Veterinary Clinical Medicine-I (General and Systemic)

MANAGEMENT

• Dietary modification and pancreatic enzyme supplementation.
• A highly digestible, lowfat, low-fiber diet has been shown to ameliorate clinical signs of EPI.
• Dietary supplementation of medium-chain triglyceride oil (2 ml/meal every other day)
• Powdered pancreatic extracts (2 teaspoons/20 kg BW/meal for dogs, 0-1 teaspoon/cat/meal for cats)
• The powdered form of pancreatic extracts is more suitable compared to the enteric-coated tablets, capsules or raw-chopped pancreas.
• Dogs and cats with EPI require parenteral cobalamin, vitamin K and oral vitamin E supplementation.
• Inadequate enzyme supplementation may be a cause of treatment EPI failure. In these cases reevaluation of dose is indicated. Lipase is acid-sensitive enzyme.
• In some dogs with EPI the enzyme supplementation must followed by an antacid administration (ranitidine, cimetidine).
• Small intestinal bacterial overgrowth and/or inflammatory small intestinal diseas: Metronidazole and/or prednisone administration