• Porcine Pancreatic Replacement Enzymes needed with every meal. NO treats in-between meals.
• Powdered enzymes are preferred (where available), BUT they are not necessarily available in all parts of the world and may not be suitable for all dogs. Others available  enzymes are: enteric coated, granules, tablets, raw, etc. Some of which are well established and some others that may work via trial and error. See list on this page.
• “Suggested” dose of powdered enzymes (USA products):  1 level tsp per 1 cup kibble (with liquid added)
• Heat over 130 degree destroys enzymes, Cold inhibits enzyme activity
• When using powdered enzymes, not necessary BUT advisable to incubate 20/+ minutes with slightly warm liquid to avoid “possible” mouth sores
• DISCOUNT ENZYMES! “Enzyme-Diane Enzymes” http://www.enzymediane.com/ generic food grade enzymes available at less than 1/2 cost of pharmaceutical grade enzymes used for years by many on this website/EPI forum members
• Check out the list of various European Enzyme products and their potency.
• Check out the Enzyme conversion guide
• Check out the Enzyme Research and research on canine gastric enzymes

The convenient method of treatment for EPI is with porcine replacement enzymes (not enzyme supplements). These enzymes are needed to break down all foods that a dog ingests. Although raw pancreas is considered as a viable treatment, raw pancreas is not always obtainable, hence the preference for pancreatic replacement enzymes.

If you live outside the USA, please check with your vet if any of the porcine-based enzyme products listed on the Enzyme List page are available in your country.

Enzyme potency in the USA is measured in USP units 
(this is a different measurement than elsewhere in the world).
The necessary 3 main ingredients (enzymes) with any EPI enzyme product are porcine-based
Lipase, Protease & Amylase.
If you live outside the USA and are trying to determine the proper amount of enzymes to use, please share these USA USP Units with your vet or pharmacist and have them work with you on determining the proper potency amount.

In the USA, the potency of the “powdered” porcine-based replacement enzyme may range from approximately (some products use a higher potency):

Most often, the initial recommended dose is 2.8 grams or 1 teaspoon of enzymes with each meal (approximately 1 cup of food) . But talk to your vet- -they need to determine what the proper dose is for your individual dog. Beware… many “over-the-counter enzyme supplement” products do not supply enough of the proper amount of enzymes needed for an EPI dog. When determining what product to use, talk to your vet and/or other EPI dog owners.

FEEDING RAW PANCREAS:  If you would like to try using raw pancreas;  fresh beef, pork or lamb pancreas are recommended. Raw BEEF Pancreas is available for purchase in the USA at http://www.hare-today.com/  or http://www.greentripe.com/ .  or Sirius Natural Pet Foods . There is also an amazing selection of raw pancreas at: https://www.mypetcarnivore.com/ . If you are in the U.K. you can look into http://rawtogo.co.uk/ . One to three or four ounces of raw pancreas can replace one teaspoon of pancreatic extract. Raw pancreas may be frozen in cubes for future use and thawed naturally, but never heat on the stove or in the microwave.

First puree the raw pancreas and (for your convenience) then freeze it in 1 ounce packets (or an ice try should work). Once you figure out how many ounces of raw pancreas your dog responds best to per 1 cup of food….(whether it is 1, 2 ,3 or 4 ounces of the raw pancreas)….. let the proper amount of frozen raw pureed pancreas thaw naturally (DO NOT HEAT !) …. and mix in with the food. It appears to usually work best when allowed to “incubate”… we suggest 15 – 20 minutes… but some do fine with less time, and some seem to need a few minutes more and others need no incubation time. In the beginning there will be some trial and error until you figure out what works best for your dog.

If possible beef or lamb raw pancreas is recommended over pork pancreas because of the “possibility” of the transmission of pseudorabies, although rare.
http://en.wikipedia.org/wiki/Pseudorabies

Also… raw pancreas is not all the same.  Each and every gland has a different potency of enzymes.  This is not just species to species.  The potency can vary from one farm animal to another farm animal as well. If you use 1 ounce of raw pancreas with the batch you are currently using the next batch may need to be tweaked. Fresh pancreas has a shelf life (in the freezer) of up to 3 months.

Adding enzymes to a raw fed meal:
Since raw food is harder to measure by the cup since the densities of different meat/bones will require different levels of enzymes, it is easiest to go by weight rather than amount! ” To add the enzymes, you can either puree a portion of the raw meat and add the enzymes to that pureed slurry and pour over the remainder of the raw food, let sit for 20 minutes and serve, or you can add the enzymes to something like yogurt/kefir and either add to the food as mentioned above, or serve the enzymed slurry first ahead of the meal. Try both to see which works best with your EPI dog. (Thank you Cait for these great suggestions!)

POWDERED ENZYMES may be kept in tightly sealed double plastic bags and then in a sealed container in the refrigerator to lengthen the longevity of the stored enzyme. However, it is very important that the enzymes be kept dry since moisture ruins the enzymes. Powdered enzymes shelf life (approximately 2 years).

ENZYME TABLETS do not appear to work as well other products such as the powders or even enteric coated capsules, however, if crushed, they may work..it depends on the individual dog.

PORK ALLERGY Alternatives:  Universally it is suggested to try Beef (bovine) Enzymes. Contact EnzymeDiane (USA) for beef powder, or see below for various raw pancreas sources, or do a search on beef enzymes on the internet; start with a double dose and increase as needed, usually need to play around with the dose/product until you find a workable solution. If there is an allergy to both pork (porcine) and beef (bovine) enzymes, Try sheep (ovine) enzymes. If in the USA, you can contact one of the raw pancreas suppliers, if you are outside the USA, you can try the whole gland sheep (ovine) capsules available on Amazon.com

Allergy Research Group – Pancreas Lamb 425mg, 90vcaps. By Allergy Research Group by Allergy Research: 

Also…. if your dog truly has a PORK ALLERGY…..depending on the severity of the allergy, you can continue to give the pork enzymes along with an antihistamine (prescribed by your vet), or you can try beef, lamb or even ox bile enzymes, and as a last resort… you can try plant enzymes. If your dog is a confirmed EPI dog….. any or all of these substitutes “might” help to one degree or another (no guarantees) but you will have to use much more than what is recommended to compensate for the insufficient potency.  With regards to possible plant enzymes, two products have been used that we know of with some success in dogs with true pork allergies:  TotalZymes http://www.k9medicinals.com/pet-products/digestive-support/total-zymes  and Dr. Goodpet http://www.goodpet.com/dogs/canine-digestive-enzymes/

HOWEVER…. we strongly advise not using these alternative unless your dog has a confirmed pork allergy.  Almost 99% of the time, when an owners swears the pet has a pork allergy (without being tested to confirm this) it turns out to be something else……

TO SEE A COMPREHENSIVE LIST OF ENZYME PRODUCTS, PLEASE GO TO THE ENZYME LIST PAGE: https://epi4dogs.com/enzyme-list/