Exocrine Pancreatic Insufficency (EPI) — The pancreas is an organ that is attached to the first section of the small intestine and is devided into exocrine and endocrine portions. Nearly 98% of the pancreas secretes digestive enzymes and the other substances, including an enzyme inhibitor that protects the pancreas from digesting itself. This is the exocrine pancreas. The remaining 2% of the pancreas secretes insulin and is termed the endocrine pancreas.
Exocrine pancreatic insufficiency (EPI) refers to a degenerative process of the non-insulin producing portion of the pancreas. The pancreas secretes its juices into the small intestine at all times, 10% of the juices between meals and 90% in response to eating a meal. The pancreas receives signals to secrete its enzymes through an interplay of nerves and from hormones that originate in the intestines.
Pancreatic acinar atrophy (PAA) is the most common form of EPI and results from the destruction of the basic enzyme-secreting element of the pancreas. The cause of PAA is not well known, but it may occur at any age and is inherited in the German Shepherd. Suspected causes of PAA include obstruction of the ducts leading from the pancreas, infections, poisons (originating from either inside or outside the body), lack of proper blood supply to the pancreas, and immuno-mediated disorders (self-allergy). Other less common forms of EPI include pancreatic cancer and chronic pancreatitis(chronic inflammation of the pancreas).
Signs of EPI include
- ravenous appetite
- weight loss
- large volume of light colored stool (due to increased fat in the stool)
- abdominal pain
- recurring digestive problems
- increased flatulence (gas)
- poor haircoat
Affected dogs are treated with enzyme replacements, vitamins, (and occasionally steroids) that are added to their food daily. Lifetime treatment is required in most cases and can get somewhat expensive. AFFECTED DOGS SHOULD NOT BE BRED!
Bloat/Gastrodilation (+/- Volvulus) — Gastric dilation is a life threatening disease characterized by a tremendous ballooning (dilatation) of the stomach with gas and frothy material. Dilatation may be followed by twisting of the stomach (volvulus) that closes both the inlet and outlet of the stomach. As swelling continues, shock develops as the swollen stomach blocks the return of blood from the abdomen to the heart. Widespread tissue damage and kidney failure occur and death from respiratory and cardiac arrest soon follows.
While most cases occur in large, deep-chested dogs, small dogs can occasionally be affected. The disorder appears suddenly in apparently healthy dogs. The cause is unknown, but the condition is complex and multiple causes are suspected.
Prompt treatment is essential for a successful outcome. Irreversible damage can occur in a surprisingly short time. In fact, many affected dogs die before treatment can be given. Surgery is necessary in ALL cases of gastric volvulus and recurrences are common in some pets.
Diarrhea from Bacterial Overgrowth — This condition is now known as SIBO (Small Intestine Bacterial Overgrowth). It is a disorder that may be the cause of persisting diarrhea, increased appetite, and weight loss. The GSD has been thought to have a low serum and mucosal level of IgA – the surface protection mechanism of the immune system. Simply put, there are too many bacteria living in the small intestines for the dog’s health. These bacteria take some of the best nutrients out of the food eaten that passes from the stomach to the small intestine.
Diagnosis has to be confirmed by blood tests, then a month long course of antibiotics together with a modified low fat diet is usually sufficient to clear the disorder entirely.