Ahh, thank you so much for contacting us about Tucker and for the information you provided. And thank you to you and your vet for getting the TLI test done. YOu are halfway there now to getting Tucker feeling better
A couple of things came to my attention.
1. When you say the B12 test results were normal.... please find out the exact results. Unfortunately with B12, EPI dogs NEED to be in the upper mid-range, normal is often not good enough. Sometimes, even if you are doing everything right, if the B12 is not optimal, then the dog will continue to falter.
2. Good move to get away from the enzyme pills, as you discovered, although the right stuff, they need to be crushed and incubated, so you are better off using the powder.
Fast forward to the Pan-tenex you are using. Right stuff but i suspect if you use a different application technique you'll find much improvement.
With the Pantenex, i know they claim that it is 10x, but the lipase USP units is 71,000... please try giving the ratio of 3/4 (with wet food) tsp to 1 level tsp (with dry food) of Pan-tenex with 1 cu of food. Enzymes are to be given according to the volume of food, not per meal. .. Be sure to add enough liquid (room temp water is fine) to moisten the food so that the enzymes have something to stick to, mix and let incubate for about 20 minutes. then serve. HOpefully this will improve the poo condition.
3. REgarding the cost of Pan-tenex with shipping.... OMG!!!! that is a lot of money. We know how difficult and expensive it is for Canadians caring for EPI dogs.
I looked up the price and Pan-Tenex is $238.00 = 4 Jars (35.2 Ounces/1 Kilogram) with customs it comes to $401 UGH! EnzymeDiane for 1 kilo of Enzymes is $303 for 6x which is equivalent (35.2 Ounces/1 Kilogram). If you find that the change in the Pan-tenex dosing doesn't work out, then i would try half a kilo (500 grams) of EnzymeDiane's 6x at $156 to see if that works better. Some folks claim that EnzymeDiane's enzymes work better for their EPI dog, while others claim that Pan-tenex works better for their dog.... SO..... you might have to try this.
There are other options, like CREON, but i would first try the increased technique with the Pan-tenex and/or EnzymeDiane's 6x.
4. FYI.. You CANNOT test for SID. They used to think that the Folate test results (when the B12 blood test is done) would indicate SID, but have since discovered that ALL dogs with EPI have SID (small intestinal dysbiosis).
https://epi4dogs.com/microbiomemicrobiota-research/
At this date, we don't know how to get rid of SID in EPI dogs. SO our goal is to do our best to keep it in good control. Trust me, Tucker has SID. ONce you get a better handle on the right amount of enzymes for Tucker, if you are still seeing sloppy stools, then most likely you are dealing with out of control SID. EPI dogs don't have enough bacteria in their gut flora AND they also don't have enough of a diversity of bacteria in their gut flora. The recommendation in managing SID is as follows:
a. try a prebiotic first (this feeds bacteria) many of us try SLippery ELm powder https://epi4dogs.com/slippery-elm/ it is a mucilage and we think coats the small intestinal lining preventing bad metabolites to get thru. And it also has some prebiotic properties (SCFA: Butyrate) . It's cheap and often (although not always) it helps a lot. If this doesn't work... then
b. try for a synergistic effect with both prebiotics and probiotics (some of the probiotics that we suggest, but what works really depends on your individual dog's gut flora) are products like: Proviable, Visbiome, Mercola Complete Probiotics, VetriScience Mega Probiotics. Recently someone wrote on the forum, from Canada, a pre+probiotic that they are using and it sounds like an excellent product.... might want to read thru some of the forum messages.
c. if all of the above fails, then you will need your vet to try a course of Tylan, 45 days, twice daily ... do NOT use Metronidazole. Metronidazole will kill ALL the bacteria and the problem is that some of the strains can never be replenished no matter how many probiotics you give the dog. WIth Tylan you do not kill all the bacteria, but rather only inhibit the reproduction of more.
d. We try to do everything we can to avoid putting an EPI dog on any antibiotic, many times the problem is the diet. Many EPI dogs do not do well with prescription kibble, (unless needed for another health condition) and if a commercial food has more than 4% fiber content, or a lot of peas or lentils in it... this usually doesn't bode well for EPI dogs SID. We strongly suggest starting with a low fiber content food, 3.5% usually works better than 4% for most dogs and avoid foods with pea splitting ingredients or if peas/lentils is one of the top 3 to 4 ingredients.... further down the line (and if not repeated a lot) seems to be okay with many of our dogs. If the dog does fine on low fiber food, once stable, then try introducing a little fiber, like your own cooked rice, as see if the poos is still okay..... this will help you determine if your EPI dog while on enzymes can tolerate fiber. The problem with Fiber and EPI dogs is that fiber can inhibit the efficacy of the enzymes from anywhere between 0% to 50% and we have no idea which EPI dog is affected by how much.. This is why we tell folks to "start" with a low fiber/grain free food first and then work from there.
Regarding the Feb 12th apt.... personally i would maybe hold off on the allergy/food sensitivity testing until after you try the above suggestions...... although IBD (food sensitivities) is pretty common with a lot of EPI dogs. However, the issues that Tucker is currently having just might be that a few things need to be slightly tweaked. ... or he does have a food sensitivity. Just out of curiosity, when the vet ran the B12(Cobalamin) test.... was the Folate score below 7.7 ? if so, then TUcker might be dealing with small intestinal proximal disease which often is some sort of food sensitivity.....and can often be like IBD....
Please share everything we are suggesting to you with your vet.... and if he/she would like, please have him/her check out our EPI research section
https://epi4dogs.com/epi-research/
.... which has a lot of the most current EPI research and findings.... that has yet to be well known........
Sorry for the long winded response.....but i hope there are some points in it that helps you and Tucker