Prognostic factors in canine exocrine pancreatic insufficiency: prolonged survival is likely if clinical remission is achieved

J Vet Intern Med. Jan-Feb 2007;21(1):54-60. doi: 10.1892/0891-6640(2007)21[54:pficep]2.0.co;2.

Abstract

Background: Response to therapy in canine exocrine pancreatic insufficiency (EPI) varies considerably, making it difficult to determine prognosis for individual patients.

Hypothesis: Response to initial treatment (RIT) and survival are affected by signalment, clinical variables, and therapeutic regimen employed.

Animals: Client-owned dogs diagnosed with EPI between 1990 and 2002 were included in this study.

Methods: The study comprised a retrospective, questionnaire-based review.

Results: One hundred seventy-eight completed questionnaires were returned. RIT was good in 60% of treated dogs, partial in 17%, and poor in 23%. On univariate analysis, dogs that received antibiotics (P = .037) or had high serum folate concentration (P = .037) had a poorer RIT. On multivariate analysis, there were no strong predictors of good RIT. Nineteen percent of treated dogs were euthanized within 1 year, but overall median survival time for treated dogs was 1919 days. No clear benefit of changing to a fat-restricted diet could be demonstrated, but marked hypocobalaminemia (< 100 ng/L) was associated with shorter survival (P = .012). Use of uncoated pancreatic enzyme supplements, antibacterials, or H2 antagonists was not associated with longer survival. Breed, sex, age at diagnosis ( < or = 4 years or > 4 years), and clinical signs at diagnosis also made no difference.

Conclusions and clinical importance: Long-term prognosis in canine EPI is favorable for dogs that survive the initial treatment period. Although there are few predictors of good RIT or long-term survival, severe cobalamin deficiency is associated with shorter survival. Therefore, parenteral cobalamin supplementation should be considered when hypocobalaminemia is documented.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Dog Diseases / diagnosis*
  • Dog Diseases / drug therapy
  • Dogs
  • Exocrine Pancreatic Insufficiency / drug therapy
  • Exocrine Pancreatic Insufficiency / veterinary*
  • Female
  • Gastrointestinal Agents / therapeutic use
  • Histamine H2 Antagonists / therapeutic use
  • Male
  • Pancreatin / therapeutic use
  • Prognosis

Substances

  • Anti-Bacterial Agents
  • Gastrointestinal Agents
  • Histamine H2 Antagonists
  • Pancreatin