Epi4Dogs

Hi - I’m new to the forum. My 11 year old chocolate lab Bodie was diagnosed with EPI early this year.
My vet and I are struggling to manage the condition enzyme/B12 wise mainly (she thinks) that he has other medication for thyroid (Forthyron) arthritis (Gabapentin/Tramal/Arthridog) and atopic dermatitis (Atopica) which are creating unsatisfactory, acidic gut conditions which kill off a proportion of the pancreatic enzyme supplement (Lypex). He also takes pre and pro biotics…and we are now trying omeprazole to reduce gut acid.
Does anyone have any advice or experience here ? I cannot stop the other meds or his life quality would be severely limited.
He’s currently happy, active and stable at 32kg but his fur is terribly dry and he hasn’t produced a normal poop in months…
Here’s hoping
Bev

PS We are using enteric coated enzymes (Lypex) because of the acid… the powdered don’t really work at all

Hi Bev and welcome to you and Brodie. Will you please post the test results for the Tli, B12 and Folate so we can take a look?
The pups B12 needs to be up on the high range of normal and this can be achieved with either shots or daily supplementation.
4 things need to be addressed before it all comes together for the management of Epi:

Diet: needs to be a grain free food of 4% or less fiber.

Enzymes: needs to be given with every bit of food from now on. The Lypex capsule is to be opened and sprinkled on food before eating and consumed. Enteric coated to withstand the stomach acid.

Antibiotic: most dogs have SID(Small intestinal symbiosis) which causes stomach acid, gas, belching etc... Trying prebiotic first is recommended, then adding an antibiotic (not flagyl(metronidaxole) if prebiotic doesn't work.

B12: supplementation as mentioned.

What food are you feeding?

Here are some links:

https://epi4dogs.com/b12-in-brief-2/
https://epi4dogs.com/sidsibo-in-brief/

Jill

Hi Jill
Many thanks for the quick reply.
- B12 is being managed via oral supplements and shots when needed
- diet is within all the recommended fat and fiber limits and is gluten/grain free (Lily’s kitchen recovery recipe wet + grain free senior dry)
- no SIB (Just tested)

Main issue is the stomach acid caused by the other meds. We are trying to minimize them (eg phasing out Arthridog) and compensate (omeprazole).

My vet says EPI is very challenging in senior dogs with other conditions which also have to be medicated like Bodie’s arthritis and dermatitis… was really looking for tips on co-condition management from others’ experience.. for the EPI in isolation we are doing everything you mention.
Nice to hear from you!
Bev

Sorry, no SBI.
Vet thinks maybe SID, recommends pre-biotic fiber supplement (ProFiber)
Any experiences with this or alternates ?
(I live in Switzerland, US/UK brands not always accessible…)