What is EPI in German Shepherds?

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German Shepherds are a noble breed of dogs, but they can be predisposed to some genetic diseases. I didn’t know what EPI was when I heard about it mentioned, so I decided to look further into this disease and how it affects German Shepherd Dogs.

So, what is EPI in German Shepherds? EPI is a disease known as Exocrine Pancreatic Insufficiency. It occurs more commonly in German Shepherds than in other breeds and appears to have a genetic basis. It is caused by destruction of the pancreas, so digestive enzymes are not produced, which means that the dog cannot digest its foods.

German Shepherds are prone to digestive disorders, namely EPI. It can cause affected dogs to be malnourished, leading to weight loss, soft, greasy stools, and overall unthriftiness. The problem with EPI is that it doesn’t matter what food you feed your dog. If your dog is eating the highest quality dog food or even a raw diet, they can still be affected by EPI and need treatment for the rest of their lives.

What Causes EPI in German Shepherds?

Exocrine pancreatic insufficiency is caused when the pancreas, one of the body’s internal organs, gets destroyed on a microscopic level.

The exocrine, or digestive functions, get destroyed, rather than the endocrine functions, which are regulated by different cells and are responsible for blood sugar regulation. The most common cause is pancreatic acinar atrophy, when acinar cells get destroyed by the dog’s own immune system.

The acinar cells help produce enzymes and chemicals that are responsible for digesting foods, such as carbohydrates.

These chemicals get secreted from the pancreas into the small intestine, where they go to work breaking down carbohydrates, fats, and proteins that have been digested by the dog. When these acinar cells are destroyed, none of the enzymes or chemicals are produced, so the body’s ability to digest is greatly diminished.

In dogs with EPI, the body also keeps bicarbonate from getting to the small intestine, which is needed to help with digestion and buffering in the gut, neutralizing stomach acid. Lipases which help break down fats are not made, and neither is amylase which breaks down carbohydrates.

Acinar cells also produce proteases which are enzymes responsible for breaking down proteins. Without these large macromolecules being broken down, they cannot be absorbed across the intestinal barriers.

Dogs with EPI tend to be unthrifty.

They eat ravenously but continue to lose weight.

Their hair coat can become matted and greasy from lack of nutrition.

Their stools tend to be large amounts and diarrhea of soft consistency, often looking greasy, while you can hear gurgling from their intestines. Some affected pets vomit or drink large quantities of water.

Testing for EPI

If your veterinarian suspects that your dog has EPI, there are several tests that they might run to evaluate your dog.

First, they’ll want to run a fecal test, to ensure your pup doesn’t have evidence of intestinal parasites, which can present in very similar ways. They may also run baseline blood work or take X-rays, also known as radiographs, to rule out other underlying diseases or causes for your dog’s symptoms.

As part of testing, your veterinarian may check your dog’s folate and cobalamin levels, which are nutrients found within the body.

Folate tends to be elevated in cases of EPI, while cobalamin levels tend to decrease in cases of EPI. This is related largely to the bacterial overgrowth that tends to occur in cases of EPI, which may need antibiotics to be treated.

The standard of testing for EPI is an assay known as serum trypsin-like immunoreactivity (TLI).

Trypsinogen is a component that leaks from the pancreas into the bloodstream. With EPI, the levels for TLI on blood work are very low because large amounts of the pancreas are destroyed, generally more than 90% in cases of EPI.

Treatment for EPI

Treatment for EPI tends to be lifelong, so it can get expensive for your dog, especially since dogs tend to be diagnosed when they are younger, often less than 5 years of age.

The mainstay of therapy is supplementation of pancreatic enzymes.

These are available in a variety of forms, including powders and capsules, with the powders tending to be more effective than other forms.

Some pets do better with supplementation of fresh pancreas.

This can be maintained in the freezer for several months to maintain its effectiveness. Unlike some forms of enzyme supplementation, you don’t need to incubate your dog’s food with fresh pancreas before you feed them. You can add it and feed them at the same time.

Many dogs with EPI need cobalamin supplementation, determined if their value when tested is low.

They may also suffer from other vitamin deficiencies that need to be supplemented, such as Vitamin K deficiency, which can lead to issues like blood clotting disorders if it is not corrected.

Vitamin B-12 may also need to be supplemented.

If your dog has EPI, he may also need antibiotics.

This occurs because the normal protective mechanisms of the gut are not working properly, allowing pathogenic bacteria to overgrow, a process known as bacterial overgrowth. The antibiotics used may include metronidazole or amoxicillin.

For some GSD’s, supplementation with probiotics may also need to occur.

Depending on how your dog responds, they may also need to go on a different diet.

Some veterinarians recommend low-fat diets, such as Royal Canin Gastrointestinal Low Fat, while others may recommend hypoallergenic diets, such as Hill’s z/d.

This may also be determined by if they have compounding intestinal disease, such as inflammatory bowel disease.

Preventing EPI

There is not much that can be done to prevent EPI from developing in a given dog.

It appears to likely be a polygenic trait, so breeding to avoid it would be key.

Affected dogs should be removed from breeding programs, as should their progeny. If an unaffected breeding pair produces puppies that go on to develop EPI, they should not be bred again. In addition, line-breeding can increase the risk of genetic diseases like EPI developing.

At this time, there are no tests that can determine if a puppy is going to develop EPI.

Monitoring your German Shepherd closely as they age is an important part of getting a diagnosis more quickly. If you start to notice your German Shepherd is having issues with their stool, having bad gas, and constantly hungry, make an appointment with your veterinarian to go over potential causes.

Related Questions

What age do German Shepherds develop EPI?

German Shepherds can develop EPI at any time in their lives, but it tends to begin occurring when they are younger, usually between 6 months and 6 years of age, with the vast majority being less than two years old when they are initially diagnosed.

What is the best dog food for German Shepherds with EPI?

The best dog food for your pet really depends on how they respond to pancreatic enzyme supplementation and if they have other diseases at the same time. Some pets do better without grains or with low fat, and your veterinarian may recommend a diet composed of novel proteins for your pet. Treats should be limited without enzyme supplementation; instead toys or ice cubes are recommended.

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