Mary Allen
If the pancreas is not up to its job, no matter how full the food bowl is, your dog will be hungry all the time and still lose weight. Read here about how this happens and how you can help.
What Causes Pancreatic Insufficiency?
A hereditary, so-called juvenile form of pancreatic insufficiency occurs in young dogs. Although they are usually born with a functioning pancreas, this begins to shrink as puppies (pancreatic atrophy), so many young dogs develop their first symptoms between the ages of 6 and 18 months. But some later. It is believed that an autoimmune reaction causes this shrinkage. Large dogs such as German shepherds are particularly often affected, as are short-haired collies.
However, pancreatic weakness can also be the result of inflammation of the pancreas (pancreatitis), when the inflammation destroys so much tissue that there are no longer enough enzyme-producing cells to meet the need for digestive enzymes. It is extremely rare for a single acute inflammation to destroy so much tissue. In most cases, hypofunction is the result of chronic pancreatitis, the recurring flare-ups of which can go unnoticed.
Tumors rarely cause pancreatic insufficiency, and cancer patients usually have symptoms other than pancreatic insufficiency.
What Happens with Pancreatic Insufficiency?
Pancreatic insufficiency means that the pancreas does not produce enough digestive enzymes to break down food sufficiently. Signs of the disease only appear when about 90% of the pancreas is no longer functioning. Technically, the disease is then called “exocrine pancreatic insufficiency”, or EPI for short.
The hormone-producing (endocrine) part of the pancreas is not usually affected in puppies with pancreatic atrophy, so they do not develop diabetes. If the EPI is the result of inflammation, the insulin-producing cells are also damaged and the dogs can suffer from diabetes.
Due to the lack of digestive enzymes, fats, proteins, and carbohydrates cannot be broken down sufficiently to be absorbed through the intestinal wall into the bloodstream. The vital nutrients are ultimately excreted unused with the feces, resulting in malnutrition. Before that, however, they are fermented by colon bacteria into water-attracting (osmotic) substances. The result is foul-smelling diarrhea.
Fat digestion is most impaired in EPI. This not only leads to a lack of energy intake, but also to a reduced intake of fat-soluble vitamins (A, D, E, K), which can lead to vitamin deficiencies. The absorption of vitamin B12 (cobalamin) is also impaired with EPI, so in a study over 80% of the dogs had a vitamin B12 deficiency which, if left untreated, worsened the chances of recovery.
In about two-thirds of the dogs affected by EPI, the small intestine is also overgrown with bacteria (SIBO = small intestinal bacterial overgrowth), which is normally prevented by bacteria-inhibiting substances in pancreatic juice. This also impairs fat digestion.
How Does Pancreatic Weakness Manifest Itself?
Dogs with exocrine pancreatic insufficiency typically suffer from persistent diarrhea that has its origin in impaired small intestine digestion (chronic small intestine diarrhea). However, mucoid diarrhea in the large intestine can also occur.
Typically, affected dogs defecate in large amounts very often (about 6 to 10 times). This is usually very light (clay-colored), has a foul-sour smell, and contains a lot of fat (steatorrhea). Undigested food components can be seen in the feces. Loud belly growling (borborygmus) and flatulence are also common.
Since dogs with pancreatic insufficiency cannot or only insufficiently absorb the nutrients from the food, they suffer from weight loss and have constant cravings. Some dogs eat everything that comes in front of their nose, e.g. feces or waste (allotriophage, pica).
Attempting to feed these dogs a high-energy diet often only makes diarrhea worse, as the diet is usually high in fat and fat digestion is most affected in EPI.
If the pancreas weakens in the first year of life, affected dogs show developmental delays.
Malnutrition and especially the lack of essential fats can lead to scaly skin (seborrhea) and a dull coat.
In very severe cases, coagulation disorders can occur due to a vitamin K deficiency, which becomes visible, for example, as bruising in the subcutaneous tissue.