Exocrine Pancreatic Insufficiency in the Dog

Many of you may have have heard of Exocrine Pancreatic Insufficiency (EPI), but I only learned of it recently. I stumbled upon a wonderful NYTimes article, As Dogs Waste Away, Owners Seek Answers.

I did a little bit of research and found an article published recently titled "Exocrine Pancreatic Insufficiency in the Dog: Historical Background, Diagnosis, and Treatment" by Westermarck et al (2012). The article summarizes the latest research that has been done on EPI in the last ten years. This very sad disorder is what  causes a lot of canines to be severely malnourished-looking. 

It is actually a dysfunction of the pancreatic function. The authors state "When clinical maldigestion signs of EPI appear, enzyme replacement therapy is indicated. Despite accurate enzyme supplementation, only a small portion of orally administered enzymes are delivered functionally intact into the small intestine. In dogs, the highest enzyme activity in the duodenum has been obtained with nonenteric-coated supplements: raw chopped pancreas or powdered enzymes. Aside from dietary enzyme supplements, dietary changes are often made to improve clinical response, but sometimes weight gain and stool quality remain suboptimal. Other medications for treatment of gastrointestinal tract signs are often used in such dogs with EPI. Antibiotics are the most common adjunctive medication. Of the antibiotics administered, tylosin is used in Finland almost exclusively."

It seems as though I am hearing more and more about this disorder, but that maybe just because they are starting to diagnose it better now. I hope a trip to the vet solves your pup's issues before it is too late. This wonderful online resource  www.epi4dogs.com can provide you with some assistance in the mean time. 

DOG TREAT RECALL: Waggin' Train, Canyon Creek Ranch, and Milo's Kitchen's

Verbatim from ABC LOCAL

January 9, 2013 (NEW YORK) -- Two makers of pet treats are pulling products from the market because they may contain traces of poultry antibiotics that aren't approved in the U.S.

Nestle Purina PetCare is taking Waggin' Train and Canyon Creek Ranch brand dog treats off the market, while Milo's Kitchen is recalling its Chicken Jerky and Chicken Grillers home-style dog treats.

The chicken jerky products, which are made in China, may contain minute amounts of antibiotic residue, the companies said Wednesday. The antibiotics have been approved by Chinese and European Union regulators, but they are not approved in the U.S.

The companies said the treats don't pose a safety risk to pets, but they are still pulling them off the market. The recall doesn't cover other products the companies sell.

Milo's Kitchen said there is no known health risk associated with the antibiotics, but their presence means the products don't meet its standards. It said the chemicals "should not be present in the final food product."

The recalls come after the New York State Department of Agriculture detected the antibiotics in samples of the companies' products. Purina said that the regulator asked that its affected products be pulled from stores in New York.

U.S. federal regulators have also been looking into reports of pet illnesses stemming from their snacks.

The Food and Drug Administration says reports of sick pets connected to jerky treats, particularly chicken jerky made in China, have been increasing for years. The agency said in September that it had been notified of 360 dogs that died after eating jerky treats over the last 18 months and is conducting a broad investigation. No definitive cause for the dogs' sicknesses has yet been identified.

Waggin' Train and Milo's Kitchen are mentioned often in consumer complaints made to the agency, and Canyon Creek is also named in a few complaints. Purina said Wednesday that there is no indication the recall is linked to the problems the FDA is investigating.

Symptoms reported to the FDA include gastrointestinal problems like vomiting and diarrhea, as well as kidney problems, which can cause dogs to drink and urinate more than usual.

The FDA says that commercially produced pet foods contain all the nutrients that pets need, so treats are not necessary for nutrition, and commercial pet food "is very safe."

Purina is a U.S. division of Swiss consumer products giant Nestle that is based in St. Louis. Milo's is owned by Del Monte Foods and is based in San Francisco.

(Copyright ©2013 by The Associated Press. All Rights Reserved.)

Drugs, supplements, and osteoarthritis

A very small trial was conducted in Italy that I thought may be of interest to those whos dogs are suffering from osteoarthritis.  "Two groups of [osteoarthritis affected] dogs and one group of healthy dogs (6 dogs each) were clinically evaluated and blood was sampled before (T0) and after 20days (T20) of dietary administration of NSAID [on-steroidal anti-inflammatory drugs] (NSAID group) or curcumin (CURCUMIN group).


Genes involved in "inflammatory response" and in "connective tissue development and function" dramatically decreased at T20. Other genes, included in "cellular movement", "cellular compromise" and "immune cell trafficking", were differentially expressed at T0 but not at T20 in both groups. Specific molecular targets of CURCUMIN, not observed for NSAID, were the IkB up regulation in the "TNRF1 signaling pathway" and IL18 down regulation in the "role of cytokines in mediating communication between immune cells". The activity of CURCUMIN was also evidenced from the inhibition of macrophages proliferation (HBEGF), related to a strong down regulation of TNFα and to activation of fibrinolysis (SERPINE1). The results would suggest that curcumin offers a complementary antinflammatory support for OA treatment in dogs."

(Colitti et al.2012.Transcriptome modification of white blood cells after dietary administration of curcumin and non-steroidal anti-inflammatory drug in osteoarthritic affected dogs.)

In my current position in the healthcare industry, I rarely mention an article with such a small sample size and length of follow up. However, these are studies on dogs. The industry rarely has large-scale studies of products for animals that are not sponsored by a manufacturer. Therefore, I would take this normally VERY low quality study, and say it has interesting results for those that are desperate. Curcumin (turmeric) is known to be very beneficial for humans for a range of ailments, and a large part of Indian Ayurvedic medicine.  

I will keep an eye out for any further scientific studies. 

Blue Dog Bakery Treats for Adult Dogs

The following table highlights the popular treats by Blue Dog Bakery.  An "x" under a category indicates that this product has ingredients that are widely accepted, but not always, as useful for that specific indication.  

Blue Dog Bakery Treats for Adult Dogs

Product	Healthy Coat	Healthy Eyes	Skin Allergies	Healthy Hips/Joints	Cardiovascular Health	Weight Maintenance
All Blue Dog Bakery treats	x

Peanut Butter & Molasses Treats: Dark brown color (black strap molasses)
Ingredients: Unbleached wheat flour, whole wheat flour, black strap molasses, soy oil, nonfat milk, oats, natural caramel color, egg powder, salt, baking soda, natural peanut butter flavor, brewers yeast.

Natural Cheese Treats: Light golden brown color (paprika)
Ingredients: Unbleached wheat flour, whole wheat flour, black strap molasses, soy oil, nonfat milk, oats, egg powder, baking soda, salt, cheese powder, paprika (color), natural cheese flavor, brewers yeast.

Grilled Chicken Treats: Slight yellow color (turmeric)
Ingredients: Unbleached wheat flour, whole wheat flour, black strap molasses, soy oil, nonfat milk, oats, egg powder, baking soda, salt, turmeric (color), natural chicken flavor, brewers yeast.

Bacon & Cheese Treats: Light orange color (annatto)
Ingredients: Unbleached wheat flour, whole wheat flour, black strap molasses, soy oil, nonfat milk, oats, egg powder, baking soda, salt, natural bacon and cheese flavors, brewers yeast, cheese powder, annatto (color).

Guaranteed Analysis (all varieties): Crude Protein (min) 9%, Crude Fat (min) 8%, Crude Fat (max) 9%, Crude Fiber (max) 2%, Moisture 6%.

Made in the USA.

I can't say I am a huge fan of these treats simply based on their ingredients. Soy oil, bacon and cheese flavors...? I would say definite pass on these for obvious reasons.