Exocrine Pancreatic Insufficiency in the Dog: Breed Associations,Nutritional Considerations,and Long-term Outcome

Canine exocrine pancreatic insufficiency (EPI) is an alimentary tract disorder causing malabsorption and debilitations in affected individuals. This article covers predisposing factors to EPI and response to therapy. Although relatively easy to diagnose, knowledge of breed predispositions (and also of those breeds where the disease is less common) can guide the clinician. Numerous studies have examined therapy for EPI, and a key finding is the variability in response among affected dogs. This implies that close monitoring and individual tailoring of therapy is needed to maximize the chance of success. Important factors affecting outcome are the choice of enzyme preparation, presence of hypocobalaminemia, and the response to the first 2 to 3 months of therapy.     

Exocrine Pancreatic Insufficiency in the Cat

Exocrine pancreatic insufficiency (EPI) is a syndrome caused by an insufficient amount of pancreatic digestive enzymes in the small intestine. Clinical signs most commonly reported in cats with EPI are weight loss, loose and voluminous stools, steatorrhea, polyphagia, and in some cases a greasy soiling of the hair coat in the perianal region. Serum feline trypsin-like immunoreactivity concentration is the diagnostic test of choice for the diagnosis of affected cats. Treatment of cats with EPI consists of enzyme supplementation with either a powdered pancreatic extract or raw pancreas. Most cats with EPI also have severely decreased serum cobalamin concentrations and may require lifelong parenteral cobalamin supplementation. Most cats respond well to therapy and can have a normal life expectancy and quality of life.     

Serum Trypsinlike Immunoreactivity Measurement for the Diagnosis of Subclinical Exocrine Pancreatic Insufficiency

Dogs (n = 158) with serum trypsinlike immunoreactivity (TLI) concentrations < or = 5.0 microg/L were studied. The diagnosis of clinical exocrine pancreatic insufficiency (EPI) was made in 114 of 158 dogs based on TLI concentration < 2.5 microg/L and clinical signs typical of EPI (eg, polyphagia, voluminous feces, weight loss). In 44 of 158 dogs, a single TLI measurement and clinical signs were not diagnostic. In 9 of 44 dogs, TLI was < 2.5 microg/L, indicating EPI, but the gastrointestinal signs were atypical or the dogs were asymptomatic. In 35 of 44 dogs, TLI was 2.5-5.0 microg/L. All 44 dogs were retested for TLI within 1-27 months (mean, 11.9 months). In 20 of 44 dogs, the retested TLI was normal (> 5.0 microg/L). In 4 of 44 dogs with clinically diagnosed EPI, the retested TLI was < 2.5 microg/L. In the remaining 20 of 44 dogs, TLI was persistently < 5.0 microg/L (range, 1.0-4.9 microg/L; mean, 3.1 microg/L). Of these dogs, 15 had no clinical signs of gastrointestinal disease, and 5 had occasional clinical signs atypical for EPI. Gross examination of the pancreas (12 dogs) showed that the amount of normal pancreatic tissue was remarkably diminished. These dogs were diagnosed with subclinical EPI. The TLI-stimulation test, in which TLI is measured before and after stimulation with secretin and cholecystokinin, showed a significant response (P < .05) both in dogs with subclinical EPI and in control dogs, but showed no response in dogs with clinical EPI. In this study, EPI was diagnosed in its subclinical phase by TLI concentrations persistently < 5.0 microg/L, and a single TLI concentration < 5.0 microg/L was not diagnostic. Retesting after TLI concentrations < 5.0 microg/L is recommended even in clinically normal dogs, because of the possibility of subclinical EPI.     

Heritability of Exocrine Pancreatic Insufficiency in German Shepherd Dogs

Background: Several studies have revealed that exocrine pancreatic insufficiency (EPI) is an inherited disease in German Shepherd Dogs (GSDs). Pedigree analyses have suggested an autosomal recessive inheritance model. Objective: Test mating of 2 dogs with EPI. Animals: A sire and dam purebred GSD both with EPI and a litter of 6 puppies. Methods: Test mating and long‐term follow‐up of offspring. The pancreas was biopsied via laparotomy on 26 occasions. Serum trypsin‐like immunoreactivity was measured. Study was approved by Animal Ethics Committee. Results: During the 12‐year study period only 2 of the 6 offsprings developed pancreatic acinar atrophy (PAA). In 1 puppy, end‐stage PAA and in the other puppy partial PAA was diagnosed. Conclusions and Clinical Importance: PAA is not a congenital disease in GSDs. This study provided evidence that PAA is not inherited in a simple autosomal recessive fashion.     

Exocrine Pancreatic Insufficiency in Dogs and Cats: Online Support for Veterinarians and Owners

Pet owners increasingly refer to online sources before, during, and after seeking veterinary advice for their pets. Although some online information is inaccurate or unhelpful, there is much useful material, and we believe much is to be gained by directing owners to online material that supports and complements veterinary advice. With regard to managing veterinary patients with exocrine pancreatic insufficiency (EPI), there is an excellent online community that not only offers moral support and practical advice, but also facilitates clinical research and fundraising. For genetic diseases like canine EPI that affect primarily young animals, but for which a decade or more of treatment can reasonably be expected, online support can greatly facilitate optimal lifelong management. In this article we provide some information that may be of value when veterinarians consider which web sites to recommend to their clients managing patients with EPI.     

Current Status of Genetic Studies of Exocrine Pancreatic Insufficiency in Dogs

Exocrine pancreatic insufficiency (EPI) is a disorder wherein the pancreas fails to secrete adequate amounts of digestive enzymes. In dogs, EPI is usually the consequence of an autoimmune disease known as pancreatic acinar atrophy. Originally believed to be a simple autosomal recessive disorder, a test-breeding recently revealed that EPI has a more complex mode of inheritance. The contributions of multiple genes, combined with environmental factors, may explain observed variability in clinical presentation and progression of this disease. Research efforts aim to identify genetic variations underlying EPI to assist breeders in their efforts to eliminate this disease from their breed and provide clinicians with new targets for therapeutic intervention and/or disease prevention. Genome-wide linkage, global gene expression, and candidate gene analyses have failed to identify a major locus or genetic variations in German Shepherd Dogs with EPI. Recently, genome-wide association studies revealed numerous genomic regions associated with EPI. Current studies are focused on alleles of the canine major histocompatibility complex. In this article we review findings from scientific investigations into the inheritance and genetic cause(s) of EPI in the purebred dog.     

The Treatment of Acute Adrenocortical Insufficiency in the Dog

Acute hypoadrenocorticism in the dog is a true medical emergency that requires a prompt and accurate diagnosis and appropriate treatment in order to provide for the most optimal outcome. Because the signs of adrenal insufficiency mimic those caused by other more common clinical conditions such as renal failure, intoxications, and various gastrointestinal disorders, it behooves the emergency clinician to always include this condition in the list of differential diagnoses. This paper will review the main elements of this hypoendocrinopathy in order to provide the emergency clinician with the essentials that will be required for appropriate diagnosis and treatment.
J Vet emerg Crit Care 2001; 11(1):7–14     

犬肠梗阻的诊疗

当内容物在肠道内的正常运行发生障碍不能顺利通过时，称为肠梗阻。本病由物理性和功能性所致，临床上以呕吐、腹痛及明显的全身症状为特征。由于肠腔内容物运行障碍，使机体的胃肠功能发生改变，造成水、电解质平衡失调，酸碱平衡紊乱，肠内毒素的积聚，还可能出现休克。     

一例观赏犬腹水症的诊治

犬腹水症又称腹腔积水 ,是一种慢性、非炎症性疾病 ,该病致死率较高 ,老龄犬和幼犬多易发生 ,是犬病中较常见疾病、危害很大。最近 ,我县兽医院遇到一起典型的犬腹水症病例 ,采用标本兼治的方法进行处理 ,收到了良好的疗效。1　临床症状患病犬为砖厂职工李某家饲养的 1只 4岁小蝴蝶犬 ,曾产仔两窝 ,主诉该犬产仔后 1个月开始渐进性腹围增大 ,手摸内存大量液体 ,患犬喜坐姿休息 ,食欲 ,饮欲正常 ,但随病情加重 ,食欲减退 ,病程半月后 ,犬主前来就诊。经临床检查 ,患犬被毛粗乱 ,Ｔ正常 ,Ｐ增数 ,下腹部两侧对称性膨大 ,体位改变时 ,腹部外形…     

一例犬糖尿病的诊断与治疗

犬糖尿病是犬的常发疾病,其临床症状为多饮、多食、多尿、体重下降。持续的血糖升高导致机体代谢紊乱,出现如白内障、胰腺炎、肾上腺皮质机能亢进等继发症,对犬的生活质量及生命健康造成严重的威胁。论文对1例Ⅰ型糖尿病犬进行详细分析,通过测量血糖、尿糖确诊为糖尿病,并通过实验室检查包括血细胞计数、血清生化检测及血气分析,排除并发症。治疗过程与主人共同配合,使用外源性胰岛素结合食物疗法与运动疗法。目前该犬的血糖稳定并接近正常值,身体状况得到改善,生活质量提高,主人对治疗效果满意。持续治疗方法是根据犬的身体情况及血糖变化适当调整胰岛素的剂量。     

犬产后惊厥的诊断和治疗

犬产后惊厥是小动物临床经常发生的产科疾病。该病表现为体温升高、呼吸急促、全身痉挛,容易误诊,治疗不及时甚至造成死亡。在小动物临床上要注意该病的诊断、治疗和预防。     

哺乳母犬低血钙症的诊疗

哺乳母犬低血钙症又称犬产后抽搐、产后子痫、泌乳期惊厥症、产后风等 ,是以发病突然、高热、呼吸急促、肌肉强直性痉挛为特征的一种营养代谢性疾病。多发于产后 1～ 3周 ,产仔较多的小、中型母犬。初产和经产母犬均可发生 ,但青年母犬的发病率较高。笔者在近几年的临床工作中诊治此类病 37例 ,除 1例由于户主就诊不及时而死亡外 ,其余全部治愈。现报告如下。1　临床资料37例病犬中 ,2岁以内的青年母犬有 33例 ,其余 4例母犬的年龄为 3～ 4岁 ,4岁以上母犬未见发病。多在产后 9～ 2 3天发病 ,个别犬在产后第 3天即可发病 ,发病时间最长的可…     

宠物犬牙周病的诊治

牙周病是指发生在牙齿支持组织的疾病,是犬最常见、最严重的一种口腔疾病。论文根据临床治疗经验,对犬牙周病的发病原因、临床症状、诊断及防治措施等进行了论述,可为该病在小动物临床中的诊疗提供参考。     

犬瘟热的诊疗及血细胞变化监测

患犬经临床检查和实验室检验确诊为犬瘟热.综合采用抗病毒、抗菌、对症治疗和支持疗法,并对诊疗过程中患犬的血细胞变化进行了监测;患犬康复后留有抽搐后遗症.     

一例犬皮下气肿的诊治

随着宠物饲养数量的增多,犬皮下气肿逐渐成为小动物临床的一种常见病.其原因复杂,常见于食道、胃或气管、肺等损伤,皮肤伤口、手术切口感染等.患处皮肤肿胀,因发病原因各异而出现不同的临床表现,轻微者无明显不适,严重者会出现饮食欲下降,精神不振,甚至致死.皮肤疏松部位的气肿如不及时治疗,易向周边扩散,甚至蔓延至全身.论文报告了...     

一例犬脾脏血管肉瘤的诊治

在对1例患有脾脏血管肉瘤的松狮犬进行临床检查、超声诊断和病理组织学检查的基础上,对患犬施行了脾脏切除术,结合化疗,取得了较好的治疗效果.     

宠物犬巴贝斯虫病的临床诊疗

犬巴贝斯虫病是一种虫媒性血液寄生虫病。由于流行病学的特点,多发生于工作犬。近年来由于宠物犬的数量剧增,本病在宠物犬中时有发生。笔者在宠物门诊工作过程中,通过对数例宠物犬巴贝斯虫病的诊治实践,针对本病的流行特点,采用对因疗法和对症疗法,取得了较好的疗效。     

一例犬恶性黑色素瘤的临床诊治

犬黑色素瘤比较常见,以皮肤色素深的老年犬多发。通过对1例患恶性黑色素瘤松狮犬的跟踪观察和治疗,就其临床症状、病理诊断做了较为详细的研究,以期为该病在小动物临床中的诊疗提供依据。