Please enable JavaScript.
Coggle requires JavaScript to display documents.
EPI: Exocrine Pancreatic Insufficiency - Coggle Diagram
EPI: Exocrine Pancreatic Insufficiency
functions of exocrine pancreas
duct cells
neutralization of gastric acid
HCO3-
CL-
H2O
intrinsic factor secretion
acinar cells
enzymatic digestion of food
protease
lipase
amylase
anti-bacterial proteins
pathophys
duodenitis
B12 depletion
maldigestion
overgrowth
:dog:
pancreatic atrophy
subclinical: lymphocytic pancreatitis
clinical: acinar atrophy/destruction
endstage: glandular atrophy
chronic pancreatitis
pancreatic neoplasia
breed disposition
german shepherd obvs
rough coated collie
american beagle
:cat:
chronic pancreatitis
pancreatic neoplasia
pancreatic atrophy
signs won't develop until 90% of exocrine function is lost
presentation
maldigestion
diarrhea
increaed volume
grey/yellow
weight loss
flatulence
increased appetite
coprophagy
malnutrition
cachexia
rough hair coat
malnutrition
diagnosis
trypsin-like immunoreactivity (TLI)
normal is 5-45 ug/dl
must be an 8-12hr fasted sample
EPI if <2.5
highly sensitive and specific
B12
folate or dysbiosis index
therapy, management
pancreatic enzyme replacement
1-3tsp/cup food
acid suppression
dietary modification
high digestibility
low fiber
moderate fat
probiotics, antibiotics (2nd line)
tylosin
metronidazole
vitmain b12
weekly supplemental
tapers to monthly
fat soluable vitamines
A
D
E
K