Exocrine pancreatic insufficiency (EPI) is caused by the inability of the pancreas to secrete digestive enzymes. Without these enzymes to help break down and absorb nutrients, the body becomes so compromised that the dog either starves to death or dies of organ failure. Visible symptoms, which often mimic symptoms of other conditions, may not appear until most of the pancreas has atrophied, and one of the major difficulties with this uncommon disease is that it takes so long to properly diagnose. ̶0;About 70 percent of dogs with exocrine pancreatic insufficiency are German shepherd dogs," according to the website "VeterinaryPartner"'s Wendy C. Brooks, DVM.
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Diarrhea
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Diarrhea and yellow, orange, gray or pale-colored "cowpie"-looking stools are one of the most common symptoms of EPI and may be the first sign the owner notices. Many dogs have voluminous and frequent stools that are fluffy, pulpy, puttylike, watery, greasy or oily-looking as well as foul-smelling.
Many EPI dogs are assumed to have Giardia or some other parasitic condition, but the diarrhea seldom goes away, no matter what you or your vet try. Any dog, especially if it is a German Shepherd, that has chronic diarrhea and weight loss, should have the TLI test, a reliable way to diagnose EPI.
Weight Loss
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The signs associated with EPI "usually fit a distinct pattern," according to Dr. Race Foster, DVM. In some dogs, the symptoms show up gradually; in others they may "develop rapidly over a period of a week or two." Because they are not absorbing nutrients, dogs show rapid weight loss caused by deterioration of body fat and subsequent muscle atrophy. As the disease progresses, the deterioration often becomes quite rapid.
Appearance
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Your dog's coat will probably have a poor quality and her skin will become progressively drier. The dog will appear to be starving to death because she is. Symptoms may be exacerbated by physical or emotional stress, a change in food, routine or environmental factors. Due to the lack of absorbed nutrients, the body starves: muscle mass wastes away and bones may also be affected. The most alarming symptoms include gradual wasting away despite a voracious appetite.
Hunger
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A German shepherd with pancreatic insufficiency will be constantly hungry and eat as much food as he can ingest at one time. Many dogs exhibit pica, eating abnormal things such as plants, dirt and household items and coprophagia, which is eating its own feces. When their hunger becomes overwhelming, many dogs act almost feral.
Behavior
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As the process of starvation continues, the dog's nervous system, including the brain, may be affected, and this will wreak havoc with your dog̵7;s temperament and personality. Some EPI dogs become increasingly anxious and fearful of other dogs, people, objects or situations.
Feeling sick all the time can cause dogs to lose interest in their usual activities, and some prefer to just lie down or hide from everything and everyone.
Misdiagnosis
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Unless your veterinarian is familiar with EPI, vet visits may become numerous and costly as one diagnosis after another is suggested. Expenses may include testing for giardia, coccidiosis and other parasitic diseases, antibiotics, x-rays, ultrasounds and even surgery.
Owners of EPI dogs can become extremely frustrated, as they attempt to feed more and different foods, while their dogs continue to waste away. Some people do a lot of research and eventually come upon websites and online support groups that offer explanations for their dogs' symptoms. One such resource is the "k9-EPIGLOBAL" list whose membership consists of people whose dogs, many of which are German Shepherds, have been diagnosed with exocrine pancreatic insufficiency.
(reference 3
http://pets.groups.yahoo.com/group/k9-EPIGLOBAL/)
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