This page has EPI Quick Guides for those living in countries outside the USA such as: UK, Australia, Portugual/Brazil, France, South Africa and Spain.
UK Brochure for Managing EPI in the UK
Below is an EPI Brochure produced by Ann, one of our EPI FORUM members living in the United Kingdom listing EPI resources in the United Kingdom in an effort to help other UK members manage this dreaded condition with resources that are available to them. Thanks Ann!
MANAGING EPI IN THE UK
I thought I would chip in with this in the hope that it will help any of the new members and give them an insight into hopefully reducing their costs and insuring that the dog/cat receives the best treatment.
A low fibre diet is best for your dog, i.e. below 4%. Fat need not be restricted unless there is another medical condition. So what do we recommend? Well, a lot of us started with a duck and potatoes product which are manufactured by GA but sold under various names and I have included these below.
Prescription diets are not required unless there is another concurrent condition that the prescription diet, such as hydrolysed food, might address.
We give our dogs 150% of the daily recommended intake initially so a good starting point for a German Shepherd Dog is 3 meals of 200 -250 grams. We continue feeding this until they have reached goal weight.
What other foods are there if you don’t want to use grain free? So okay, we have discussed low fibre and most cereal based foods should be avoided. Can you feed rice? Well, some of our members do but most of these tend to stick to the lamb-based ones. Burgess sensitive/ Burns lamb and rice are two…….. Whatever works for your dog and gives you tootsie roll poops 2-3 times a day and puts weight on your dog without causing any other issues. My dog does well on the Burns high energy lamb and the Barking Heads lamb products. They are more expensive but they suit my dog.
I will issue a warning: a lot of our dogs don’t seem to tolerate chicken ………so give some thought to that.
Raw food again is another option but you have to get the balance right with this one and often it can be expensive.
All of these can be purchased on the internet no prescription is required. Animed direct/Vet.Co.Uk – are a couple of sites that stock the enzymes; you do not need to purchase these from your vets. At the time of publishing some of these are in short supply.
Are all enzymes the same? NO! They all have different strengths (more detail on the enzyme tab of the epi4dogs.com website). Lipase is the main enzyme we look at so I have put those values against each of the major enzymes that we tend to use:
|Type of Enzyme||Brand of Enzyme||Amount of Lipase||Cost per Gram / capsule||Approx dose per 100g of Dry Dog food|
|Enteric Coated: open & empty capsule on food||Lypex||30,000 per capsule||60p||1 capsule|
|Powder||Panzym||38,000 per gram||18p||1 gram|
|Powder||Pancreatin||15,000 per gram||22p||2 grams|
|Granules||Pancrex Granules||5,000 per gram||17p||6 grams|
|Enteric Coated: open & empty capsule on food ..OR… give whole 5 minutes prior to meal||Creon (RX required)||10,000 or 12,000 to 40,000||refer to vet or pharmacist||start with 10,000 or 12,000. Increase if needed.|
|Raw organ||Raw pancreas||varies from one animal to the next animal’s||talk to your butcher or various on-line resources||start with 50 grams|
|Powder in capsules||Chemeyes, LLC||20,000 per gram||16p||
For anyone outside the UK using Chemeyes capsules and not measuring their pet’s food in grams, the dosing is:
1/2 cup: 1-2 capsules
1 cup: 3-4 capsules
1+1/2 cup: 5-6 capsules
2 cups: 7-8 capsules
Most enzymes are different strengths (confusing). So this is the hard part, finding the right balance for your dog……….so what happens?? A box of Lypex doesn’t say what you need per volume of food it refers to the size of the dog for instance I need 1 Lypex per 100 grams of food some need 1.5, some need less. You have to find the right dose for your dog that gives tootsie roll poops 2-3 times per day. With Panzym I need 1.5 ml measure which gives me roundabout the same lipase as two Lypex but at a fraction of the cost this breaks down 200 grams of food… Remember I am referring to dry food here raw or tinned require less. And also what works with my dog!!!! But by giving too little enzymes you will cause problems and likewise so will too much!!!
Initially many of our dogs require these but we have to obtain them from the vets we have to buy Tylan/Metro/Oxyet etc and they should advise you re dosing although we have a good tab on here called SIBO that discusses this. Tylan is the cheapest option and has been proven to work.
How important is this? VERY IMPORTANT and sadly often overlooked. Why is it important? Well please read the B12 tab for more information but this being low can cause countless issues. So what do we do? Initially I would ask my vet for a 6 week course of injections now some UK vets will sell you that vial of b12 and the needles and let you do this at home…….because B12 can be important for the rest of their lives I used to import from the states for £50.00 the Wonder Labs b12 product with intrinsic factor (Trinfac B) http://www.wonderlabs.com/itemleft.php?itemnum=6881 …..However, as of April 2014 Chemeyes http://www.chemeyes.co.uk/#!gut-health/c1xam in the UK now also carries “Trinfac B” that has the same specifications as the USA Wonderlabs Trinfac. The specifications are:
Chemeyes’ TRINFAC-B provides Intrinsic Factor, Folate and Methylcobalamin B-12 for enhanced absorption and utilization of orally administered Vitamin B-12
Each white gelatin capsule contains
Folate as folic acid – 800mcg
Vitamin B-12(as methylcobalamin)- 1000mcg
Intrinsic Factor – 40mg
Work with them…point them to this site it contains all the most recent research.
Probiotics and the like: Look at a company called Protexin they carry a good animal range of probiotics and prebiotics http://www.protexin.com/categories/dogs/24
Dorwest also carry some good products such as slippery elm etc.
FOOD – UK Options grain free
* This company is in the process of launching a new food and I will update the forum when I have more details
There are also some overseas imports and if anybody uses anything that I have missed please check out this thread on the epi4dogs forum at http://www.epi4dogs.com/apps/forums/ and feel free to add to this thread: http://www.epi4dogs.com/apps/forums/topics/show/8209542-epi-in-the-uk
I hope this helps! Ann in the UK
EPI management Brochure for Australians
As of March 16, 2019 – powdered porcine enzymes now available in Sydney, Australia through CHEMEYES, LLC … will ship anywhere within Australia in a few days. Please visit/order from https://www.chemeyes.co.uk/shop/
Below is a 6-page EPI Brochure originally produced and periodically updated by Craig. Craig is one of our EPI FORUM members living in Australia and has listed specific EPI resources in Australia in an effort to help other Australians better manage this dreaded condition.
Click on the following link for your copy of this comprehensive 6 page brochure and share it with your vet:
Aussie EPI MANAGEMENT 3 Oct 2016
EPI management Brochure in Portuguese
The following has been submitted by one of our members, Melissa, with EPI “Maddie” from South America… a slide show / Brochure in PORTUGUESE with veterinarian information about EPI:
EPI management Brochure in French
If you would like a copy of our brochure in French, please click the following link: EPI French Brochure v2
EPI Management in Columbia, South America
Although we do not have a specific brochure for those in South America….. through the kindness of Columbia, South American residents with an EPI dog…. we do have some EPI resources to list that are available in South America (Columbia).
1. Current foods available in Columbia:. https://www.agrocampo.com.co/perros/comida/concentrados#page=1
You need a grain free food with less than 4% fiber. You will probably have to try several different types to find one that works.
2. This is a link to a pharmacy website that has all the enzymes available in Colombia except Enzymax which i persoanlly used with great success when my EPI dog Nate was first diagnosed in 2015. This is a link to a pharmacy website that has all the enzymes available in Colombia except Enzymax which I used with great success when Nate was first diagnosed in 2015. https://www.farmalisto.com.co/buscar?controller=search&orderby=position&orderway=desc&search_query=pancreatina&submit_search=Buscar
One of the problems with the generic enzymes is they likely do not contain the strength they say they do. McK and Genfer (sanofi) are the only safe generics and that is debatable… One of my supervisors is a surgeon at the Santa Fe and he said only to buy brand-name enzymes.
Enzymes are difficult in Bogotá. You can buy Creon 25000 at Clinica del Country, Locatel and Farmalisto. I’ve only seen at pharmacies in the Norte. You can also buy Enzymax at some of the health stores near Hospital Fundación Santa Fe. Make sure they are the ones that contain pancreatin from pigs.
You will need 4-6 capsule per cup of food with Enzymax
3. For SIBO you need Tylosina powder/200 mg capsules. Agrocampo sells it. Flagyl will also work. (Hopefully Agrocampo still sells Tylosin 200mg capsules!). Elanco does not import Tylan to Colombia .
4. There is a vet on Bogota, Columbia, Dr Diego Ordoñezf. He was at UNal Clinica para Animales Pequeños. He is a very good and knowledgeable vet. His email is firstname.lastname@example.org
5. For B12 you can buy injectable from any pharmacy. I use hidroxicobalamina
EPI management Brochure for South Africans
IF you live in South Africa and would like to know how and what resources are available to you, please feel free to download this brochure put together by one of our SA members, Cheri McDougall (Thank you Cheri!!!) : So African EPI Brochure
EPI Management Brochure in Spanish
If you would like a copy of an EPI Brochure in Spanish, please click the following link:
EPI in Spain-Insuficiencia Pancreática Exocrina