Monday, June 23, 2008

EPI - We Learn More

Over the past few weeks I have learned a lot about Catcher's issues. Simply put Exocrine Pancreatic Insufficiency means that he cannot absorb the nutrients he is digesting. Which explains his wasting over the last few weeks.

From an online article:

"The pancreas has two functional parts. The endocrine part secretes insulin and glucagon, which are essential for the metabolism of carbohydrates. The exocrine part consists of units called acini that produce and secrete enzymes essential for the digestion of protein, into the small intestine. With EPI, there is a gradual wasting away (atrophy) of the acini. Clinical signs do not develop until most of the acini are gone. As dogs lose the ability to digest protein, they progressively lose weight despite a voracious appetite.

Affected dogs lose weight despite voracious appetites, and usually pass large amounts of semi-formed feces. They often eat their own stools, or other inappropriate substances. Some dogs with this condition do not show these typical signs, and may experience intermittent watery diarrhea or vomiting.

Although this disorder cannot be cured, management is generally fairly straightforward. Powdered pancreatic enzyme extract is mixed in with each meal. Within a few days, your dog's appetite and stools should become more normal, and s/he will begin to gain weight. Enzyme supplementation of your dog's food will be necessary for life." 1998 Canine Inherited Disorders Database.

From the Cornell website:

Description: EPI is characterized by inadequate production of digestive enzymes from pancreatic acinar cells. This might be a result of chronic pancreatitis, juvenile pancreatic atrophy, decreased function in severe protein-calorie malnutrition, or rarely following acute hemorrhagic pancreatitis. The lack of digestive enzymes and bicarbonate secretion results in acidification of the gut, malnutrition and weight loss, with voluminous stools containing undigested fat, muscle fibers and protein.

Signs: Abdominal distention, Abnormal behavior, aggression, changing habits, anorexia, diarrhea, dullness, flatulence, increased borborygmi, internal abdominal mass, lack of growth or weight gain, pale, pica, polydipsia, polyphagia, rough hair coat, steatorrhea (fatty stools, feces), Tachycardia, underweight (poor condition, thin, emaciated, unthriftness, ill thrift), unusual or foul odor (stools, feces), vomiting or regurgitation, weight loss

After reading several different articles, and talking with my friend Jenn whose collie is suspected to have EPI, I realized that Catcher had certainly been showing most of the symptoms. The problem was that they were intermittent, and any of those symptoms could be evidence of something else. For a long time we suspected that his off and on again diarrhea was due to a parasite problem (he had picked up whipworms at daycare as a puppy and we'd been treating with panacur regularly to break the cycle). It was only when looking at everything as a whole did the pieces of the puzzle begin to fit together.

I was still left with asking how and why. How did an adolescent dog who was perfectly healthy (as proven by multiple blood workups) develop all of these conditions (KCS, EPI, Diabetes) within 2 months of each other. What had changed? Did his neuter have any effect on this? The unfortunate problem was that no one had any answers. All 3 conditions are fairly rare in Border Collies, especially ones under the age of two. EPI and Diabetes are both pancreatic and if untreated EPI can lead to Diabetes. However, the KCS was a totally unrelated issue.

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