A blinded randomised controlled trial to determine the effect of enteric coating on enzyme treatment for canine exocrine pancreatic insufficiency

Thirty-eight client-owned dogs with naturally occurring EPI were included in this multicentre, blinded, randomised controlled trial. Dogs received either an enteric-coated enzyme preparation (test treatment) or an identical preparation without the enteric coating (control treatment) over a period of 56 days.There were no significant differences in either signalment or cobalamin status (where cobalamin deficient or not) between the dogs on the test and control treatments. Body weight and body condition score increased in both groups during the trial (P<0.001) but the magnitude of increase was greater for the test treatment compared with the control treatment (P<0.001). By day 56, mean body weight increase was 17% (95% confidence interval 11-23%) in the test treatment group and 9% (95% confidence interval 4-15%) in the control treatment group. The dose of enzyme required increased over time (P<0.001) but there was no significant difference between treatments at any time point (P=0.225). Clinical disease severity score decreased over time for both groups (P=0.011) and no difference was noted between groups (P=0.869). No significant adverse effects were reported, for either treatment, for the duration of the trial.Enteric coating a pancreatic enzyme treatment improves response in canine EPI.Exocrine pancreatic insufficiency (EPI) is a common condition in dogs, resulting from inadequate functional reserve of pancreatic acinar tissue [1]. The most common cause of EPI is pancreatic acinar atrophy, although other causes have been reported, including chronic pancreatitis, pancreatic neoplasia and (possibly) congenital hypoplasia. Clinical signs only develop when a critical mass (e.g. >90%) of exocrine tissue has been lost, and result from maldigestion and subsequent malabsorption.Clinical management usually involves enzyme replacement therapy with the addition of dietary modification (e.g. highly digestible diet) and ancillary therapies (e.g. antibacterials) if response to e