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List of Appropriate Enzymes for an EPI dogs (or cat)

In AUSTRALIA There are four varying strengths of CREON® available in Australia – 5,000, 10,000, 25,000 and 40,000. What is recommended as a starting point is to use one Creon 10,000 per meal (not per cup as recommended with porcine pancreatic powders only available overseas), except for miniature dogs in which case you might want to start with half the contents of one Creon 10,000 capsule.  Creon 10,000 and less available without a prescription from all pharmacies. Creon 25,000 and greater is only available with a prescription issued by your vet. You may then choose to have the prescription filled at a discount pharmacy. If you are in Australia, please read the regularly updated EPI Management for Australian Dogs brochure on the Brochures outside of USA page. Note: In October 2015, we became aware of another prescription pancreatin product called PANZYTRAT® 25,000 that is almost identical to Creon 25 000. This may also be an option (more information as it comes to hand).

If you decide on pancreatin CREON capsules (please share with your vet!):
For a much discounted CREON you can try either:
www.chemistdirect.com.au or  www.chemistwarehouse.com.au or www.chemistking.com.au
 

BIOCASE V made by Thomas Labs, 800-359-8387. Available from Amazon

BPOPARTS LLC. USDA raw Bovine, Porcine and Ovine parts that service Medical, Pharmaceutical & Research industries.  For raw pancreas… please contact Randy Feser at bpopartsrf@gmail.com or you can call him directly at 1-435-770-3132 (Utah)  http://www.biosciregister.com/BPO_Parts_LLC/Supplier/sid3870.htm

CHEMEYES  porcine pancreatin powder for Uk members  at very reasonable rates. Visit the http://www.chemeyes.co.uk/ and/or contact the proprietor, Cameron,  directly at sales@chemeyes.co.uk (see below for a full description)

CREON (available world-wide!!!!)

 

These are enteric coated microspheres of enzymes encased in capsules. These capsules may be given whole or sprinkled on food if served immediately. Alternately, some people find that after giving Creon waiting for a period (5, 10 or 15 minutes) before feeding is more effective. Every dog is different and experimentation is required to find the most effective method. Please note: if you are going to sprinkle the contents ensure that the dog eats the entire meal so that all of the Creon is ingested. If in doubt, give the capsule whole before trying the sprinkling method.

CREON is commonly used in many places outside the U.S.  Existing CREON enzyme capsule products vary from region to region with not all strengths available in all regions. They can come in 5 , 6, 10, 12, 25, 40 strengths and new strengths approved as of 2009 of 6, 12, strengths are becoming more readily available mainly in the US.  When initially treating an EPI dog, it is recommended to start with CREON 12 or CREON 10 which has 10,000 USP of Lipase, 37,500 USP of Protease, 33,200 USP of Amylase. There is some latitude using Creon as its effectiveness is dependent on the dog’s pH level (you do not need to test for this) so getting the exact strength is not strictly necessary.

The CREON the potency measurement comparison is as follows:

CREON 10 Composition : 150 mg Pancreatin
Amylase 8,000 PhEur units (BP Units) also equals 33,400 USP units
Lipase 10,000 PhEur units (BP Units) also equals 10,000 USP units
Protease 600 Ph Eur units (BP units) also equal 37,500 USP units

CREON 25 Composition : 300 mg Pancreatin
Amylase 18,000 PhEur units (BP Units) also equals 74,700 USP units
Lipase 25,000 PhEur units (BP Units) also equals 25,000 USP units
Protease 1,000 Ph Eur units (BP units) also equal 62,500 USP units

However… please know, once you start with a particular brand of CREON and it works… TRY NOT TO SWITCH brands!!!! “There are so many variables with prescriptions for CREON from different countries.   Different countries fill the CREON differently. It is not regulated like medicine for hypertension etc.    Changing from one CREON made by Abbott opposed to CREON made by Mylan as an example will vary very much.  It is strongly suggested that when you use a particular CREON made by a particular company …. stick with the one and do not try to use or vary them from one company or the another unless the amounts are exactly the same as you  have been using and working for your pet. 

A 2012 Research Study on the use of enteric coated enzymes (CREON, LYPEX, etc) for EPI dogs:
http://www.biomedcentral.com/1746-6148/8/127/abstract

Giving CREON is not straight-forward…. the pet owner will have to trial and error to find the right dose and the right administration technique.  The following is a little guidance on how to do this:

The trick to giving CREON is make sure that its activation starts at the right time while going thru the digestive system- -and that will depend on each dog’s very own pH level in their digestive tract / small intestine.. So…. it is all based on what your dog’s pH level is, not his size nor the amount of food given…. and this is why it takes a little trial and error with these dogs when placed on CREON.

First…. the dose.  We suggest starting with a CREON 10,000 (or 12,000) per meal (you can add more if this amount doesn’t work)

Next… the technique…. the best way is to just try the following techniques to see which works best … and that is determined by the poo quality:

1. Give the CREON 10,000 (or 12,000) capsule whole or sprinkle the contents and feed immediately or wait for 10 minutes before feeding (some dogs respond better with either method). Watch the poo for a few days and try to assess. Please note: if you are going to sprinkle the contents ensure that the dog eats the entire meal so that all of the Creon is ingested. If in doubt, give the capsule whole before trying the sprinkling method.

2. if the above does not produce optimal poo results, then you can try 2 x CREON 10,000 (or 12,000) capsules. Watch the poo for a few days and try to assess if this helped, or if it is just right or not working at all….

3. if the above is not working at all…. then try giving a CREON 10,000 (or 12,000)  capsule about 5 minutes prior to a meal… again, watch the poo and try to assess if this appears to work better than the above or not.  If it does appear to work better…. but  still isn’t perfect, then try giving the CREON 10,000 (or 12,000) about 10 minutes prior to a meal and again assess the poo over the next few days.

These are some techniques… the trick in giving CREON will be up to you to try and figure out TWO THINGS!

1. what is the best “timing” method of giving CREON.. whole in capsules or in some cases whether opened and served immediately or 5, 10 or 15 minutes prior to a meal.

2. and then the right “dose”… whether one CREON 10,000  (or 12,000)  is enough or if you need two CREON 10,000 (or 12,000)… or if your dog is going to need approximately CREON 25,000 .

Some comparisons regarding CREON (Spring 2018): 

Two bottles of Creon from Canada Drugs cost me $121.78 (Unfortunately there is a rumor that Canada Drugs will be closing soon) ,  CHEMIST WAREHOUSE WITHOUT A PRESCRIPTION  Creon 10,000 units…. costs $31.69 plus shipping $8.55 comes out to $40.64  a lot less than Canada Drugs , the NEW  company …. called YOUR CANADA DRUG STORE…www.YCDSCC.com….(started by a pharmacist) costs for a prescription required Creon the Creon 10,000 will cost $63.89. All drugs from YCDSCC come from the UK.

(CREON) in Canada… YOUR CANADA DRUG STORE…www.YCDSCC.com

COTAZYM  (Pancrelipase) is the same as Creon http://www.drugs.com/mtm/cotazym.html

ENZYPLEX POWDER (Australia only) Enzyplex Powder for Dogs is an Australian made plant-based enzyme supplement for mild digestive conditions only. It is NOT a treatment for EPI and has been deregistered as a treatment for EPI from the Australian Pesticides and Veterinary Medicines Authority (APVMA) at the request of its manufacturer (de-registration date: April 2016). One of our members lodged a complaint with the Australian Consumer & Competition Commission (ACCC) against the manufacturer CEVA about the continued marketing of Enzyplex as a treatment for EPI. 

It contains insufficient amounts of enzymes required for normal digestion and is not a replacement for a functional pancreas. It is not potent enough to fully address the EPI condition and over time may encourage SID/SIBO to proliferate if used in this way. If your Australian vet recommends Enzyplex for EPI in the first instance you are STRONGLY encouraged to share the APVMA deregistration advice with your vet. CREON is the recommended commercial product capable of successfully treating EPI in companion animals in Australia.

ENZYME-DIANE: GENERIC PANCREATIN (available in the US but can be shipped to certain countries outside of the USMany people on the EPI FORUM use these generic enzymes for a savings of anywhere between 30-50%. If you are interested in ordering bulk-priced supplemental pork-based enzymes manufactured in the US, they can be directly purchased from http://www.enzymediane.com/ 

 (EnzyneDiane also generously donates enzymes to rescue and shelter organizations 
and gifts donated enzymes to those in need)
  • Pancreatin 6x10  (batch sample USP units
    Lipase 70,840 USP units, Protease 448,000 USP units, Amylase 512,000 USP Unit.  COST:  250 grams for $50, 500 grams for $76, 1 kilo for $145  (shipping included)
  • Pancreatin 8x10
  • Lipase 111,720 USP units, Protease 579,600 USP units, Amylase 694,400 USP Unit.  COST:  250 grams for $61, 500 grams for $91, 1 kilo for $173  (shipping included)

For Your Information:   1 kilo = 35.274 ounces
There are 357 teaspoons in a kilo of 6x since a teaspoon is 2.8 grams of powder. 

Since a teaspoon of powder is 2.8 grams ¾ tsp is 2.1 grams so 476 1 teaspoon equivalents in a kilo of 8x.  

EPIZYME8  made by V.E.T. Pharmaceuticals, 800-766-7543 http://www.allivet.com/

EUROBIOL (available in France)  http://drugs-about.com/drugs-e/eurobiol.html

GREEN TRIPE – Raw Ground Beef Pancreas   http://www.greentripe.com/

Green Tripe is located on the west coast  (California) of USA and their counter-part, GreenCuisine4Pets.com is located on the east coast (Georgia)…. please see their link below.

GREEN CUSINE 4 PETS – Raw Ground Beef Pancreas

http://www.greencuisine4pets.com/  GreenCuisine4Pets.com is located on the east coast (Georgia) and is the counter-part of Green Tripe located on the west coast (California) …. please see their link above.

HARE TODAY – Raw Ground Beef Pancreas   http://www.hare-today.com/

  • Ground Beef pancreas (can be used as an alternative to pork enzymes) $2.29 per pound. Click on Raw Pet Foods and then select “Organ meats”

LYPEX (available in England and Europe)  is an enzymatic concentrate derived from the porcine pancreas gland, available in capsules, must be opened and sprinkled on food. Do not incubate on the food. The purified and concentrated pancreatic enzymes are made into micro-pellets and each pallet is enteric-coated. This gives 100% protection to the enzymes from the damaging degradative acids present in the stomach.

Within ten minutes of the pellets passing the stomach to the alkaline environment of the small intestine the protective enteric coating dissolves and releases the protected enzymes to maximize digestion.

Excerpt from Lypex Mfg “

Due to the enteric coating, we do not recommend premixing Lypex granules with water. Please apply the granules directly the food for consumption, as this ensures protection of the enzymes and therefore efficacy. As Lypex is tasteless, hopefully this should not affect palatability for your pet. 

Kind regards and thank you for your enquiry,
Lauren Davis
BVSc MRCVS
International Technical Adviser

M: + 44 (0) 7525986487
E: lauren.davis@vetplus-int.com

PANCRE PLUS  Vet One, NDC #13985-051-77, Qty 500 pills. Mfg by NEOGEN Corp, Dist by MWI in Meridan ID 1-888-694-8381
Tablet minimum: Lipase 9000, Protease 57000, Amylase 64000, Vitamin A 1000, VitaminD3 100, VitaminE 10.
Price can vary (1000 pills for $128-$160) discuss with vet…. EPI dog usage (each dog dose may vary) crush approximately  3 pills and sprinkle on each meal.

PANCREA-TABS PLUS  by Butler Animal Health Supply NDC# 11695-1235-7
Tablet minimum: Lipase 9000, Protease 57000, Amylase 64000, Vitamin A 1000, VitaminD3 100, Vitamin E 10.
500 pills approximately $95. EPI dog usage: crush approximately (each dog dose may vary) 3 pills and sprinkle on each meal.

PANCREATIC ENZYME SUPPLEMENT  by Partnar Animal Health (as of 12/16/2011 available in Canada)  http://www.partnaranimalhealth.ca//product_info.php?cPath=184&products_id=682&osCsid=cb0218985b4d36546fcc32a570c0a6c5
Pharmaceutical Grade porcine replacement enzymes. 15% more powder per package (131g) at the same price as  competitors with 114g pack size.
T
his product is available through veterinarians and now available through internet-based pet pharmacies in Canada.

Please go to this link to order: http://thepetpharmacy.ca/content/pancreatic-enzyme-supplement

Lipase      67,200 USP Units
Protease 280,000 USP Units
Amylase 280,000 USP Units
 
This is the ONLY Pharmaceutical-Grade powdered porcine enzyme manufacturer that is supporting EPI Research. A percentage of all sales were donated to the EPI Genetic Research that was conducted at Clemson University in South Carolina, USA by Drs. Leigh Anne Clark and Kate Tsai.
 
Partnar Animal Health is also helping EPI Awareness by including an EPI Brochure with each package of enzymes it sells. THANK YOU Partnar Animal Health! 

 

PANAKARE PLUS  Enzymatic concentrate derived from the porcine pancreas gland with serum concentrations of fat soluble vitamins A, E &D. made by Neogen Corp, 800-477-8201   http://www.drugs.com/vet/panakare-plus-powder.html

PANCREATIC ENZYME a porcine pancreatic replacement enzyme for EPI dogs available in Canada soon to be available on-line

PANCREASE-V  a porcine pancreatic replacement enzyme for EPI dogs mfg in Canada
http://www.bionicheanimalhealth.com/Products.aspx?ProductID=43&PatientTypeID=12
however… this product may be  purchased for $60 per 114 gram bottle through http://www.crossborder-pet-services.com/

(FOR CANADIAN CUSTOMERS:  The above mentioned company has just started a new on-line company to specifically serve the needs of Canadian clients..feel free to check out:  The Pet Pharmacy  http://thepetpharmacy.ca/

PANCREOFLAT is an enzyme product available in India http://www.medindia.net/drug-price/pancreatin/pankreoflat-170plus80.htm

http://www.abbott.co.in/products-gastroenterology.html 

Pankreoflat 170 mg
22,825 USP units of amylase
6,500 USP units of lipase

Pankreoflat 170 mg: 22,825 USP units of amylase; 6,500 USP units of lipase; 25,000 USP units of protease

Pankreoflat 170 mg
22,825 USP units of amylase
6,500 USP units of lipase
25,000 USP units of protease
 

PANCREZYME is an enzymatic concentrate derived from the porcine pancreas gland, available in powder form. made by Virbac Animal Health, 800-338-3659

PANCREX (available in the UK)  enteric coated capsules http://www.vetuk.co.uk/index.php?main_page=product_info&products_id=37

Pancreatin BP to provide enzymatic activity per gram not less than:

  • Free protease 1400 BP units
  • Lipase 25000 BP units
  • Amylase 30000 BP units

If so…. you need to “try” 2 level teaspoons or 2.5 level teaspoons of this powder per 1 cup of food (dry food) add in approximately 1/4 cup of warm (not hot) water….. mix and let this food, water and enzyme sit for 20 minutes… mix again and then serve. Make sure this enzyme powder is not cold (stored in the frig) it needs to be room temperature… Try this for 3-5 days and see if things (poop) is looking good…..


PANCREPLUS
  http://www.drugs.com/vet/pancreplus-powder.html

PANK-AID ( available in Canadahttps://www.drugs.com/vet/pank-aid-can.html

PANZYME made by Aristavet  http://www.aristavet.co.uk/ (available in the UK)

PROTEXIN  (Available in the UK )  http://www.viovet.co.uk/Protexin_Pro-Enzorb_for_Dogs/c21473/
or http://www.vetimed.co.uk/en/pet/product/protexin-pro-enzorb-pack-of-60/

480mg Pancreatin enteric-coated micro-pellets:

  •  Lipase  27,050 Ph. Eur. U. (minimum)
  • Amylase  22,604 Ph. Eur. U. (minimum)
  • Protease  1,325 Ph. Eur. U. (minimum)
  • Enterococcus faecium (NCIMB 10415) E1707 ? 1 x 108 CFU
  • Cyanocobalamin (Vitamin B12)  >1mg

IN SPAIN & LATIN AMERICA

As of February 2015…. a new enteric coated porcine enzyme product will be available in Spain and Latin American countries.  The product is called “SUP-ENZIM” touted to be 41% less expensive then brand name enzymes for dogs and cats.

To read about this product…please click here:  Spain_LatinAmer SUP-ENZIMS.pdf

Please contact Dr. Jordi Gimeno, Veterinario directly via email (jordi@jglobal.com.es) for availability .. or check to see if it is listed yet at JG Global: http://www.jglobal.com.es/quienes-somos/

Contact options

(+34) 637 551 254
info@jglobal.com.es

C / Hort de la Vila, 38 1-2 08017 Barcelona

RAW-TO-GO Fresh raw pancreas available in the U.K.  http://rawtogo.co.uk/ . Please ask for Lesley Osbourne, located at:

The WarehouseMarket Street
Abergavenny
MonmouthshireNP7 5SD
Telephone: 01873 268086

VIOKASE an enzymatic concentrate derived from the porcine pancreas gland, available in powder or tablet form.  Made by Axcan Pharma, 800-950-8085

(plant enzymes may be attempted to use for EPI dogs with severe allergies to porcine enzymesTOTAL-ENZYMES In some cases, a dog may have pork-based allergies, or meat protein allergies. If so, you may want to try an alternative plant-based enzyme. But please realize… plant enzymes are “supplements”, EPI dogs need “replacement enzymes” however, if you have to use plant enzymes because your EPI dog medically cannot tolerate pork enzymes, there have been some EPI cases (not all) that have had success using this product. At the very least, you will need to double the recommended dose. We always advise against plant enzymes, but sometimes there are situations where porcine-based enzymes are not an option.