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, however, the disease can develop in dogs of other breeds, including mestizos. It is known that German Shepherds have a genetic predisposition to NEPV, but the etiology of this phenomenon is unknown. The disease is progressive in nature: 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 the ages of 1 and 5 years. In other cases, NEPV can be caused by chronic, recurrent inflammation (pancreatitis), which is commonly seen in cats, and pancreatic hypoplasia. NEPV 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, pancreatic juice, which 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 can also occur with this disease.
Most owners note that their pets have an increase in the volume of semi-formed feces. There may be bouts of vomiting, flatulence, abdominal pain.
Outwardly, dogs with NEPV look emaciated, their muscle mass is reduced, their coat loses its luster and becomes unpleasant, oily to the touch. However, animals are physically active and mobile. If your dog is drowsy, refuses to eat, and has a fever, the diarrhea is most likely due to another illness.

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

The determination of pancreatic elastase in the feces of dogs 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 detect comorbidities. If helminthic invasion or bacterial infection is suspected, fecal examinations are performed (for the presence of helminth eggs and for bacteriological cultivation).

Treatment
Most dogs and cats affected by NEPV have a good clinical response to enzyme replacement therapy.
(Dry pancreas extract). Usually, two feedings are enough for the animal to begin to increase body weight.
After clinical improvement, the owners will be able to choose the minimum effective dose of drugs to prevent relapse.

Feeding
The ideal diet should be complete, and if the animal continues to lose weight on the background of enzyme replacement therapy, it should be transferred to a dietary diet (therapeutic dry and wet food)
In cats with NEPV, it is good to supplement enzyme replacement therapy with parenteral administration of cobalamin, since in this pathology they have impaired absorption of vitamin B12 in the digestive tract.

Conclusion
Those animals that have an unsatisfactory response to the above treatments usually respond positively 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 NEPV are irreversible, so treatment must be carried out throughout life.

Veterinarian, Vinokurova M.V.

Many diseases of pets occur as a result of improper feeding regimen and diet. Hard-to-digest porridges on fatty bone broths, tidbits from the master's table, poor quality ready-made feeds, uncontrolled amount of food with little physical activity contribute to the emergence of obesity in dogs. As a result impaired functioning of organs that ensure normal digestion, which leads to serious illnesses in pets.

Pancreas in dogs

There are seven different glands in the 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 (lat. - Greek pancreat + itis)- inflammation of the glandular tissues, which affects the process of pancreatic juice production. The inflammatory process causes a narrowing of the ducts of the gland for the passage of food-splitting enzymes into the duodenum, an insufficient amount of them negatively affects the gastrointestinal tract system.

At the same time, stagnation of enzymes (enzymes that speed up metabolism) is formed in the gland itself, their accumulation and activation leads to self-destruction of its tissues, provokes the release of formed 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

Pancreatitis in acute form occurs suddenly, the inflammatory process in dogs can be caused by poor-quality feed, overeating of fatty foods, intoxication of the body caused by exposure to chemicals and drugs, and ingestion of toxic substances into the stomach.

Early signs of pancreatitis in dogs have similarities with ordinary bowel disorders or poisoning, then as they accumulate, a sharp deterioration occurs.

When in pain, the dog thrashes around uneasily, squealing.
Shows no interest in food, but greedily laps up water.
Frequent vomiting before and after feeding.
The mucous membrane dries out, dehydration sets in.
Feverish state.
There is severe itching.

Chronic pancreatitis in a dog: symptoms

Also cause a chronic form of pancreatitis in dogs, congenital changes in the structure of the gland tissue, traumatic damage to it, frequent exacerbations of the acute form of pancreatitis.

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

The dog becomes lethargic, lies most of the time, reluctantly goes for a walk.
Eats little, sometimes does not touch food, spitting up 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 tone of the abdomen is tense, the stomach is swollen from gases.

Pancreatitis acute and chronic: treatment

An accurate diagnosis is made by a veterinarian. During a clinical examination, the symptoms and treatment of pancreatitis in dogs are considered, the umbilical region of the abdominal cavity is palpated, the necessary tests (blood, urine, feces) are taken, an ultrasound scan and an x-ray are taken. Sometimes gastroscopy, biopsy are additionally required.

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

In 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 ducts of the gland (solution of No-shpa, Eufillin); give tablets (Cerucal, Ondansetron) that stop vomiting. A dehydrated animal is given droppers with sodium chloride (saline) to replenish the water-salt balance. All medicines are taken in dosages prescribed by a veterinarian, strictly according to the instructions.

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

Can a dog die from pancreatitis? Launched at a certain stage of treatment, the disease causes pancreatic necrosis in dogs, the pathological process takes place in stages: sequential deformation of the pancreatic tissues and their slow death. In the body of a dog, the energy and chemical processes of metabolism are disturbed, which leads to death.

Pancreatin for dogs: pros and cons

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

Is it possible to give a dog pancreatin? Instructions for use include:

The number of tablets is calculated according to the scheme: 25-50 mg of pancreatin is allowed per 1 kg of dog weight. Reception is carried out during feeding, adding to food, 3-4 times a day. For puppies and dogs of small breeds, 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 for 1-3 days, while giving the dog water every hour in small (1-2 tablespoons) portions.

Fractional (5-6 times during the day) diet food is gradually introduced at regular intervals (2-3 hours).

The dry food habitual for the dog is replaced with special, therapeutic, enriched with vitamins or temporarily switched to another diet.

With natural feeding, cereals are prepared without broth, they give boiled poultry breast or chopped fish, mashed green vegetables, carrots, and 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, shortness of breath.

The chronic form can cause exacerbations of the disease and persist in the animal for life. There is a vulnerability of the intestinal mucosa to various infections. Ulcerative or tumor (pseudocyst) neoplasms in the glandular tissues of the pancreas are possible, surgery will be required to remove the affected areas of the gland.

For prevention, it is required to observe the composition and nutritional norms: fresh, finely chopped lean meat or offal (beef liver, heart), cereals from cereals in lean broth with vegetables, cottage cheese, eggs and other low-carbohydrate foods. The dog should receive the vitamins necessary for health, vaccinations, the number and duration of walks should be increased. You also need to regularly conduct a medical examination of the pet for the timely detection of 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 heredity. Dogs of the Yorkshire Terrier breed have a vulnerable digestive system, violations of the selected diet provoke inflammation of the pancreas at the age of 4-5 years.

High-calorie food, overweight, overuse of packaged food, ill-conceived 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 considered: a sharp change in behavior, involuntary vomiting after feeding, sudden heavy molting, frequent changes in bowel movements from diarrhea to constipation.

Diagnosis is carried out in a veterinary clinic, where clinical and biochemical analyzes (feces, blood, urine), x-rays and ultrasound are done.

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

During the recovery period, you should follow the instructions given by the veterinarian, especially in the rules of feeding: 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 disease in puppies

Predisposition to the disease in puppies can be transmitted through the hereditary line, from adult parents who have had hepatitis. Acquired pancreatitis in puppies (older than 6 months) 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 haphazard and uncontrolled feeding of a puppy - overweight, they are vulnerable to the disease. You can not give food prepared for adult dogs, it is difficult to digest by their digestive system, poor in essential vitamins.

At the first symptoms of unhealthy puppies (vomiting, severe diarrhea, fever), you should contact the veterinary clinic. Examinations of 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 fragile body of a puppy is difficult to tolerate the acute form of pancreatitis, the likelihood of transition to a chronic form is very high. Therefore, it is so important to follow all the recommendations of the rehabilitation period: observe dietary feeding, use special feeds and products for puppies, do all the necessary vaccinations, provide vitamins and minerals needed for growth.

Attention, only TODAY!

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. Acinar 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 weight compounds, are further destroyed by the 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 difficult section of clinical gastroenterology. As evidenced by the work of leading specialists - gastroenterologists, the prevalence of these diseases in recent years has a clear upward trend (Zhukova EN, 1998; Nimand HG, 2004; Westermarck E., 1980). The variety 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, at an older age - acute and chronic pancreatitis due to various reasons. The information given in the literature on the incidence of NEPV 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 (J. Simpson, 2003) . The features 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 NEPV, even if a diagnosis has been made, is often limited to only enzyme replacement therapy, which does not always lead to positive results.

We were faced with the task of developing a therapy for NEPV. After the diagnosis was made, 2 groups of animals of 20 heads each were formed - experimental and control, according to the principle of pairs of analogues. 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 appointment for late indications, that is, as replacement therapy for exocrine pancreatic insufficiency.

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

Animals of the experimental group (10 heads) were prescribed therapy according to the following scheme: Creon 10,000 at a dose of 10,000 units. (1 capsule) per feeding for 90 days; placenta emulsified denatured at a dose of 2 ml subcutaneously, a total of 7 injections with an interval of 36 hours, a multivitamin at a dose of 1 ml per 10 kg of body weight 1 time in 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 during the first 10 days of treatment. Diet therapy is identical to scheme 1.

The monitoring of the general condition of the dogs of 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, on the content of neutral fat, undigested muscle fibers, 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 droplets (in 10 fields of view)


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 in the animals of the experimental group is explained by the choice of the enzyme preparation. Creon 10000 is a fourth-generation double-shell enzyme preparation in the form of minimicrospheres enclosed in a capsule, which is the drug of first choice in replacement therapy for exocrine pancreatic insufficiency. 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 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 composition of 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, there is no withdrawal syndrome.

Tableted 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 along the digestive tract separately from the chyme and having no point of application for their action, can come out intact with feces.

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

An important factor in the complex therapy of NEFP is strict diet therapy, which excludes the use of any food, except for patented low-fat veterinary diets, which ensures the stability of the quality composition of the feed.
Thus, the algorithm for the treatment of NEPV is as follows: replacement therapy, preferably with drugs in the form of minimicrospheres, correction of diarrhea, replacement of pathogenic intestinal microflora with normoflora, 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. Elliot, V. Fresh et al. / / Focus. - Royal Canin, 2007.-67 p.
Zhukova E.N. Comparative evaluation of various diagnostic criteria for exacerbation of chronic pancreatitis./ E.N. Zhukova// Russian Gastroenterological Journal.- No. 1,1998 p.17-21.
Knight R. Diseases of the pancreas in dogs and cats /R. Night.-M.: PALMA press, 2003.-37 p.
Nimand H.G. Diseases of dogs / H.G. Nimand., 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 in dogs.
Don state agrarian university, Rostov-on-Don, Russia
At of exocrine pancreatic insufficiency complex therapy is prescribed. A preparation of the
first choice of replaceable therapy Kreon 10000.

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

The pathophysiology of exocrine pancreatic insufficiency is still not fully understood. Acinar 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 weight compounds, are further destroyed by the 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 difficult section of clinical gastroenterology. As evidenced by the work of leading specialists in gastroenterology, the prevalence of these diseases in recent years has a clear upward trend (Zhukova E.N., 1998; NimandKh.G., 2004; Westermarck E., 1980).

The variety 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, at an older age - acute and chronic pancreatitis due to various reasons. The information given in the literature on the incidence of NEPV 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 (J. Simpson, 2003).

Signs of exocrine pancreatic insufficiency are similar to diseases of the small intestine, which greatly complicates the differentiation of 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 NEPV, even if a diagnosis has been made, is often limited to only enzyme replacement therapy, which does not always lead to positive results.

We were faced with the task of developing a therapy for NEPV. After the diagnosis was made, 2 groups of animals were formed, each with 20 heads - experimental and control, according to the principle of pairs of analogues. As the most expedient, 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 appointment for late indications, that is, as replacement therapy for exocrine pancreatic insufficiency.

Animals of the control group (10 heads) were treated according to the following scheme: panzinorm 1 tablet per feeding; placenta emulsified denatured at a dose of 2 ml subcutaneously, a total of 7 injections with an interval of 36 hours, a multi-vitamin at a dose of 1 ml per 10 kg of body weight 1 time in 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 during the first 10 days of treatment.

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

Animals of the experimental group (10 heads) were prescribed therapy according to the following scheme: Creon 10,000 at a dose of 10,000 units. (1 capsule) per feeding for 90 days; denatured emulsified placenta at a dose of 2 ml subcutaneously, a total of 7 injections with an interval of 36 hours, a multivitamin at a dose of 1 ml per 10 kg of body weight 1 time in 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 during the first 10 days of treatment. Diet therapy is identical to scheme 1.

Indicators	sick animals	After 30 days of treatment	At the end of treatment	healthy animals
Indicators	Control	Control	Control	healthy animals
Number of drops of fat (in 10 fields of view)
Number of drops of fat (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 the dogs of the experimental group were close to the physiological norm.

The positive dynamics of the animals of the experimental group is explained by the choice of the enzyme preparation. Creon 10000 is a fourth-generation two-shell enzyme preparation in the form of minimicrospheres enclosed in a capsule, which is the drug of first choice in replacement therapy for exocrine pancreatic insufficiency. 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 small intestine. The enteric coating ensures the stability of the drug in an acidic environment, which significantly increases the effectiveness of replacement therapy in malabsorption/maldigestia syndrome. The absence of bile acids in the composition of the preparation excludes the risk of developing hologenous diarrhea. In addition, Creon 10000 does not suppress its own synthesis of enzymes; when switching to maintenance therapy, there is no withdrawal syndrome.

Tableted 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 along the digestive tract separately from the chyme and having no point of application for their action, can come out intact with feces.

In addition to pathogenetic therapy, symptomatic treatment is also mandatory. The use of a biostimulant - the placenta - improves the quality of life, restores metabolic processes in the body. Eubicor and bifiform restore the normal flora of the intestine, stop secondary enteritis, relieve the syndrome of excessive bacterial growth. The introduction of a multivitamin helps to quickly fill the deficiency of B vitamins.

Important in the complex therapy of NEFPZH is a strict diet therapy, which excludes the use of any food, except for patented veterinary diets with a low fat content, which ensures the stability of the qualitative composition of the food.

Thus, the algorithm for the treatment of NEPV is as follows: replacement therapy, preferably with drugs in the form of minimicrospheres, correction of diarrhea, replacement of pathogenic intestinal microflora with normoflora, 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 / DDeLorenzi, D.Elliot, V.Fresh et al.// Focus-Royal Can in, 2007.-67 p.
Zhukova E.N. Comparative evaluation of various diagnostic criteria for exacerbation of chronic pancreatitis / E.N. Zhukova// Russian Journal of Gastroenterology.-N°1,1998 p.17-21.
Knight R. Diseases of the pancreas in dogs and cats. Night.-M.: PALMA press, 2003.-37 p.
Nimand H.G. Diseases of dogs / H.G. Nimand., P.B. Suter.-M.: Aquarium, 2004.-806 p.
Westmark 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

Veterinary doctor of the treatment room, intern doctor.

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

Chronic diarrhea (diarrhea) is noted, feces acquire a pasty, shapeless appearance, have a large volume. Not infrequently there is coprophagia (eating one's own feces) or perversion of appetite, flatulence, weight loss with increased appetite. Wool loses its luster and becomes dull. Vomiting is rare. Dogs do not lose activity.

The pancreas is a digestive organ with exocrine and endocrine functions. The endocrine function consists in 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 is reduced, food is not digested, and the animal shows 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 is young dogs up to 4 years old.

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 may be a consequence of chronic pancreatitis.

One of the causes of EPI may be a violation of the motility of the stomach, namely, the acceleration of its emptying. This leads to insufficient stimulation of duodenal hormone synthesis, leading to inadequate secretion of the pancreas and the inability to activate its enzymes. An uncommon cause may be blockage of the excretory ducts of the pancreas (for example, neoplasms).

EPI is diagnosed based on a thorough history, clinical presentation, and exclusion of all other causes of diarrhea and weight loss. Routine tests, such as general and biochemical blood tests, are not possible to make a diagnosis, since we do not observe characteristic changes. Often there is a decrease in cholesterol, an increase in alanine aminotransferase (ALT), blood proteins in most cases are within the normal range.

To make a diagnosis, a specific test for species-specific serum trypsin-like immunoreactivity (TLI) should be used. A decrease in TLI indicates exocrine insufficiency. An alternative test is the determination of pancreatic elastase in feces, but the reliability of such a 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 the dog does not have EPI, but if elastase is lowered, 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. Apply powdered preparations or in the form of granules. At the moment, Russian veterinarians use the medical preparation Creon, which is given strictly in capsules (since the capsule dissolves in the acidic environment of the stomach, and the granules themselves enter the duodenal lumen unchanged). As a side effect, we can observe gingivitis / stomatitis, to eliminate these manifestations, it is necessary to reduce the dose. Any cancellation of enzymes leads to the return of clinical manifestations.

An alternative way to make up for enzyme deficiency is to give the animal a fresh or dry pancreas. Abroad, there is a dry pancreas Viokase, Pancrezyme.

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

From industrial feeds, Royal Canin (Gastrointestinal low fat, Hypoallergenic, Hypoallergenic moderate calorie), Purina Pro Plan (EN, HA), Hill's (i / d low fat, i / d) are prescribed.

It is also important to carry out symptomatic therapy. To replenish dehydration in the first days of treatment, infusion therapy with crystalloids is used. To prevent deficiency of vitamin B12 (cyanocobalamin), it is introduced into the treatment regimen. Antibiotic therapy is prescribed to suppress excess bacterial growth in the intestine.

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

Bibliography:

1. Pascal Pibaud, Vincent Bourge, Denise Elliott. Encyclopedia of Canine Clinical Nutrition. Aniwa S.A.S. Encyclopedia. Third edition. – 2006

2. Peter F. Suter, Barbara Cohn. Diseases of dogs. Aquarium Print LLC. 10th edition. – 2011.

3. Sophia Yin. The Complete Guide to Small Animal Veterinary Medicine. M: Aquarium. Second edition. – 2008.