EPI - Exocrine Pancreatic Insufficiency in Dogs

EPI is the inability of the pancreas to secrete digestive enzymes.  In short, this means that dogs eat, but their body does not digest food, so they starve.

A great overview of EPI is found in this Whole Dog Journal article, courtesy of DogAware.com

http://dogaware.com/articles/wdjepi.html

The two ongoing supplements required by most dogs with EPI are:

1. Pancreatic Enzymes
2. B12

Pancreatic Enzymes

Pancreatic enzymes are easy to find, and can be bought online through vitamin stores and Amazon.com.  Veterinarians also sell prescription enzymes.

The cheapest source we have found is EnzymeDiane.com  That company purchases enzymes from American Laboratories, and resells them.  In a phone call during February 2012, American Laboratories stated the minimum purchase size for Pancreatin 8X is 25 kilos, or over 50 pounds.  This is too much for a single dog, or several dogs.  American Labs charges $184 per kilo for 25 kilos, while Enzyme Diane charges $300 for 2 kilos, for a cost per kilo of $150.

Unfortunately, artificial enzymes will probably need to be purchased for a dog with EPI, for the life of the dog.  However, while some people talk of spending $100 - $400 per month, in our experience, a teaspoon or two per day of 8X is enough for most dogs, so a more realistic cost is $20 per month, or around $200 per year.  With our dog, we are using only a fraction of a teaspoon per day mixed with the same exact recipe of fresh, raw food we feed each other dog.

Enzyme Buying Club - Save Money

If you would like to cut costs by joining others to purchase enzymes in bulk, please contact Iowa Pet Adoptions.

B12

A low level of B12 is common, and is easily supplemented with B12 injections.  This may cost $20 per year.

The B12 injection is given in the same method as a regular canine vaccine injection.  A veterinarian or fellow EPI dog owner should be able to easily show how this is done.

Meal Preparation - Weight Gain

This is the process we used to add weight for a dog which came in at 55 pounds.  After 5 weeks he weighed 72 pounds.  This was our first case of EPI so the diet varied each week, to determine what worked best.  The weight gain likely would have been faster if we had followed these guidelines consistently.

• Amount of Food: 15 - 20 cups of combined total food per day, spread out over 4 meals (we feed a raw diet)
• Number of Meals: 4 meals per day - 7 am, 11am, 3pm, 7pm
• Meal Content: 40% meat, 40% vegetables (primarily potatoes or rice), 2 whole eggs per day (egg shell provides calcium)
• Supplements, per day: 1/4 cup of vegetable oil, 400 i.u. Vitamin E, 2 Fish Oil gel caps, 1-2 ounces Coconut oil, a few walnuts, plain nonfat yogurt with no artificial sweeteners
• Medication: Metronidazole, 1 CC B12 per week
• Enzymes: 2 teaspoons per day, mixed in food processor while preparing meals

Meal Preparation for 10 Cups - we made two meals per day, and split each into two feedings

• Soak Vegetables and Eggs in water mixed with vinegar to clean
• Mix 1 teaspoon 8X strength Enzymes in a small amount of warm - not hot - water
• Slice veggies and mix with meat, enzymes, and other ingredients in food processor
• Feed 1/2 (about 5 cups) and save the other half for a meal 4 hours later

Raw Diets Contain Enzymes

Enzymes occur naturally in raw meat, fruits, and vegetables.  Heat kills enzymes, so dog kibble will not contain live enzymes.

Thus, it may seem logical that feeding a raw diet with enzymes leads to a better outcome for dogs with EPI.  We know of no scientific tests of this theory.  Many traditional veterinarians dismiss the notion that real food is better for our pets than highly processed kibble, most notably the American Veterinary Medical Association. I think the experience of many pet owners shows the AVMA is flat wrong and backwards.

Raw Pancreas

There is some discussion about feeding raw pancreas meat to dogs with EPI.  We have been able to acquire raw pork pancreas and for a time fed 4 - 7 ounces per day, along with one teaspoon of artificial enzymes.  We have stopped feeding raw pancreas because it is hard to acquire - at least in Iowa - and the dog is using so few processed enzymes that buying raw pancreas is not worth the effort it takes.

Resources

There is much information and misinformation regarding pet health generally.  The same chaos exists with EPI.  Be sure to find a veterinarian with experience, who can instantly spot a dog with EPI symptoms.

• Whole Dog Journal Article
• Enzyme Diane
• Texas A&M
• Small Animal Gastroenterology - from a book edited by Jorg Steiner, 14 page section on Diseases of the exocrine pancreas, EPI section starts page 294 / 12