Kodi is a very handsome and clever German Shepherd Dog (GSD). He presented to us with the concern of weight loss, a ravenous appetite and frequent bouts of watery diarrhoea. Kodi had in fact lost 6 kg in 3 months! However, his remaining physical examination was unremarkable.

Weight loss despite a really good appetite suggests there is some form of abnormal digestion and/or utilisation of the nutrients he is receiving. This type of disorder could also be the reason for his diarrhoea. However, there can be lots of other reasons for diarrhoea and these too must be considered.

GSD’s are a breed known to suffer from a condition called exocrine pancreatic insufficiency (EPI). The pancreas contains specialised ‘exocrine’ cells which produce enzymes; the enzymes are transported to the small intestine where their role is to digest food. In dogs with EPI their is a loss of these exocrine cells. This leads to reduced enzyme production and therefore significantly reduced digestion.

Due to this lack of digestion and nutrition, dogs suffering from EPI will inevitably lose weight. They respond to the malnutrition with an increased appetite and the undigested food travels through the GIT in the form of diarrhoea.

So why does EPI occur more commonly in GSDs? The destruction of the pancreas is due to inappropriate immune attack on the pancreas, in other words, their body attacks their own pancreatic cells. The exact reason for this unclear. However, it is thought to be a hereditary condition. In theory, any breed can suffer from immune mediated EPI and any disease affecting the pancreas can result in the destruction of pancreatic cells, for example, severe cases of pancreatitis.

Based on Kodi’s history and breed  we were keen to rule in or out EPI. This requires a specific blood test. His results were supportive of EPI. What next? The pancreas cannot regenerate new exocrine cells so EPI is a lifelong condition requiring medical management. The bulk of this management is the addition of  ‘replacement enzymes’ on Kodi’s meals.

Unfortunately, this alone is often not enough and the overall management can be very complex with a number of other things that must be addressed:

• These dogs often have concurrent deficiency in vitamin B12 requiring regular Vitamin B12 injections.
• The condition can be ‘diet responsive’ so changing to one high in fibre and low in carbohydrate must be considered.
• They can also be prone to small intestinal bacterial overgrowth and at least in the early stages of diagnosis and stabilisation antibiotics may be required.
• Last, but not least, there can be concurrent GIT disease. This can be particularly true for GSD’s who can be more likely to suffer from conditions such as inflammatory bowel disease (IBD). In fact, we think this is the case for Kodi as he responded very well to feeding a lamb and vegetable diet (diet-responsive IBD)

It has taken lots of time, patience and fine tuning of his medications. However, thanks to his owner’s commitment Kodi is currently doing very well! He has gained weight and has normal faeces which are important indicators of how stable his condition is.

With frequent visits to the vets we think Kodi definitely deserves recognition as a brave pet!