Can a dog or cat live a normal life with EPI?

Absolutely! While EPI is a lifelong condition that requires daily management, pets that receive consistent enzyme supplementation and appropriate nutrition usually have a normal life expectancy. The key is never skipping a dose of their prescribed enzymes, as even one "un-supplemented" meal can cause a return of digestive upset.

Why does my pet with EPI need Vitamin B12 injections?

When the pancreas isn't functioning correctly, the body often loses its ability to absorb Vitamin B12 (cobalamin) from food. Low B12 levels can lead to lethargy, poor appetite, and even further digestive issues. Many pets with EPI require an initial course of B12 injections followed by periodic boosters to keep their energy levels up and their gut healthy.

Can I just feed my pet more food to stop the weight loss?

Unfortunately, no. Because the body lacks the enzymes to break down the food, feeding more "un-supplemented" food usually just results in more diarrhoea and discomfort. The nutrients simply pass straight through the system. The goal isn't more food, but making the food they do eat more "digestible" through enzyme replacement.

Does my pet still need enzymes if their stools look normal?

Yes. Normal-looking stools are a sign that the treatment is working, not that the condition has been cured. If you stop the enzymes, the malabsorption will return immediately. Think of the enzymes as a vital "missing piece" of their digestive puzzle that needs to be replaced at every single meal.

Are there specific treats I should avoid for a pet with EPI?

It is best to stick to low-fat, highly digestible treats. Since fat is particularly difficult for EPI patients to process, high-fat snacks (like cheese or fatty meat offcuts) can trigger a relapse of symptoms.

Last Updated: 03/02/2026

Managing Exocrine Pancreatic Insufficiency in Cats and Dogs

Exocrine Pancreatic Insufficiency is a complex disorder that affects the pancreas. Explore the causes symptoms diagnosis and treatment in our Vet-written article.

Author: Dr Carla Paszkowski BVSc (Hons)

Reading Time: 6 minutes - short read

close up of german shepherd looking at camera

It is heartbreaking to watch your pet eat like a horse yet continue to lose weight, often accompanied by messy, "clay-like" bathroom trips. If this sounds familiar, your furry friend might be struggling with Exocrine Pancreatic Insufficiency, or EPI. Essentially, the pancreas is "sleeping on the job" and failing to produce the vital enzymes needed to break down food. While it sounds daunting, EPI is a very manageable condition. With the right enzyme "helpers" and a few tweaks to their dinner bowl, most pets can return to their happy, bouncy selves in no time.

What is exocrine pancreatic insufficiency?

Exocrine Pancreatic Insufficiency, also known as 'EPI', is a condition in which the pancreas does not secrete certain enzymes necessary for digestive functions.

What does the pancreas do?

The pancreas is a small, pink, glandular organ that sits under the stomach and along the upper part of the small intestine. In order to understand EPI, it's important to understand the pancreas and its functions.

The pancreas has two types of tissue:

Endocrine tissue, responsible for secreting hormones including insulin, and
Exocrine tissue, responsible for producing digestive enzymes.

Basically, the endocrine portion of the pancreas digests sugar, while the exocrine portion digests fats, starches and proteins.

EPI occurs when the functional reserve of the exocrine portion of the pancreas has been lost. The exocrine digestive enzymes are not able to be secreted properly, which means that fats, proteins, vitamins, and trace elements are not able to be digested and absorbed.¹ This is known as 'maldigestion' and 'malabsorption'. The food passes through the guts, but without digestive enzymes, the body can't retrieve the nutrients present in the food.

Common causes of pancreatic insufficiency in pets

In cats and dogs, EPI is generally caused by a primary disease that destroys the pancreatic tissue. Most commonly, the culprit is an autoimmune disease known as pancreatic acinar atrophy², which is where the body attacks its own pancreas. Other causes include chronic pancreatitis, cancer, pancreatic duct obstruction, and congenital disorders.

In cats, the most common cause is chronic pancreatitis. Rarely, cats may also develop EPI after ingesting a parasite known as a 'fluke' (specifically, Eurytrema procyonis), which they can catch after eating infected grasshoppers.

Did you know? Multiple bouts of pancreatitis can destroy the pancreatic tissue, and result in EPI. This is why it is important to respect your vet's nutritional recommendations after your dog or cat has suffered from pancreatitis and ensure they don't have a relapse.

Recognising the signs of EPI in dogs and cats

The clinical signs of exocrine pancreatic insufficiency may include:

Increased appetite
Weight loss
Loose stools - often discoloured yellow or white, may have a fatty or clay-like appearance
Greasy appearance in the fur around the anus (due to fat in stools)
Dry, flaky coat due to an inability to absorb fats
Anaemia from an inability to absorb Vitamin B12
Eating faeces or soil
May have other signs if pancreatitis was the cause of EPI, such as tender abdomen, vomiting and lethargy

Breeds most at risk for EPI

Dog breeds that are prone to EPI include:

A breed predilection has not been reported for EPI in cats.⁵

INTERESTING FACT: About 70% of dogs with exocrine pancreatic insufficiency are German Shepherds and 20% are Rough Collies.⁶

How your vet diagnoses pancreatic insufficiency

Your vet may be suspicious of EPI after hearing your pet's history of weight loss and observing the faeces, however laboratory tests are still necessary because other diseases can have similar signs. Your vet may perform the following tests:

Blood Chemistry and Complete Blood Cell Count (CBC): base blood tests like these will help give a complete picture of your pet's overall health and look for secondary problems such as anaemia. It will also help rule out issues such as liver disease, or infections, which can mimic EPI symptoms.
Trypsin-Like Immunoreactivity Test (TLI): a blood test specific to EPI. Trypsin is a digestive enzyme produced by the exocrine portion of the pancreas, which means that it is low or almost zero in pets with EPI. This test is considered diagnostic for the condition.
Vitamin B12 (cobalamin) levels: your vet may test the blood to determine if any Vitamin B12 deficiency is present, as this is a common secondary problem with pets suffering from EPI.
Abdominal ultrasound: may be indicated to rule out other issues such as pancreatic or stomach cancers.
Faecal protease test: this involves testing the faeces for the presence of digestive enzymes. Three samples are required to get an accurate result, and sometimes soybeans are fed to the dog to simulate digestive enzyme release.⁶

Effective treatment and enzyme supplementation

The standard treamtent for EPI is daily pancreatic enzyme supplementation. Your vet will prescribe supplements, such as Creon, which you can easily add to your pet's food. Quite simply, these supplements do the work of the digestive enzymes that aren't being secreted by the underactive pancreas. These supplements usually come as a powder, tablet or capsule.

Other supplements, such as Vitamin B12 and folate, may also be given in the early stages to correct any secondary vitamin deficiencies. Vitamin B12 injections periodically are often required.

Probiotics and prebiotics are a great idea for dogs with EPI, as the condition can cause unbalanced microflora in the gut. Ongoing supplementation with pro- or pre-biotics long term can really help to restore a healthy gut microbiome.

Learn more in our guides to the Best Probiotics for Dogs and Probiotics for Cats.

What about raw pancreas meat?

Another source of pancreatic enzymes can be obtained from eating the raw pancreas of cows, pigs, or other mammals. This type of organ meat can sometimes be purchased from a butcher or a raw pet food supplier. However, this form of treatment is not usually recommended as raw meat may contain parasite or bacterial contamination.

The best diet for pets with EPI

Usually, a specialised veterinary or therapeutic diet is not required for cats or dogs with EPI. Instead, adding supplemental pancreatic enzymes to food at every meal is the main therapy for long-term management of EPI.

However, dietary modification - such as lower fat or higher digestibility - may help reduce the severity of some clinical signs.

FAQs

EPI might change how you manage your pet's mealtime, but it doesn't have to change their quality of life. By consistently adding pancreatic enzymes to every bowl and monitoring their Vitamin B12 levels, you are giving your pet the tools they need to actually absorb the love (and nutrients!) you put into their diet. If you notice those tell-tale greasy stools returning, always check in with your vet to fine-tune their supplement dosage.

References

Rallis TS, Adamama-Moraitou K. Exocrine Pancreatic Insufficiency in Dogs and Cats: An Update. World Small Animal Veterinary Association World Congress Proceedings, 2004.
Westermarck E, Wiberg M. Exocrine pancreatic insufficiency in the dog: historical background, diagnosis, and treatment. Top Companion Anim Med. 2012 Aug;27(3):96-103.
Mas, A., Noble, PJ.M., Cripps, P.J. et al. A blinded randomised controlled trial to determine the effect of enteric coating on enzyme treatment for canine exocrine pancreatic insufficiency. BMC Vet Res 8, 127. 2012.
Daniel J. Batchelor, Peter-John M. Noble, Peter J. Cripps, Rebecca H. Taylor, Lynn McLean, Marion A. Leibl, AIexander J. German. Breed Associations for Canine Exocrine Pancreatic Insufficiency. Journal of Veterinary Internal Medicine, 2008 Feb;05.
Steiner, JM. Exocrine Pancreatic Insufficiency in Cats. World Small Animal Veterinary Association World Congress Proceedings, 2014.
Brooks, W. Exocrine Pancreatic Insufficiency in Dogs and Cats. Veterinary Partner. 2004.
Westermarck, E., Wiberg, M., & Juntilla, J. Role of feeding in the treatment of dogs with pancreatic degenerative atrophy. Acta Veterinaria Scandinavica, 1990, 31(3), 325-331.

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History

Our experts continually monitor the health and wellness space and we update our articles when new information becomes available.

Tue 3 Feb 2026

Edited by Dr Gillian Hill BVSc (Hons)

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About the Author

Dr Carla Paszkowski BVSc (Hons)

Veterinarian

Dr. Carla graduated from the University of Queensland in 2013 with a Bachelor of Veterinary Science and worked for a number of years in small animal clinics across South East Queensland. While Carla enjoys most facets of clinical veterinary work, she holds a special passion for feline medicine, pocket pets, and nutrition.