Exocrine Pancreatic Insufficiency in dogs: Is yours at risk?
If your dog has just been diagnosed with EPI (exocrine pancreatic insufficiency), you likely feel relieved to have an answer – and worried about what it means. EPI in dogs means the pancreas is not producing enough digestive enzymes, so your dog eats but cannot properly digest or absorb nutrients.
The result is a very hungry dog that keeps losing weight, passing large smelly stools, and often looking scruffy or under-muscled. The key point is that, with the right treatment from your vet and a few practical adjustments at home, most dogs with EPI can live a normal, happy life. [1]
TL;DR
- EPI = not enough digestive enzymes, so food passes through poorly digested. [1]
- Classic signs: weight loss despite big appetite, pale/greasy smelly poo, lots of poo, gas, poor coat. [1][4][5]
- Diagnosis: your vet confirms EPI with a TLI blood test (usually after fasting) and often checks B12. [1][7]
- Treatment: enzymes with every meal for life + correct any B12 deficiency; diet is typically highly digestible and low fibre (fat level varies by dog). [1][5][11]
- Working dogs can still thrive once stable — you just need a routine and to plan enzymes/food for training days. [1]
Key takeaways for UK owners
- EPI in dogs = pancreas not making enough digestive enzymes, so your dog eats but can’t absorb nutrients properly. [1]
- Typical signs: weight loss despite a big appetite, large pale smelly stools, poor coat, and low energy. [1][4]
- Treatment is lifelong: enzyme replacement plus diet adjustments, usually guided by your vet. [1][5]
- Prognosis is usually excellent: most dogs with EPI can live a normal, active life when well managed. [1][10]
What is EPI in dogs (exocrine pancreatic insufficiency)?
Exocrine pancreatic insufficiency (EPI) in dogs is a condition where the pancreas can no longer do its exocrine job: making digestive enzymes. In a healthy dog, the pancreas releases enzymes into the gut to break down protein, fat and carbohydrate. In a dog with EPI, most of those enzyme-producing cells have been lost or damaged, so food passes through the intestine largely undigested. [1]
Any breed can develop EPI, but it is seen most often in young adult German Shepherd Dogs, who comprise a large proportion of cases in several studies. [2] In many affected dogs, especially German Shepherds and Rough Collies, EPI is caused by a genetic problem called pancreatic acinar atrophy – the enzyme-producing cells gradually shrink and are destroyed, likely involving immune mechanisms. [3][16] EPI can also develop in older dogs after severe or repeated pancreatitis (inflammation of the pancreas), or more rarely after pancreatic surgery or because of a birth defect. [1][4] Whatever the cause, the end result is the same: your dog is not getting enough nutrition from their food.
Because the body has a large “reserve” of enzyme-producing tissue, symptoms often do not appear until around 90% (or more) of pancreatic function is lost. [1][5] Without treatment, the dog becomes progressively malnourished – they may eat huge amounts yet still lose weight. EPI is not contagious and it is not caused by anything you did wrong as an owner. It cannot be cured, but it can be managed for life with enzyme supplements and the right diet. [1]
What this means for you at home:
- Add enzymes to every meal for life. Your dog’s pancreas will not “recover”, so they rely on enzymes with all food. [1]
- Remember it is not your fault. EPI usually has genetic or medical causes; you did not cause it, and it is not contagious. [4]
- Plan for lifelong management. Consistent enzymes, the right food and regular vet checks keep most dogs well. [1]
- Working dogs can still thrive. Many working dogs continue to train and work once their EPI is under control. [1]
Symptoms of EPI in dogs
Because a dog with EPI can’t absorb nutrients, they effectively begin to starve no matter how much they eat. The most commonly reported signs are weight loss, loose stools and (in dogs) polyphagia (big appetite). [1][4]
| Symptom | What you see at home | Why it happens |
|---|---|---|
| Weight loss | Dog looks ribby or thin despite eating well | Food is not digested, so calories are lost in stool |
| Big, pale, smelly stools | Large, soft or runny yellow/grey poo with strong smell | Undigested fat and nutrients pass straight through |
| Ravenous appetite | Constant hunger, scavenging, stealing food | Body is “starving” so brain drives the dog to eat more |
| Poor coat | Dull, thin coat; flaky or greasy skin | Lack of protein, fat and vitamins for hair and skin |
Typical symptoms include:
- Weight loss despite a big appetite: Many EPI dogs act ravenous, yet keep losing weight or condition. [1][4]
- Large, soft or runny poos: Pale, loose, voluminous, often malodorous stool is common; greasy stool (steatorrhoea) can occur too. [1][4]
- Gas, tummy rumbling and “odd” eating: Flatulence, borborygmus, coprophagia and/or pica are reported in some dogs with EPI. [5]
- Poor coat and condition: Poor coat quality and muscle loss can happen over time due to malnutrition. [5]
These signs can look like other digestive problems too. EPI is considered uncommon, and diagnosis relies on specific testing rather than symptoms alone. [1] Some UK sources estimate EPI affects around 0.1–0.3% of dogs. [6]
What this means for you at home:
- Weigh and photograph your dog regularly. Tracking weight and body condition helps you spot changes early.
- Keep a simple “poo and food” diary. Note what you feed, enzyme dose, and stool quality.
- Be patient with past behaviour. Food-stealing or eating stool can be driven by malnutrition and often improves as treatment works.
- Call your vet if symptoms return. Fresh weight loss, sloppy stools or poor coat usually means treatment needs adjusting.
EPI in dogs diagnosis: TLI test and B12
Confirming exocrine pancreatic insufficiency in dogs requires veterinary tests – it’s not something that can be diagnosed just from symptoms. The key diagnostic test is a blood test called TLI (trypsin-like immunoreactivity). A very low serum TLI is diagnostic for EPI. [1][7] Laboratories typically advise fasting before sampling (often 8–12 hours). [7]
Vets will often check vitamin B12 (cobalamin) at the same time, since many dogs with EPI are B12 deficient and this can affect response to treatment. [1][5] Your vet might also run other bloodwork or imaging to look for concurrent disease (e.g. chronic pancreatitis, chronic enteropathy). [1]
What this means for you at home:
- Trust the diagnosis. If your dog’s TLI test confirms EPI, focus on consistent management.
- Ask specifically about B12. B12 deficiency is common in EPI and should be corrected if present. [1][5]
- Expect follow-up checks. Periodic weigh-ins and occasional blood tests are normal for a chronic condition.
EPI treatment in dogs: enzymes, B12 and medication
The cornerstone of EPI treatment is enzyme replacement therapy – giving your dog the digestive enzymes their pancreas can’t make. Enzymes are typically mixed into food at every meal. [1][5] Veterinary references note that powdered formulations are generally more effective than tablets/capsules in many cases. [1]
Many vets recommend moistening the food so the powder mixes evenly. Some veterinary references state that pre-incubating (soaking) the food is not necessary with pancreatic enzymes, although your vet may still advise a short sit time in some situations. [1]
If enzyme powder isn’t mixed well, some dogs can develop oral irritation or bleeding; this has been reported in the veterinary literature and can improve when the enzyme dose is reduced and/or the food is moistened. [1][9]
In addition to enzymes, many dogs need vitamin B12 (cobalamin) supplementation if levels are low, which can be given by injection or orally depending on your vet’s plan. [1][15]
Some dogs have concurrent intestinal dysbiosis and may benefit from vet-directed antimicrobial therapy (for example, tylosin) if signs don’t fully resolve with enzymes + diet + B12 correction. [1] Don’t give human medications or antibiotics without veterinary direction.
What this means for you at home:
- Mix enzymes into every meal. Moist food helps even mixing. Follow your vet’s dose and method. [1]
- Take mouth irritation seriously. If you see drooling, red gums, reluctance to eat, or oral bleeding, speak to your vet. [1][9]
- Follow the B12 plan. If your dog is deficient, supplementing B12 is part of core EPI management. [1][15]
- Be consistent. EPI is managed day-to-day — skipping enzymes usually backfires fast.
Best diet for dogs with EPI (feeding guide for UK owners)
Besides enzyme therapy, diet is the other critical piece. There’s no single “EPI diet” that works for every dog, but a common theme is high digestibility and low fibre (a “low residue” approach), especially early on. [5][1]
Trial bag (for dogs stable on enzymes)
If your dog has confirmed EPI and is stable on enzyme therapy as advised by your vet, you’re welcome to try our Grain Free Duck & Potato. We can help you work out a sensible transition plan and feeding amount for your dog’s weight and activity.
We can’t give veterinary advice and our food doesn’t treat EPI — it’s simply an option some owners use alongside enzyme replacement.
Historically, low-fat diets were often recommended, but responses vary by dog and not all studies show a clear benefit to low fat; some modern guidance cautions that very low-fat feeding can create other issues and is not universally recommended. [11][12][1] What matters most is that the diet is tolerated, supports weight gain, and results in acceptable stool quality – all alongside enzymes.
Some types of dietary fibre can interfere with pancreatic enzyme activity, so many veterinary references recommend keeping insoluble/non-fermentable fibre on the lower side for EPI dogs. [1][5] If your dog is a working breed, you may also need enough calorie density to fuel activity once stable — the aim is a diet that supports body condition without triggering diarrhoea. [5]
Beyond the type of food, how you feed your EPI dog can make a big difference. Smaller, more frequent meals can be helpful, especially when rebuilding weight. Every meal (and ideally any significant treats) should be “covered” with enzymes. [5][1]
Work closely with your vet when making diet changes. Transition over 7–10 days, and change one variable at a time so you can see what helps. Diet doesn’t “treat” EPI — it supports enzyme therapy.
What this means for you at home:
- Aim for digestible + low fibre. Many dogs do best on low-residue style feeding, especially early on. [5]
- Don’t assume “low fat” is always best. Let your vet guide you based on stools, weight and tolerance. [11][12]
- Feed little and often if needed. Especially for very underweight dogs.
- Keep enzymes non-negotiable. Every meal, every day. [1]
Living with an EPI dog: daily routine & working dogs
Once your dog is on the proper enzyme dose and a suitable diet, life can become fairly normal — it just takes planning. Most dogs respond well to therapy and can return to normal activity, including working roles, once stable. [1][10]
Practical routine tips:
- Consistency wins. Fixed mealtimes and consistent enzyme dosing helps you spot changes quickly.
- Keep an “EPI kit”. Spare enzymes + measuring spoon + a day’s food for training/shoot days.
- Track progress. Weekly weights at first, then monthly once stable.
Can dogs with EPI live a normal life? (prognosis & life expectancy)
Most dogs with EPI, when properly treated, go on to live a normal lifespan and quality of life. [1] Clinical remission is a good sign, and published work suggests prolonged survival is likely when remission is achieved. [10]
If a dog struggles long-term, common reasons include inadequate enzyme dosing/formulation, uncorrected B12 deficiency, concurrent intestinal disease, or inconsistent management. [1][5][15]
What this means for you at home:
- Don’t panic about lifespan. Managed EPI is usually compatible with a normal life. [1]
- Measure success by weight + poo + energy. Those are your day-to-day “dashboards”.
- Stay consistent long term. Enzymes, diet and check-ups are for life.
EPI in dogs – FAQs
Quick answers to common UK owner questions about symptoms, diagnosis, diet and working dogs.
What are the symptoms of EPI in dogs?
Typical signs include weight loss despite a good or increased appetite, large volumes of pale/greasy smelly stool, increased stool volume, gas and tummy rumbling, and sometimes poor coat quality. Symptoms often improve once enzymes are given correctly with meals and any B12 deficiency is addressed. [1][4][5]
How is EPI diagnosed in dogs and what is the TLI test?
EPI is diagnosed with a blood test called TLI (trypsin-like immunoreactivity). A very low serum TLI is diagnostic. Many labs recommend fasting beforehand, and vets often check B12 (cobalamin) at the same time. [1][7]
What is the best diet for a dog with EPI?
There isn’t one perfect diet for every dog, but common guidance is highly digestible and relatively low fibre (“low residue”), especially early on. Fat level varies between dogs — some tolerate moderate fat well, while others need adjustment. Any diet should be used alongside enzymes and under veterinary guidance. [1][5][11][12]
Can dogs with EPI live a normal life?
Yes. With appropriate enzyme therapy, diet management, and correction of B12 deficiency when present, most dogs can live a normal life for a normal lifespan. Achieving clinical remission is a very good prognostic sign. [1][10]
Can my gundog with EPI still work?
In many cases, yes. Once stable and back at a healthy weight, working dogs can usually return to activity. The key is planning: enzymes with meals, enough calories to support work, and taking food and enzymes on long days. [1]
Disclaimer: This article is for general information and is not a substitute for professional veterinary advice. Always consult your vet about your dog’s specific condition and treatment.
References
- MSD Veterinary Manual (Professional): “Exocrine Pancreatic Insufficiency in Dogs and Cats”. Source
- VIN / WSAVA Proceedings (2003): “Exocrine Pancreatic Insufficiency”. Source
- UFAW: “German Shepherd – Exocrine Pancreatic Insufficiency”. Source
- VCA Animal Hospitals: “Exocrine Pancreatic Insufficiency in Dogs”. Source
- Today’s Veterinary Practice (2025): “Canine and Feline Exocrine Pancreatic Insufficiency”. Source
- Joii Pet Care (2025): “Exocrine Pancreatic Insufficiency in dogs”. Source
- Texas A&M GI Lab: “Serum Trypsin-Like Immunoreactivity (TLI)”. Source
- VCA Animal Hospitals: “Trypsin-Like Immunoreactivity”. Source
- Snead EC. (2006) “Oral ulceration and bleeding associated with pancreatic enzyme supplementation in a dog”. Source
- Batchelor DJ et al. (2007) “Prognostic factors in canine exocrine pancreatic insufficiency…”. Journal of Veterinary Internal Medicine. Source
- Westermarck E, Junttila JT, Wiberg ME. (1995) “Role of low dietary fat in the treatment of dogs with EPI”. Am J Vet Res. Source
- Biourge VC. (2004) “Exocrine Pancreatic Insufficiency and Adverse Reaction to a Low-Fat, Low-Fiber Diet…” Journal of Nutrition (PDF). Source
- Westermarck E, Wiberg ME. (2006) “Effects of diet on clinical signs of exocrine pancreatic insufficiency in dogs”. JAVMA (PDF). Source
- Purina Institute: “Exocrine Pancreatic Insufficiency in Dogs”. Source
- Wiberg ME et al. (1998) “Response to long-term enzyme replacement treatment in dogs with EPI” (PDF). Source
- Wiberg ME et al. (1999) “Exocrine pancreatic atrophy in German Shepherd Dogs, Collies” (PubMed). Source
- MSD Manual (Pet Owner): “Pancreatitis and other disorders of the pancreas in dogs”. Source
- Chang CH et al. (2022) “Effect of oral or injectable supplementation with cobalamin…” (open access). Source
- Pelligra T et al. (2022) “Ultrasonographic Findings of Exocrine Pancreatic Insufficiency in Dogs” (review/open access). Source