment, on the 30th day of treatment and at the end of treatment, by conducting scatological studies, as the most informative, for the content of neutral fat, undigested muscle fibers, and starch grains. The ratio of serum folate and B12 was also taken into account. Table 1.
Table 1. Monitoring of the general condition of dogs under treatment

Indicators	Sick animals	After 30 days of treatment	At the end of treatment	Healthy
Indicators	Control	Control	Control	animals
Number of fat drops (in 10 fields of view)


Number of undigested muscle fibers

After 30 days of treatment, the indicators of scatological studies of dogs in the experimental group were close to the physiological norm.
The positive dynamics in the animals of the experimental group is explained by the choice of the enzyme preparation. Creon 10000, a fourth-generation double-shell enzyme preparation in the form of minimicrospheres enclosed in a capsule, is the drug of first choice for replacement therapy for insufficiency of exocrine pancreatic function. Minimicrospheres have a diameter of about 1.2 mm, which is optimal for timely evacuation from the stomach along with chyme and rapid release of enzymes in the upper part of the small intestine. The enteric coating ensures the stability of the drug in an acidic environment, which significantly increases the effectiveness of replacement therapy for malabsorption/maldigestion syndrome. The absence of bile acids in the drug eliminates the risk of developing hologenic diarrhea. In addition, Creon 10000 does not suppress its own synthesis of enzymes; when switching to maintenance therapy, no withdrawal syndrome is observed.

Tablet forms (in particular panzinorm) linger in the stomach. In addition, enzyme preparations in tablet form do not increase fat absorption, because their diameter is more than 2 mm, which does not lead to the complete disappearance of steatorrhea, due to the development of asynchronism during the passage of chyme and tableted enzyme preparations. This asynchronism can even lead to the fact that tableted enzyme preparations, moving through the digestive tract separately from the chyme and not having a point of application for their action, can exit intact with the feces.

In addition to pathogenetic therapy, symptomatic treatment is also required. The use of a biostimulator - placenta - improves the quality of life and restores metabolic processes in the body. Eubicor and bifiform restore normal intestinal flora, relieve secondary enteritis, and relieve bacterial overgrowth syndrome. The introduction of a multivitamin helps to quickly compensate for the deficiency of B vitamins.

Equally important in the complex therapy of NEFP is strict dietary therapy, which excludes the consumption of any food other than proprietary veterinary diets with a low fat content, which ensures the stability of the quality composition of the food.
Thus, the treatment algorithm for NEFP is as follows: replacement therapy, preferably with drugs in the form of minimicrospheres, correction of diarrhea, replacement of pathogenic intestinal microflora with normal flora, fractional feeding that satisfies the dog’s appetite, vitamin therapy.

Bibliography

Gubergrits N.E. Conservative treatment of chronic pancreatitis /N.E. Gubergrits D.E. Klochkov /
De Lorenzi D. Problems of diagnosing diseases of the digestive system in dogs / D. De Lorenzi, D. Elliott, V. Fresh et al.//Focus. - Royal Canin, 2007.-67 pp.
Zhukova E.N. Comparative assessment of various diagnostic criteria for exacerbation of chronic pancreatitis./ E.N. Zhukova // Russian Gastroenterological Journal.- No. 1, 1998 pp. 17-21.
Knight R. Diseases of the pancreas in dogs and cats / R. Knight.-M.: PALMA press, 2003.-37 p.
Niemand H.G. Diseases of dogs / H.G. Niemand., P.B. Suter.-M.: Aquarium, 2004.-806 p.
Westermark E.The hereditary nature of canine pancreatic degenerative atrophy in the German shepherd dog./E. Westermark .- Acta Veterinaria Scaninavica, 1980.-N 21.-S.389-394

Summary
Abramova L.A., Derezina T.N.: Complex therapy of exocrine pancreatic insufficiency at dogs.
Don state agricultural university, Rostov-on-Don, Russia
At of exocrine pancreatic insufficiency complex therapy is appointed. A preparation of the
first choice of replaceable therapy Kreon 10000.

L . A . Abramova Sh Donskoy state agrarian
T . N . Derezina university, veterinary clinic "Center", G. Rostov- on- Don

The pathophysiology of exocrine pancreatic insufficiency is still not fully understood. Acinous cells of a healthy pancreas secrete enzymes involved in the initial stage of digestion of food components; the products of their activity, relatively low-molecular compounds, are further destroyed by enzymes of the brush border of the cells of the mucous membrane of the small intestine (Gubergrits N.E., Klochkov D.E.) Pancreatic enzymes include lipase (the pancreas is the main source of this enzyme), and -amylase, phospholipase, proteolytic enzymes (elastase, chymotrypsin and trypsin).

Diagnosis and treatment of pancreatic diseases is the most complex section of clinical gastroenterology. As evidenced by the work of leading gastroenterologists, the prevalence of these diseases has recently shown a clear upward trend (Zhukova E.N., 1998; Niemand H.G., 2004; Westermarck E., 1980).

The diversity and characteristics of the clinical manifestations of pancreatic diseases give rise to numerous diagnostic and tactical errors. In young animals, malformations of the pancreas are more often diagnosed, in older animals - acute and chronic pancreatitis due to various reasons. Information given in the literature on the frequency of NEFP and chronic pancreatitis in animals in the structure of diseases of the digestive system is extremely contradictory (from 5% to 25% of the number of gastroenterological diseases). This is primarily due to the lack of a unified classification of pancreatic diseases in veterinary medicine and a unified diagnostic approach (Simpson J., 2003).

The signs of exocrine pancreatic insufficiency are similar to diseases of the small intestine, which makes it very difficult to differentiate the two diseases on a clinical basis alone. Both diseases occur in the same breeds, which becomes a source of additional diagnostic problems. In addition, therapy for NEFP, even if a diagnosis has been made, is often limited to enzyme replacement therapy, which does not always lead to positive results.

Animals in the control group (10 animals) were prescribed therapy according to the following regimen: panzinorm, 1 tablet at each feeding; emulsified denatured placenta in a dose of 2 ml subcutaneously, a total of 7 injections with an interval of 36 hours, multi-vitamin in a dose of 1 ml per 10 kg of body weight once every 10 days, a total of 4 injections. Eubicor at a dose of 3 g 2 times a day and Bifiform 1 capsule 2 times a day with meals in the first 10 days of treatment.

Feeding fractional 3-4 times a day with the Royal Canin INTESTINAL veterinary diet as a monoration.

Indicators	Sick animals	After 30 days of treatment	At the end of treatment	Healthy animals
Indicators	Control	Control	Control	Healthy animals
Number of fat droplets (in 10 fields of view)
Number of fat droplets (in 10 fields of view)
Number of undigested muscle fibers
Number of undigested muscle fibers

Already after 30 days of treatment, the indicators of scatological studies of dogs in the experimental group were close to the physiological norm.

The positive dynamics of the animals in the experimental group is explained by the choice of the enzyme preparation. Creon 10000, a fourth-generation double-shell enzyme preparation in the form of minimicrospheres enclosed in a capsule, is the drug of first choice for replacement therapy for insufficiency of exocrine pancreatic function. Minimicrospheres have a diameter of about 1.2 mm, which is optimal for timely evacuation from the stomach along with chyme and rapid release of enzymes in the upper part of the small intestine. The enteric coating ensures the stability of the drug in an acidic environment, which significantly increases the effectiveness of replacement therapy for malabsorption/maldigestion syndrome. The absence of bile acids in the drug eliminates the risk of developing hologenic diarrhea. In addition, Creon 10000 does not suppress its own synthesis of enzymes; when switching to maintenance therapy, no withdrawal syndrome is observed.

Equally important in the complex therapy of NEFP is strict dietary therapy, which excludes the consumption of any food other than patented veterinary diets with a low fat content, which ensures the stability of the quality composition of the feed.

Thus, the treatment algorithm for NEFP is as follows: replacement therapy, preferably with drugs in the form of minimicrospheres, correction of diarrhea, replacement of pathogenic intestinal microflora with normal flora, fractional feeding that satisfies the dog’s appetite, vitamin therapy.

Literature

Gubergrits N.E. Conservative treatment of chronic pancreatitis/N.E. Gubergrits D.E. Klochkov // www. medicusamicus. com.
De Lorenzi D. Problems of diagnosing diseases of the digestive organs in dogs / D. DeLorenzi, D. Elliot, V. Fresh, etc. // Focus - Royal Can in, 2007. - 67 pp.
Zhukova E.N. Comparative assessment of various diagnostic criteria for exacerbation of chronic pancreatitis / E.N. Zhukova // Russian Gastroenterological Journal.-N°1, 1998 pp. 17-21.
Knight R. Diseases of the pancreas in dogs and cats/R. Knight.-M.: PALMA press, 2003.-37 p.
Niemand H.G. Diseases of dogs/H.G. Niemand., P.B. Suter.-M.: Aquarium, 2004.-806 p.
Westermark E. The hereditary nature of canine pancreatic degenerative atrophy in the German shepherd dog./E. Westermark.-Acta Veterinaria Scaninavica, 1980.-N 21.-S.389-394

Treatment room veterinarian, intern.

Exocrine pancreatic insufficiency (EPI) is a disease characterized by non-specific symptoms.

Chronic diarrhea (diarrhea) is noted, feces take on a pasty, shapeless appearance and have a large volume. Coprophagia (eating one's own feces) or perversion of appetite, flatulence, weight loss with increased appetite are often observed. The coat loses its shine and becomes dull. Vomiting is rare. The dogs remain active.

The pancreas is a digestive organ with exocrine and endocrine functions. The endocrine function is the secretion of a number of hormones by the islet cells of the pancreas, such as insulin. The exocrine function lies in the secretion of digestive proenzymes (trypsinogen, chymotrypsinogen, proelastase, prophospholipase) by acinar cells to digest food. With progressive loss of acinar cells, enzyme production decreases, food is not digested, and the animal exhibits symptoms of malabsorption.

Exocrine insufficiency is not a congenital pathology, but there is a breed predisposition (German shepherds, rough collies). This disease can manifest itself at any age, but most often it occurs in young dogs under 4 years of age.

The cause of exocrine insufficiency is atrophy of acinar cells, which leads to a decrease in the production of digestive enzymes. Cell atrophy most often occurs spontaneously, but can be a consequence of chronic pancreatitis.

One of the reasons for EPI may be a violation of gastric motility, namely the acceleration of its emptying. This leads to insufficient stimulation of hormone synthesis in the duodenum, leading to inadequate secretion of the pancreas and the inability to activate its enzymes. A rare cause may be blockage of the excretory ducts of the pancreas (for example, neoplasms).

EPI is diagnosed based on a thorough history, clinical manifestations, and exclusion of all other causes of diarrhea and weight loss. It is not possible to make a diagnosis using routine tests, such as general and biochemical blood tests, since we do not observe any characteristic changes. There is often a decrease in cholesterol, an increase in alanine aminotransferase (ALT), blood proteins in most cases are within normal limits.

To make a diagnosis, a species-specific serum trypsin-like immunoreactivity (TLI) test must be used. A decrease in TLI indicates exocrine insufficiency. An alternative test is the determination of pancreatic elastase in stool, but the reliability of this test is much lower. This study does not confirm the diagnosis, but excludes it. This means that if we note normal or increased elastase, then this dog does not have EPI, but if elastase is decreased, this does not mean that the dog is sick.

After making an accurate diagnosis, it is necessary to prescribe enzyme replacement therapy. Enzymes should be given to the animal at every feeding (even if some treats are given), directly with food. Powdered preparations or in the form of granules are used. At the moment, Russian veterinarians use the medical drug Creon, which is given strictly in capsules (since the capsule dissolves in the acidic environment of the stomach, and the granules themselves enter unchanged into the lumen of the duodenum). As a side effect, we can observe gingivitis/stomatitis; to eliminate these manifestations, it is necessary to reduce the dose. Any withdrawal of enzymes leads to the return of clinical manifestations.

An alternative way to correct enzyme deficiency is to give the animal fresh or dried pancreas. Abroad there is dry pancreas Viokase, Pancrezyme.

A very important factor in treatment is an easily digestible diet therapy with a reduced amount of fat and fiber, which is important for patients with impaired digestion.

Industrial feeds include Royal Canin (Gastrointestinal low fat, Hypoallergenic, Hypoallergenic moderate calorie), Purina Pro Plan (EN, HA), Hill’s (i/d low fat, i/d).

It is also important to carry out symptomatic therapy. To compensate for dehydration in the first days of treatment, crystalloid infusion therapy is used. To prevent deficiency of vitamin B12 (cyanocobalamin), it is included in the treatment regimen. Antibiotic therapy is prescribed to suppress bacterial overgrowth in the intestines.

The prognosis for this disease is favorable with continuous enzyme therapy.

Bibliography:

1. Pascal Pibot, Vincent Burges, Denise Elliott. Encyclopedia of clinical nutrition for dogs. Aniwa SAS Encyclopedia. Third edition. – 2006

2. Peter F. Suter, Barbara Kohn. Dog diseases. Aquarium Print LLC. 10th edition. – 2011.

3. Sophia Yin. A complete guide to small animal veterinary medicine. M: Aquarium. Second edition. – 2008.