Exocrine Pancreatic Insufficiency (EPI) is a condition in which a dogs pancreas is unable to produce enough digestive enzymes to break down the food they eat. This means that the dog cannot digest and absorb nutrients from their food, causing them to become malnourished. The most common cause of EPI in dogs is pancreatic acinar atrophy, which is primarily a genetic disease that leads to a dogs immune system destroying the cells in the pancreas that make digestive enzymes. Clinical signs of EPI in dogs include weight loss despite a normal or increased appetite, loose "pulpy" feces, which may have a clay-color, occasional vomiting, poor hair coat, and eating feces or other objects. Simple blood and fecal tests can accurately detect if the condition is present. Canine trypsinogen-like immunoassay (cTLI) is the preferred diagnostic test for EPI. Once an accurate diagnosis has been established, most pets do well with treatment, though treatment is required for the lifetime of the dog. Adding exogenous pancreatic enzymes to food at every meal is the main therapy for long-term management of dogs with EPI. Dogs with EPI require lifelong treatment, and improvement generally occurs within a few days to a few weeks of starting treatment.