How to Treat Pancreatic Enzyme Deficiencies in German Shepherds
The pancreas is an upside-down, V-shaped organ located near the stomach and small intestine. Part of the pancreas, called the exocrine pancreas, secretes digestive enzymes that break down food. If the exocrine pancreas stops working well, an enzyme deficiency called ‘Exocrine Pancreatic Insufficiency’ (EPI) can develop. German Shepherds are very prone to developing EPI. If your vet has diagnosed EPI in your German Shepherd, veterinary care will be required to treat the condition.
Correcting the Digestive Enzyme Deficiency
1. Seek and follow your vet’s treatment advice.
To diagnose EPI, your vet will perform a blood test called the serum trypsin-like immunoreactivity (TLI) test. If the test results indicate EPI, your vet will recommend adding a pancreatic enzyme supplement to your German Shepherd’s diet. Enzyme supplementation is the treatment of choice for EPI and will give your German Shepherd the best chance of getting better.
- Trypsin is a digestive enzyme produced by the pancreas. The TLI test measures trypsin and trypsinogen, the inactive form of trypsin that gets converted to trypsin. Low levels of each substance indicate EPI.
2. Select a pancreatic enzyme powder supplement.
Pancreatic enzyme supplements come in powder and tablet formulations. However, the concentration of pancreatic enzyme is higher in the powder than the tablets, making the powder the preferred choice. Also, enzyme tablets do not get broken down consistently once they reach the stomach, so they may not give your German Shepherd enough enzyme to get better.
- Gel-coated capsules filled with the enzyme powder are also available, but they are not very effective.
- Viokase-V is the name of the powder enzyme supplement. It is a prescription medication, so you will need to purchase it through your vet.
3. Mix the powder in with your German Shepherd’s food.
The dose of the powder enzyme supplement is 1 teaspoon/40 pounds (20 kilograms) of body weight. Add this amount to your German Shepherd’s food. Since the powder is abrasive and can lead to ulcerations on the inside of your German Shepherd’s mouth, mix the powder in really well.
- Mix the powder in with your German Shepherd’s food at each meal time.
- You do not need to warm up the powder with the food. If your dog eats only dry food, add a little bit of water to the food so you can mix in the powder more easily.
4. Observe an improvement in clinical signs.
Common signs of EPI in a German Shepherd are weight loss (despite a normal or increased appetite) and large volumes of soft, yellow-looking feces. Your German Shepherd should start to improve within the first week of treatment with the enzyme powder. Be aware that, even if your German Shepherds regains some weight, it may not gain back all of the lost weight.
- As your German Shepherd’s symptoms improve, your vet will reduce the dose of enzyme powder. Eventually, your vet will prescribe the lowest dose of enzyme powder that will still be effective.
- Treatment for EPI is lifelong. Even though you will see improvement soon after your German Shepherd starts treatment, you will need to continue treating your dog for the rest of its life.
5. Ask your vet about giving your German Shepherd an antacid.
When your German Shepherd eats the enzyme powder at mealtime, a large amount of the enzyme gets digested in the stomach. Fortunately, enough of the enzyme remains to effectively treat EPI. Antacids have been recommended as a way to prevent stomach acid from breaking down the digestive enzyme. However, antacids have not shown clear benefit in EPI, so your vet may not recommend them.
6. Use fresh pancreas with caution.
Pancreatic enzyme powder is expensive. If lifelong treatment with the powder strains your budget, consider the less expensive option: fresh, raw pancreas that comes from either a pig or cow. Because of the risk of disease transmission with raw foods, the fresh pancreas should come from animals that are certified to be free of transmissible disease (disease that can be transferred between animals).
- 1‒3 ounces of fresh pancreas is roughly equivalent to 1 teaspoon of enzyme powder. To make sure you add the appropriate amount to your German Shepherd’s food, purchase a food scale.
- Do not cook the pancreas, since cooking would inactivate the digestive enzymes your German Shepherd needs.
- Fresh pancreas can be frozen for up to several months without any loss of digestive enzymes. Also, you do not need to warm up the pancreas with your German Shepherd’s food.
- Talk to your vet about where you can obtain safe, fresh pancreas. However, if you are concerned about the risk of disease, continue with the powder enzyme supplement.
Implementing Other Treatment Strategies
1. Have your vet administer vitamin B12 injections.
In addition to causing an enzyme deficiency, EPI can lead to a deficiency of vitamin B12 (also known as cobalamin). This deficiency occurs when there is a bacterial overgrowth in the gut. These bacteria 'steal' the nutrients, leading to nutrient deficiencies. To correct this deficiency, your vet would first give your German Shepherd weekly vitamin B12 injections into the muscle, then give the injections every 3 months.
- Your vet will periodically take a blood sample to measure the amount of vitamin B12 in your German Shepherd’s blood.
- It is not known whether a vitamin B12 deficiency significantly affects in dogs with EPI. Your vet will determine whether vitamin B12 supplementation is necessary for your German Shepherd.
2. Give your German Shepherd antibiotics.
If your German Shepherd's gut cannot properly absorb nutrients due to bacterial overgrowth, diarrhea will occur. If your German Shepherd continues to have diarrhea with pancreatic enzyme supplementation, the bacteria are probably the culprit. Your vet will prescribe an antibiotic to correct the overgrowth.
- Your German Shepherd may be on the antibiotic for up to 6 weeks.
3. Discuss dietary changes with your vet.
Since EPI decreases the ability of dog’s gut to absorb nutrients, a low-fat, highly digestible diet used to be recommended for dogs with this condition. However, a low-fat diet would make it even harder for your German Shepherd’s gut to absorb fat. This could cause deficiencies of fat-soluble vitamins (vitamins A, E, and K) and essential fatty acids (omega 3 and omega 6).
- A low-fiber diet may help your German Shepherd, especially if it’s not gaining weight.
- Most dogs with EPI do not need a dietary change. Talk with your vet before making any changes to your German Shepherd’s diet.
- Chronic pancreatitis (inflammation of the pancreas) can destroy the cells in the exocrine pancreas, leading to a loss of function. Symptoms of EPI do not become apparent until 90% of the exocrine pancreas’ function is lost.
- Most cases of EPI are not cured. Fortunately, proper management of the condition would allow your German Shepherd to lead a long and happy life.
- EPI may be heritable in German Shepherds. Do not breed your German Shepherd if it has EPI.
- For unknown reasons, about 20% of dogs treated for EPI do not respond well to therapy.