What are the common symptoms of exocrine pancreatic insufficiency (EPI)?

The main signs are chronic or recurrent diarrhoea, greasy stools or undigested food in the faeces, and weight loss. If symptoms persist, seek veterinary evaluation.

How does a vet diagnose exocrine pancreatic insufficiency?

Your vet will combine a physical examination, blood count, and biochemistry panel with pancreas-specific tests (such as PLI or fTLI) and imaging to confirm the diagnosis and rule out other causes.

Can exocrine pancreatic insufficiency be treated?

In most cases, clinical signs can be managed with enzyme replacement therapy and dietary modification. A long-term monitoring plan tailored to your pet's response should be developed with your vet.

When should I take my pet to the vet?

If your pet has persistent diarrhoea, weight loss, or abnormal stools lasting more than a few days — or shows urgent signs such as vomiting with dehydration or bloody stools — seek veterinary care promptly.

How much do the tests and treatment usually cost?

Costs vary by clinic and region — ask your vet for an estimate before proceeding.

Disease Guide

Exocrine Pancreatic Insufficiency in Dogs & Cats: Symptoms, Diagnosis & Enzyme Supplement Care [2025]

Exocrine pancreatic insufficiency (EPI) occurs when the pancreas cannot produce enough digestive enzymes. Signs include chronic diarrhoea, weight loss, and increased appetite. Lifelong enzyme supplementation and specific vitamins are typically required.

Take 1 minute to check the symptoms first

Last updated: 2026/01/05

Pethealthmap Editorial Team

Sources: ACVIM, WSAVA, National Taiwan University Veterinary Hospital

When to See a Vet

Seek Emergency Care Immediately

•Persistent vomiting with inability to eat or drink, accompanied by obvious dehydration
•Bloody or dark tarry stools indicating significant gastrointestinal bleeding
•Extreme weakness, lethargy, and unresponsiveness

Schedule a Clinic Visit Soon (within 24–72 hours)

•Watery or greasy diarrhea persisting for multiple days with normal or increased appetite
•Ongoing weight loss despite adequate or slightly increased appetite
•Frequent undigested food particles or obvious greasiness visible in stools

01What symptoms indicate a problem?

EPI most commonly presents as chronic or recurrent diarrhoea and weight loss due to malabsorption. Owners often first notice changes in stool consistency and a drop in their pet's energy levels.

Chronic or recurrent watery, greasy, or foul-smelling diarrhoea
Persistent weight loss despite normal or increased appetite
Visible undigested food particles or greasy sheen on stools
Decreased energy, reduced alertness, or easy fatigability
Occasionally increased urination or changes in water intake (possible concurrent issue)
If symptoms persist, a specialist consultation is recommended for further evaluation

Seek emergency care immediately if you notice the following symptoms:

⚠️ Persistent vomiting with inability to stay hydrated or extreme weakness
⚠️ Blood in stool or black tarry faeces
⚠️ Obvious dehydration, extreme lethargy, or collapse

02What to watch for at home: observation guide and when to seek emergency care

Keeping records at home helps your vet quickly understand the course and severity of the condition — thorough preparation speeds up diagnosis and treatment.

Note when diarrhoea started, how often it occurs, and how long each episode lasts
Describe and photograph the stool (greasy sheen, colour, consistency)
Weigh your pet weekly and track the trend over time
Record daily water intake and frequency of urination (note any changes)
Observe appetite, energy level, and whether vomiting has occurred
Bring your records and stool photos to the vet appointment for reference

03How will the vet diagnose this? Common tests and examinations

The vet will combine a physical examination with laboratory and imaging tests to assess pancreatic function and check for any concurrent conditions.

Physical examination

assessing body condition, abdominal palpation, and degree of dehydration

Blood count

screening for infection, anaemia, and overall health status

Biochemistry panel

evaluating liver and kidney function and nutritional markers

Pancreas-specific testing (such as canine/feline PLI or fTLI) to assess pancreatic function

Imaging (X-ray, ultrasound, or CT if needed) to evaluate organ structure

Urinalysis to rule out metabolic or kidney-related conditions

04Treatment and aftercare: medications, diet adjustments, and home care guide

Treatment centres on enzyme replacement and dietary modification. The plan should be adjusted based on your pet's response and monitored through regular follow-up of clinical signs and blood biochemistry.

Short-term hospitalisation for fluid therapy and monitoring to stabilise the condition if needed
Enzyme replacement therapy and supportive medications as assessed by the vet
Transition to a highly digestible or low-fat diet formula with gradual feeding changes
Home care includes regular feeding schedules, stool monitoring, and symptom observation
Schedule regular follow-up visits to track weight, stool quality, and blood biochemistry
Long-term follow-up at a specialist or hospital experienced in managing pancreatic conditions is recommended

05What to prepare before the vet visit: key information to help your vet diagnose quickly

Compile a timeline of when symptoms appeared and how they have changed

Bring photos of stools from the past week or a sealed stool sample

List the current food brand, feeding amounts, and any recent changes

Prepare a list of all current medications and supplements with dosages

Bring any recent blood test or imaging reports for comparison

Consider calling ahead to book at a clinic that offers pancreatic function testing

This content is for reference only and cannot replace a professional veterinary diagnosis. If your pet shows signs of illness, please seek veterinary care promptly.