title: Prognostic factors in canine exocrine pancreatic insufficiency: prolonged survival is likely if clinical remission is achieved.
abstract: BACKGROUND
  Response to therapy in canine exocrine pancreatic insufficiency (EPI) varies considerably, making it difficult to determine prognosis for individual patients.
  
  
  OBJECTIVE
  Response to initial treatment (RIT) and survival are affected by signalment, clinical variables, and therapeutic regimen employed.
  
  
  METHODS
  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
  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.
authors.affiliation: Small Animal Hospital, Department of Veterinary Clinical Science, University of Liverpool, UK. danb@liv.ac.uk
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Batchelor
authors.forename: Peter-John M
authors.initials: PJ
authors.lastname: Noble
authors.forename: Rebecca H
authors.initials: RH
authors.lastname: Taylor
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Cripps
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: German
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004283:Dog Diseases / Q000175:diagnosis* / Q000188:drug therapy; D004285:Dogs; D010188:Exocrine Pancreatic Insufficiency / Q000188:drug therapy / Q000662:veterinary*; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D008297:Male; D010194:Pancreatin / Q000627:therapeutic use; D011379:Prognosis
chemical_list: D000900:Anti-Bacterial Agents; D005765:Gastrointestinal Agents; D006635:Histamine H2 Antagonists; D010194:Pancreatin