Exocrine pancreatic insufficiency (EPI) in dogs
EPI means the pancreas doesn't make enough digestive enzymes, so food passes through undigested. German Shepherds are especially prone.
Last updated: October 2026 · 2 sources · see sources
Signs to watch for
- Weight loss despite eating a lot
- Large, pale, greasy stools
- Eating poop
- Gas
Trouble breathing, collapse, repeated vomiting, not peeing, or a seizure that lasts more than a few minutes needs a vet right away. See when to see a vet.
How vets diagnose it
A blood test called TLI (trypsin-like immunoreactivity) confirms it. Vets often check B12 levels too. [2]
How it's treated
Powdered enzyme replacement is mixed into every meal. Many dogs also need B12 injections or supplements. [2]
Medicines your vet may mention: Vitamin B12 (Cobalamin). We don't list doses; your vet will decide what fits your pet.
What it costs to diagnose and manage
| Item | Typical US price | Src |
|---|---|---|
| Diagnosis (exam and tests) | $200–$500 | [1] |
| Ongoing treatment, per month | $50–$200 | [1] |
| Ongoing treatment over a year (monthly range × 12) | $600–$2,400 | [1] |
These are typical US ranges from the sources listed. Your pet's costs depend on how severe things are, the tests your vet recommends, your pet's size and where you live. Ask your vet for a written estimate.
Outlook
With enzymes, most dogs gain weight and do well. Treatment is lifelong. [2]
Common questions
What is exocrine pancreatic insufficiency (EPI) in dogs?
EPI means the pancreas doesn't make enough digestive enzymes, so food passes through undigested. German Shepherds are especially prone.
What are the signs of exocrine pancreatic insufficiency (EPI)?
Common signs include: weight loss despite eating a lot, large, pale, greasy stools, eating poop, gas.
How do vets diagnose exocrine pancreatic insufficiency (EPI)?
A blood test called TLI (trypsin-like immunoreactivity) confirms it. Vets often check B12 levels too.
How is exocrine pancreatic insufficiency (EPI) treated?
Powdered enzyme replacement is mixed into every meal. Many dogs also need B12 injections or supplements.
How much does exocrine pancreatic insufficiency (EPI) cost to treat?
Diagnosis (exam and tests): $200–$500; Ongoing treatment, per month: $50–$200; Ongoing treatment over a year (monthly range × 12): $600–$2,400. Costs vary with severity, tests, your pet's size and where you live.
Related
This page is general information for pet owners, not veterinary advice. Talk to your vet about your own pet.