EPI Quick-Start Guide


The information below provides the basics of how to get started if your dog has been diagnosed with Exocrine Pancreatic Insufficiency (EPI).  These basics should help stabilize most EPI dogs.  Once your dog is stable, you can experiment with changes and additions.  Make all changes slowly, and make only one change at a time, so you'll know what helps and what doesn't.  Keep a journal.  Success will follow.

A. Use the right food...
  • Pick one that's...
    • <12% Fat
    • <4% Fiber
    • Grain-Free
  • Note to raw-feeders:  Reduce bone by 50%


B.  Fix food the right way...

  • Grind it
    • So all parts of the food can come in contact with enzymes
    • If you can't grind kibble, pre-soaking kibble in water until it's thoroughly mushy is OK, but some kibbles are too hard to do this.
    • Note:  If your kibble becomes entirely soft and mushy (no hard parts) after incubating (see below), there is no need to grind or pre-mush.



  • Mix it
    • Room-temperature ground-up food
    • Warm (not hot) water
      • Enough water so end result is mushy (or even like thick soup)
    • Porcine enzyme powder (e.g., Pancreatin 6X, Viokase-V,  etc.)
      • Start with 1 tsp enzyme powder to 1 cup of kibble
        • Kibble is measured when whole (before grinding)
      • If feeding raw or canned, start with slightly less enzymes
      • Adjust enzyme quantity by 1/8 tsp every 3-5 days until your dog produces firm, wrinkled stools.
        • Finding the right quantity is trial-&-error. 
        • Some dogs need more enzymes; some need less.








  • Incubate it
    • Soak (incubate) the mixture of ground-up food, warm water, and enzymes for a minimum of 30 - 60 minutes
      • Less time can cause mouth bleeding. 
    • End result should look like mush (or even thick soup)
    • If you incubate more than one meal at a time, store the remainder covered in the fridge
      • Warm prior to serving by floating food bowl in larger bowl of very warm water


  • Feed it
    • Several small meals work best.
    • No treats whatsoever!  It's hard but necessary.
      • Your dog can only digest food that's been incubated with enzymes.
      • Untreated food will create more health problems.


C.  Find out if your dog has SIBO or B12 deficiency...

  • Ask your vet for the "Cobalamin/Folate" test and consult with your vet for all treatment.
  • B12 Deficiencies:  Cobalamin (B12) results will tell if your dog has a B12 deficiency
    • Extremely serious if not treated
      • Very treatable with regular subcutaneous injections ("TAMU Protocol").
      • Most oral supplements don't work.
  • Small Intestinal Bacterial Overgrowth (SIBO):  Folate results may help diagnose SIBO.
    • Can become entrenched if not treated promptly
    • Standard treatment is antibiotics twice daily for 6 weeks
    • Tylan powder (tylosin) is generally preferred
      • Mild, with few side-effects
    • Other antibiotics, such as metronidazole, can also be effective
    • If SIBO doesn't resolve, antibiotics probably should continue
      • Tylan is well tolerated and can generally be taken long-term if necessary
    • Note:  SIBO often exists even when test results are normal, so watch for symptoms. Common symptoms are some (but usually not all) of the following...
      • Tummy rumbles (loud stomach gurgles)
      • Gas, burping, wet burps, throwing up (often brown liquid)
      • Pica, stool-eating, grass-eating, yellow stools
      • Ravenous appetite or poor appetite (one extreme or the other)
      • Diarrhea


...and last but not least...



Information written by GlobalSpan.net using the references on the home pageAlthough we have summarized information we found from the links, we cannot attest to the accuracy.  Please consult with your veterinarian for medical information.   
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