Ultrasonographic Findings of Exocrine Pancreatic Insufficiency in Dogs

SIMPLE SUMMARY: Exocrine pancreatic insufficiency (EPI) is a syndrome characterized by insufficient synthesis of pancreatic enzymes leading to clinical symptoms of malabsorption; this pathology has also been described in dogs. No studies are present about ultrasonographic appearance of the pancreas in the course of EPI in dogs. The purpose of this retrospective study was to describe ultrasound features of the pancreas during EPI in this species. In our study, the pancreas had a significantly lower thickness compared to the reference values of healthy dogs previously proposed; however, most of the dogs did not have other ultrasonographic pancreatic alterations. Moreover, in 85% of dogs, ultrasonographic intestinal abnormal findings were also identified. Based on our study, ultrasound could be a useful tool in the diagnosis of EPI. A normal but thinned pancreas associated with sonographic intestinal signs of inflammatory bowel disease in dogs with supportive clinical signs should suggests a diagnosis of EPI. ABSTRACT: Exocrine pancreatic insufficiency (EPI) is a syndrome characterized by insufficient synthesis of pancreatic enzymes leading to clinical symptoms of malabsorption and maldigestion. There are no studies about ultrasonographic appearance of the pancreas with EPI in dogs. The purpose of this retrospective study was to describe ultrasound features of the pancreas during EPI in this species. Dogs with history and clinical signs of maldigestion, serum canine trypsin-like immunoreactivity (cTLI) values <5 µg/L, and abdominal ultrasound exam were included in the study. Size, shape, margin, echogenicity, echostructure, and pancreatic duct appearance of the right pancreatic lobe were valued. Additional sonographic intestinal findings were recorded. Thirty-four dogs were included. The mean pancreatic thickness in our population was significantly lower than the mean reference values of healthy dogs. In 68% of dogs, the pancreas had a normal ultrasound appearance. Ultrasonographic intestinal abnormal findings were identified in 85% of dogs and were suggestive of inflammatory bowel disease. Despite the fact that EPI is a functional diagnosis, ultrasound evaluation should be considered among the useful tests. The finding of a normal but thinned pancreas associated with sonographic intestinal signs of inflammatory bowel disease in dogs with typical history and supportive clinical signs could suggest a diagnosis of EPI.