Jill gave you the correct answers, but if you are interested, i'll get a little more into the weeds.... and my apologies if i give too many deatils.details.
I agree, if the poos are okay, pretty much stay the course, but if you are adding broth... in-between meals... exactly for the reasons Jill cited, i would sprinkle just a tiny pinch of enzymes in the broth too... but i then i wouldn't bother incubating it... as it is a liquid.
You are correct... there is research that states that incubation is not necessary.... HOWEVER.....the main reason why we suggest incubating is to mostly avoid mouth sores....but there is another reason. Practical Application. IN the clinical trials, they test with xxx amount of dogs, the minimum requirement is 6 dogs and usually, from the studies i have seen, it will go up to 12 or 30 or 50 dogs in the trial. THen they assess the results and found the majority didn't show a difference for xxx amount of time the study was done.
HOWEVER (again) in practical application.... what we have discovered is that many dogs (and we are basing our "observation" on thousands of EPI dogs, not just a limited amount in a clinical trial.....and we are also basing our observations long term, not just xxx amount of days)..... that many, but not all, will start to have loose stools come back over a long period of time when the enzymes are not incubated.... Others will right away have much better (formed/solid) poos when the food is incubated..... but then the big monkey wrench in this entire premise is that even those that respond better to incubated enzymes, respond in varying incubation time.
Many of us (a while back) tested our own dogs....my dog actually did fine with enzymes incubated for only 5-10 minutes. If i didn't incubate at all.... within a month her stools went south. Some others found that they could avoid incubation all together, but the majority found that their dogs did much better with some incubation... some even needed more than 20 minutes. We use 20 minutes as a general guideline.
So... what do i do personally?... just to avoid any issues, i have incubated my dog's enzymes for 20 minutes... been doing this for 13 years now.........
Also...there used to be rumors going ar9und that enzymes incubate food in the bowl.... that is incorrect. I have spoken at length to the researchers about this and for the enzymes to fully activate, they need to be in the digestive system because they need specific warmth temperature, pH levels, other digestive catalysts and they need slightly warm liquid too...... so...............when you put enzymes in a bowl of food... there is a teeny weeny little bit of activation due to the liquid in the food but no where near enough to digest the food in the bowl as some claim....
The other thing about incubation... because you are adding the enzymes to food, with a little moisture.... it will slightly decrease the caustic properties of the enzymes..... so that helps to.
Also.... just a FYI.... about 70% of the enzymes (powdered) are destroyed before they get to do their job due to the bile acids/pH in the digestive tract. this is why when enteric coated enzymes are given they are a lot less in potency BUT then you have a few other problems of the enteric coated being digested at the right time to have the enzymes be effective, and the size of the enzyme particles.... but again, EPI pet owners have learned how to work around this when there are no other options.
SO......................now i have a suggestion...... you might want to ask your vet if after the ulcers (rupture) subside somewhat from the Sucralafate.... if he/she would consider having you "try" slippery elm" powder as a mucilage to maintain keeping the ulcers in check. The reason why i am suggesting this is because i know Slippery Elm is indeed used for this... but..... recently, i happened upon some vet research where they are now suggesting that Sucralafate is not all that they thought it was when used on dogs and that it may even cause an issue.........i'll try to find the report so that you can share with your vet... and let your vet decide whether the research is actually valid or jsut a one time trial that may or may not hold credence. Some of the vets i know continue to recommend Sucralafate.... but.... i personally have requested them not to on my dogs and have instead successfully used SLippery ELm ... one time was to avoid stomach bleed from strong meds..... when my gal battled IMHA..... BUT...she did not have existing ulcers, we used it to prevent them from developing.... so i am not sure if what i am suggesting is appropriate or not, and should be discussed with your vet, don't go by jsut what i am saying.
Regarding do enzymes increase acid.....i don't know how to correctly answer this but i am attaching a piece that i took a picture of that might shed some light on this... see below...... and attached at the top of this post is the entire research article that explains gastric ulcers in dogs
....... BUT in the digestion process i do know that they now know that all EPI dogs have skewed bile acid mechanisms.... and it is all connected primary and secondary bile acid functionality and EPI.......Some have issues to the point where they need to take acid meds, others where they do not even realize their dog's bile system is messed up because they are not seeing any physical issues........ overall the premier acid med for dogs is Omeprazole....what you want is a bile acid sequestrant. Year ago they used to automatically prescribe Cholestyramine for EPI dogs.... they might now be looking back at this. Other products have been used but tend to work only temporarily....like Pepcid AC, ... but then you have to stop for a while and then start up again. and some have been able to control the situation with, again, just SLippery Elm. Unfortunately it depends on the individual EPI dog.
Please feel free to read the research pages on SID, SLippery Elm, EPI...... some of this info is there and explains it much better than i can.
Hope this helps a little and that your eyes didn't glaze over.............................................
Hi Jakey's caregiver.