Exocrine Pancreatic insufficiency (EPI) Treatment Study 

Aran Mas DVM MRCVS

P-J.M.Noble BSc BVM&S PhD MRCVS, 

A.J.German BVSc PhD CertSAM DipECVIM-CA MRCVS

EPI is a common condition in dogs with early response to therapy being critical for positive outcomes (Batchelor et al, 2007). Pancreatic enzyme supplementation is the key component of therapy in EPI. Numerous enzyme preparations exist for use in dogs, some of which are enteric-coated and some uncoated.  Although one retrospective study on treatment of EPI suggested a better response with uncoated preparations (Hall et al., 1991), there was no difference in response amongst preparations in a more recent study (Batchelor et al., 2007).  However, prospective clinical trials, on treatment of EPI, are lacking.

The Small Animal Teaching Hospital, University of Liverpool, is performing the first randomised double-blind trial to examine the effect of enteric coating on efficacy of pancreatic enzyme supplementation in the treatment of canine EPI. We are aiming to recruit dogs recently diagnosed with EPI for inclusion in this trial. Enrolled patients will undergo clinical evaluation, two months of treatment and follow-up advice, all free of charge.

Inclusion criteria:

• Clinical signs consistent with EPI (weight loss, poor weight gain, diarrhoea, polyphagia, coprophagia
• Serum trypsin-like immunoreactivity (TLI) measurement consistent with EPI

Exclusion criteria:

• Animals with concurrent diseases that may affect the diagnosis, treatment or prognosis. The decision for exclusion of a particular case will rest with the investigator
• Cases that have not had routine haematology and  biochemistry analysis performed at the referring veterinary surgeon
• Cases with severe disease or debilitation, e.g. requiring hospitalisation and intensive management. However, such individuals may be suitable candidates once recovered
• Cases already on therapy for EPI
• Owners not willing to travel to the Small Animal Teaching Hospital for 4 consultations during the study period time (2 months) 

If you have a suitable case and would like to discuss enrolment on the trial, please do not hesitate to contact us (telephone 0151 795 6100, vetinmed@liv.ac.uk)

References

BATCHELOR, D.J., NOBLE, P.J.M., CRIPPS, P.J., TAYLOR R., GERMAN, A.J. (2007) Prognostic factors in canine exocrine pancreatic insufficiency: prolonged survival is likely if clinical remission is achieved.  Journal of Veterinary Internal Medicine 21; 54-60

HALL,  E.J., BOND, P.M., MCLEAN, C., BATT, RM, MCLEAN, L (1991) A survey of the diagnosis and treatment of canine exocrine pancreatic insufficiency.  Journal of Small Animal Practice 32; 613–619.