Newly diagnosed EPI

[Olesia711]

my experience with Tylan is that it is very forgiving and does not harm to give a little more than what is suggested.... so i personally wouldn't worry about the slightly extra Tylan that you are giving.....and i have not heard of too much causing regurg.... BUT.... that being said..... it might be a good thing to try for a few days to give a reduced amount of Tylan to see if that does reduce the regurg... just in case this is the problem... but if no improvement then go back to giving your original amount of Tylan.

With the regurg... one thing that vets sometimes suggest is to reduce the amount of enzymes by a tiny pinch,... however.... this practice is kind of hard to do without then under-dosing and triggering out of control SID..... so without doing this, it leaves trying slippery elm, or trying omeprazole for the regurg. Since there is a problem with secondary bile acid functionality in the EPI dog, many EPI dogs simply have to be on an acid reducer. So,... my suggestion is to either try some slippery elm powder to see if this helps or ask your vet if he/she would prescribe omeprazole and let them determine how much your dog should take.

[Fepi]

Thank you for all the feedback.

With regards to the B-12, thank you for the advice and reason for stopping the B-12 pills 5-7 days prior to testing (makes total sense
My thought for retesting was simply to make sure that Finn was able to absorb (for lack of a better word) the pill form as opposed to giving the injections. I just want to make sure that he is back at a good level and can continue with the pill form.

With regards to the regurgitation:
- If I were to try the Wonder Labs slippery elm bark powder, do I just try a “1/4 scoop” once a day (morning meal) sprinkled into his incubated food OR twice a day (Morning and evening meal)?
-Would I still give him Tylan or would the slippery elm powder be replacing that?

Or
-if I were to ask my vet about perscribing omeprazole, would that be replacing the Tylan to see if that works better for Finn,? Or would I be giving him both Tylan and omeprazole? Is it okay for a dog to be on omeprazole long term?

Thank you so much!

[Eddiespaghetti]

I completely understand why you want to retest B12. At my local vet, it is $250, I just feel that money would be better spent elsewhere for him. Of course, it's completely your choice, I was only giving my opinion on it.
If you wanted to go the slippery elm route, I would start with 1/4th of a scoop and see how it goes before starting to reduce the Tylan powder. Honestly, any of the routes you go that is what I would do. Any of those routes would replace hopefully the Tylan powder.
Fin is doing well and you don't need to change anything. Slippery elm is a lot cheaper than Tylosin and will hopefully help with the indigestion.
A possible side effect of Tylan is vomiting it could be helpful to replace it with something else since Fin is stable. At the same time, the Tylan could be keeping the SIDs at bay and he needs to be on it. It's a tough choice. Is it worth it to change things if he is doing well?

[Olesia711]

definitely stop the pills for 7 days prior to the blood being drawn or else you can get a false read (the B12 reading may be higher than what it actually is)

Yes, with regards to the WOnderlabs slippery elm... you give 1/4... BUT... please use and give a 1/4 measuring spoon first and compare the measuring spoon with the scoop as i do not know what measurement their scoop is.

Yes, at first still give the proper amount of slippery elm WITH the current Tylan powder dose... THe Tylan powder is an antibiotic and addresses SID/SIBO/Dysbiosis... many times SLippery ELm can keep all this in check, but sometimes SLippery ELm is not potent enough to straighten things out... but often, once things are straightened out... then SLippery ELm can keep things in check and you don't need the TYlan.

SOOOOOO give both s suggested above and IF you notice ANY improvement in anything in a couple of days....then slowly try withdrawing the Tylan (while giving the Slipper ELm ) and very closely observe the poos, belly noises, lip smacking and regurg.

To withdraw the Tylan.... give full dose and then reduce to 1/2 dose morning and night (breakfast & dinner) for 1 week. If all is fine.... then the 2nd week reduce the Tylan to 1/2 dose once a day for another week. Again watch everything to make sure if all is fine. If fine.... then the 3rd week, reduce the 1/2 dose to every other day for 1 more week, and if all is fine then stop the Tylan completely... Going forward ... watch the ppo for a month to make sure there is not a set-back.

OR.......................................you can stop the Tylan completely for a couple of days (not give the SLippery ELm yet) and see if stopping the Tylan subsides the regurg or not (and watch the poos closely!) . If it does stop the regurg and the poos are fine, then after 2 days i would not give the TYlan but implement the SLippery Elm (1/4 tsp) and watch the results for another couple of days to make sure the SLippery Elm is well tolerated.... if fine... then just give the Slippery Elm powder and watch, watch, watch the poo, regurg, tummy noises, lip smacking etc to make sure none of this is going south.

As Jerey alluded to, if you can keep the dog off TYlan, all the better.... but each dog is different, so you just have to try things one at a time. 
Do keep a journal to record everything....even though i know it can be a real pain in the butt to do..... but...... it is the only way to accurately remember what works and what doesn't .

Hope this helps!