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This blog post was originally published in January 2017, it has been updated with new information and republished after my dog was diagnosed with EPI (exocrine pancreatic insufficiency) in December 2019. Please keep in mind that I'm not a veterinarian.  If you are looking to treat your dog through diet for EPI or pancreatitis, please work with a pro-raw, holistic veterinarian.

My dog was diagnosed with Exocrine Pancreatic Insufficiency (EPI) after losing a lot of weight. This post shares more about EPI in dogs, what I feed my dog, and the supplements that are saving his life.

In 2019, my dog was diagnosed with EPI (Exocrine Pancreatic Insufficiency).  Shit. Literally.

I learned about EPI several years ago, and as I read more about the condition and experiences shared by pet parents, I began to think that I finally figured out the source of Rodrigo’s digestive issues.  I brought this up to the veterinarian and was told that Rodrigo didn’t have EPI.  This was based on his normal blood work, not a special test.

Looking back, my vet may have been correct.  Most cases of EPI develop before a dog reaches his/her fourth birthday. And 70% of the cases of EPI are seen in German Shepherds, and 20% are seen in Rough-Coated Collies. However, other dogs can develop the condition, and older dogs can develop EPI or pancreatitis.

Exocrine Pancreatic Insufficiency (EPI) in Dogs

If a dog's pancreas cannot produce enough digestive enzymes to break down proteins, fats, and carbohydrates, the dog may develop EPI, which…

  • impacts a dog's GI system,
  • disrupts the absorption of nutrients,
  • may lead to weight loss and chronic diarrhea,
  • and will eventually lead to starvation.

Symptoms of EPI in Dogs

  • Continued weight loss despite always being hungry
  • Pooping more often than the other dogs; poop is larger, yellow or gray in color, and soft
  • Dog eats his own poop (coprophagia)
  • Increased gas and tummy noises
  • Occasional diarrhea and vomiting
  • Increased anxiety, fearful behavior

My Dog has Exocrine Pancreatic Insufficiency (EPI)

In November 2019, after a few months of steady weight loss, Rodrigo was examined again. The results of his blood work showed that something was up with his pancreas. It wasn't a clear sign that we were dealing with pancreatitis, but the vet decided to test him for EPI, given the blood work and symptoms (weight loss, constantly hungry, loose stool, and diarrhea)

Accurate Blood Test for EPI

The Trypsin-Like Immunoreactivity is a blood test preferred to fecal tests because the latter has proven to be inaccurate. According to my veterinarian, “a dog or cat with EPI will have almost no serum trypsin-like immunoreactivity in the bloodstream. The patient must be fasted for the test to be accurate, but only a single blood sample is needed to make the diagnosis. The feline version of this test often requires that the sample be sent to a university laboratory and generally a week or so is needed to get results but the canine test can be run in just a few days.”

On the left is the normal stomach. pancreas, and intestine in a dog or cat belly. On the right is the same organs in a dog or cat who has exocrine pancreatic insufficiency. Notice the atrophied pancreas.
On the left is the normal stomach. pancreas, and intestine in a dog or cat belly. On the right is the same organs in a dog or cat who has exocrine pancreatic insufficiency. Notice the atrophied pancreas.

Did My Dog Have Low-Grade Pancreatitis?

I suspected that Rodrigo had EPI, but he tested negative. What changed?

Our veterinarian explained that the most common cause of digestive enzyme deficiency is pancreatic acinar atrophy (PAA), where the pancreas becomes shriveled and useless (see image above). While we usually see the signs of EPI before a dog reaches four years of age, the onset of EPI can happen if a dog is subjected to chronic pancreatitis that has destroyed over 90% of the functioning acinar glands. This was hinted at in his complete blood panel results; the EPI test confirmed his condition.

Another cause of EPI in dogs is cancer of the pancreas. However, this is rare, and it isn't the case with my dog.

Pancreatitis develops when a dog's pancreas is inflamed and not working correctly.  It's seen in overweight dogs, older dogs, and dogs fed a high-fat diet.  I only saw a couple of the symptoms listed below in Rodrigo, and I thought it was just his digestive issues acting up. Maybe all this time, he was going through periods of pancreatitis.

Symptoms of pancreatitis, according to PetMD, include:

  • Fever
  • Vomiting
  • Diarrhea
  • Loss of appetite (anorexia)
  • Weight loss (more common in cats)
  • Dehydration
  • Fatigue and sluggishness
  • Mild to severe abdominal pain (may become more severe after eating)
  • Depression
  • Increased heart rate
  • Difficulty breathing

The only symptoms Rodrigo exhibited were occasional diarrhea and weight loss. The diarrhea was attributed to his digestive issues, which he's had his entire life. And the weight loss can be attributed to a slight decrease in meal size and an increase in exercise.

Best Diet for Dogs with EPI

Of course, I'm biased, so I will say a raw diet is best for dogs with EPI. Once we received this diagnosis, I was relieved that I was already feeding fresh food and wondered how much of my dog's current diet contributed to him going so long without developing full-blown EPI.

I believe that a raw diet is best because it's easier to digest, and the nutrients are readily available for absorption. But raw isn't the cure for EPI. Since my dog's pancreas isn't providing the necessary enzymes, I need to add them to Rodrigo's diet as food (pancreas) or supplements.

Benefits of Beef Pancreas for Dogs

As a raw feeder, I prefer to feed my dogs whole foods instead of supplements when I can, so the first thought for me would be to add fresh pancreas to Rodrigo’s diet to supplement what he lost through EPI.

The pancreas is a glandular organ in the digestive system and endocrine system of vertebrates. The pancreas is involved in blood sugar control and metabolism within the body, and also in the secretion of substances which help digestion. The pancreas plays a vital role in the digestive system (which captured my attention). It secretes a fluid that contains enzymes into the duodenum. These enzymes help to break down carbohydrates (usually starch), proteins and lipids (fats).

Source: Wikipedia

In my research on raw feeding, I saw pancreas listed as beneficial to dogs because…

  • it's part of a balanced raw food diet (pancreas is offal),
  • it can be used medicinally for dogs that have EPI (Exocrine Pancreatic Insufficiency) or pancreatitis,
  • it's great for digestion.

Learn 3 Things You Need to Know When Feeding Pancreas

Feeding Pancreas Medicinally to Dogs

Please keep in mind that I'm not a veterinarian.  If you are looking to treat your dog through diet for EPI or pancreatitis, please work with a pro-raw, holistic veterinarian.

Serving Amount of Pancreas for Dogs

I reached out to my source of pancreas and was told to feed 2 ounces of raw beef pancreas twice daily for every 20 lbs of body weight.  Feeding more than 2 ounces twice daily isn't recommended.

To maximize enzyme efficiency, we're advised to whip the pancreas with a fork or wire whisk to a pudding-like consistency or liquefy in a blender and serve at room temperature. And it's important to remember that pancreas has a shelf life of only three months.

I chose not to feed raw pancreas because I don't have a consistent source, and a supplement is easier to use.

How to Prepare Pancreas for a Dog

Adding pancreas to a dog's raw meal isn't as easy as adding a spoonful (or forkful) of pancreas to the dish, or so I've been told.  Someone advised me to use a blender or food processor to puree the pancreas until it's smooth in texture. You can also…

  • Add 1.5 ounces of pancreas to a bowl.
  • Mix in a small amount of hot water, whipping the two as you would scrambled eggs.
  • Mix into the meal.
  • Allow to sit for 20 minutes, then feed.

Pancreas Supplements for Dogs

My veterinarian recommended several supplements and approved the two I've tried with Rodrigo. Bio Case Plus is a powder supplement made of porcine pancreas, containing B12 (intrinsic factor to aid absorption) as many dogs diagnosed with EPI are also vitamin B deficient. I later switched to Enzyme Diane's Pancreatin 8x, which contains Protease (protein), Amylase (starch/vegetables), and Lipase (fat).

The Enzyme Diane supplement doesn't contain cellulase, an enzyme our dogs cannot produce. Cellulase helps to break down the cellular wall of vegetables, which makes the nutrients more bioavailable. Although our dogs do produce amylase, it's produced by the pancreas in low amounts. Therefore, I break the cellular wall of vegetables in my meal prep through pureeing, blanching, or freezing.

USING DIGESTIVE ENZYMES: Mix the powder into my dog's food, allow it to germinate for 15-20 minutes (to begin predigesting the food), and then feed my dog.  This supplement provides enzymes to help my dog digest food and absorb nutrients.

PREMIXING MEALS WITH ENZYMES: Some supplement brands advise against premixing batches of food with enzymes. With Enzyme Diane, I can premix up to four days of food for my dog.


If your dog has been diagnosed with EPI, send the link to Enzyme Diane's for review. They may recommend a slightly different product than what I give to my dogs. Also, if you have pet insurance, contact them to find out if the supplement will be partially covered.


More Supplements for Dogs with EPI

Other supplements recommended by our veterinarian and by pet parents raising dogs with EPI are:

Helpful Resources for Dogs with EPI

The resources that I've found most helpful include:

  • Raw Feeding Group: EPI – K9EPIGlobal – this group has a lot of members who are raw feeders.
  • Enzyme Diane: This website contains information about EPI for dogs, success stories to give us hope, and a supplement that people rave about.
  • EPI4Dogs Foundation: this is another website that has a lot of great information to help us learn about raising dogs with EPI.

My Questions About Feeding Raw to a Dog with EPI

1 – Do I have to use the supplement with every meal? – Yes. Rodrigo won't be able to digest his food without using the supplement. The supplement doesn't last a full day in his system. Instead, it pre-digests his food, allowing him to absorb the nutrients.

2 – Should I use the supplement when feeding raw meaty bones? – Yes. I was advised to mix up a small amount of ground raw with the supplement and feed it to Rodrigo 30 minutes before giving the dogs their bones. If I'm feeding recreational bones or chews to my dogs to clean their teeth and satisfy their chew drive, then the supplement isn't necessary.

3 – Can I premake meals with the supplement, saving time at mealtime? – It depends on the supplement. Some supplement brands advise against premaking meals with enzymes as their supplement doesn't work well under these conditions as it continues to break down the food, even if stored in the fridge. With Enzyme Diane supplements, I can mix up to four days of food, making it easier for others to feed my dogs.

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