Hi Erin,
1. I just looked at your labs and your dog's low folate score IS indictive of small proximal intestinal disease..... translated into english, this is kind of a catch all phrase for a variety of things... but most commonly, it is often associated with a food intolerance or even food allergy.
2. one of the things that liquid stools indicate is often food sensitivities.........
So that is TWO indications that what you are dealing with is some sort of food sensitivity. possible IBD or just a specific ingredient in addition to EPI.
That high B12 score, was rendered so high because of the shot jsut prior to the B12 blood test.... to give you perspective.... a B12 shot is not supposed to be given A MONTH PRIOR to blood being drawn for a B12 blood test. (sigh!!!) if on B12 pills, you are supposed to stop the pills A WEEK prior to the B12 blood test.
THe "Purina pro plan veterinary diet EN gastoenteric wet canned food." doesn't always agree with our dogs...
THE" Ollie fresh human grade food, (beef lamb and turkey recipes), and Natural Balance Limited Ingredient Lamb & Brown Rice Recipe Dry Dog Food. On 7/28 and 7/29 her overall demeanor improved and she was less lethargic. " sounds like she started responding better to it...... but if you can continue with the Ollie fresh and just do one protein (either the beef, lamb or turkey ) for a week straight and record which one seem to give better poos and which one seems to give worse poos.
THe lamb and Rice dry food may or may not be okay... because you have no idea if how much / if any the rice in this food interferes or agrees with her system now that she is on pancreatic enzymes.
Glad you ONLY ordered a sample of the SPort food (because even though a LOT of EPI dogs do great on this food because of the lack of peas (they do horribly with too many peas in the diet) if this is IBD, you don't want to try too many different proteins without knowing if this is what you are really dealing with.
SO.... if you can just do the individual OLLie FOODS 1st- record the results... and one of the food trial weeks try the sample of the SPORT food and see how well that is or is not tolerated.
IF nothing is well tolerated then talk to your vet about trying a hydrolyzed prescription food and we suggest starting with Ultamino by Royal Canine.
NEXT........... the lethargy could be SID. Especially if your dog is struggling with both EPI and Small proximal intestinal disease. with EPI SID is always present to one degree or another. WITH Proximal disease/food sensitivities... same thing... there is inflammation
The WEIRD thing about SID is that some dogs can have a bad case and go about their routine as if there is no problem, no pain... just loose stools.
BUT........some other dogs can have the same degree of SID and act sick and lethargic..... SOOOOOOOOO based on this i would insist that the vet put your dog on a curse of TYlan....
https://epi4dogs.com/antibiotics/ ...
There is TONS of information and research on this and Metronidazole is definitely a no-no.
Metro kills ALL the gut bacteria, where as Tylan is a Macrolide and only inhibits the bacteria from reproducing... of course if you leave a dog on Tylan forever, that too will eventually result in all the bacteria being gone too... but with Tylan it takes a very LONG time...
Of course all this to say, that even though the lethargy "may" be related to SID... it is best that your vet 1st rule out other possibilities,... just in case... cause not everything is related to EPI with an EPI dog.
i hope this helps a little.............