

胰腺疾病
犬胰腺外分泌功能不全
胰腺外分泌功能不全 (EPI) 是犬的一种综合征,由正常消化食物所需的消化酶、碳酸氢盐和其他物质产生不足引起。当消化酶不足或缺乏时,会导致消化不良和营养不良。
在犬中,EPI 的常见临床体征包括体重下降(尽管食欲正常或增加)、小肠性腹泻、脂肪痢、便量增加、某些情况下排便频率增加,以及肠胃胀气增加。身体状况不佳、肠鸣音、食粪癖和/或异食癖,以及神经紧张不安或攻击性等症状也有相关报告。1,2
对胰腺外分泌功能不全的患犬进行营养干预,目的是提供足够的能量和高度可消化的营养物质,以支持理想的身体状况,避免营养缺乏,并尽量缓解临床体征。


重要信息
- 在每餐食物中添加外源性胰酶是长期管理 EPI 患犬的主要疗法。
- 尽管补充了充足的酶,但消化能力(尤其是脂肪消化)仍然无法完全恢复正常。5
- 进行降低脂肪含量或提高消化率的饮食调整,可能有助于减轻某些临床体征的严重程度。6 然而,由于患犬个体对不同饮食策略的反应各不相同,饮食选择也存在差异。6─9 对于患犬个体,可能需要先尝试多种饮食,才能确定最合适的饮食。
- 患犬个体对饮食变化的反应可能与膳食脂肪浓度无关。8
- 在患犬的营养状况得到改善和粘膜损伤(如有)得到修复之前,可能需要合理地采用高度易消化、低纤维含量的市售治疗性胃肠道饮食,特别是在初期治疗阶段。2,10,11
- 在补充胰酶的情况下,可以采用市售健康宠物食品对某些患犬进行良好的长期管理。12,13
- 在诊断为 EPI 的患犬中有 75% 至 82% 发现了钴胺素(维生素 B12)缺乏症。7,10 如未纠正,低钴胺素血症可能导致治疗失败或并发症。1 如果检测表明缺乏维生素 B12,则应通过胃肠道外途径补充维生素 B12。病情稳定后,可能仅需口服补充。


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参考文献
- Steiner, J. M. (2016). Exocrine pancreatic insufficiency. In L. P. Tilley & F. W. K. Smith, Jr. (Eds.), Blackwell’s five-minute veterinary consult: Canine and feline. (6th ed., pp. 474─475) John Wiley & Sons, Inc.
- Westermarck, E., & Wiberg, M. (2003). Exocrine pancreatic insufficiency in dogs. Veterinary Clinics of North America: Small Animal Practice, 33(5), 1165─1179. doi: 10.1016/s0195-5616(03)00057-3
- DiMagno, E. P., Go, V. L. W., & Summerskill, W. H. J. (1973). Relations between pancreatic enzyme outputs and malabsorption in severe pancreatic insufficiency. New England Journal of Medicine, 288(16), 813─815. doi: 10.1056/NEJM197304192881603
- Williams, D. A. (2020). Exocrine pancreas. In E. J. Hall, D. A. Williams, & A. Kathrani (Eds.), BSAVA manual of canine and feline gastroenterology (3rd ed., pp. 231─243). BSAVA.
- Westermarck, E., & Wiberg, M. (2012). Exocrine pancreatic insufficiency in the dog: Historical background, diagnosis, and treatment. Topics in Companion Animal Medicine, 27(3), 96─103. doi: 10.1053/j.tcam.2012.05.002
- Westermarck, E., Wiberg, M., & Juntilla, J. (1990). Role of feeding in the treatment of dogs with pancreatic degenerative atrophy. Acta Veterinaria Scandinavica, 31(3), 325─331. doi: 10.1186/BF03547544
- Hall, E. J., Bond, P. M., McLean, C., Batt, R. M., & McLean, L. (1991). A survey of the diagnosis and treatment of canine exocrine pancreatic insufficiency. Journal of Small Animal Practice, 32(12), 613─619. doi: 10.1111/j.1748-5827.1991.tb00903.x
- Westermarck, E., Junttila, J. T., & Wiberg, M. E. (1995). Role of low dietary fat in the treatment of dogs with exocrine pancreatic insufficiency. American Journal of Veterinary Research, 56(5), 600─605.
- Westermarck, E., & Wiberg, M. E. (2006). Effects of diet on clinical signs of exocrine pancreatic insufficiency in dogs. Journal of the American Veterinary Medical Association, 228(2), 225─229. doi: 10.2460/javma.228.2.225
- Batchelor, D. J., Noble, P.-J. M., Taylor, R. H., Cripps, P. J., & German, A. J. (2007). Prognostic factors in canine exocrine pancreatic insufficiency: Prolonged survival is likely if clinical remission is achieved. Journal of Veterinary Internal Medicine, 21(1), 54─60. doi: 10.1111/j.193901676.2007.tb02928.x
- Chandler, M. (2017). Nutritional management of exocrine pancreatic disease. In S. J. Ettinger, E. C. Feldman & E. Côté (Eds.), Textbook of veterinary internal medicine: Diseases of the dog and the cat (8th ed., pp. 1900─41). Elsevier.
- Campbell, S. (2010). Exocrine pancreatic insufficiency—canine. In Nestlé Purina PetCare handbook of canine and feline clinical nutrition (pp. 56─57). Nestlé Purina PetCare Company.
- Xenoulis, P. G. (2020). Exocrine pancreatic insufficiency in dogs and cats. In D. Bruyette (Ed.), Clinical small animal internal medicine (pp. 583─590). John Wiley & Sons, Inc.