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A few months ago, my dog was diagnosed with EPI, exocrine pancreatic insufficiency, via a blood test. EPI is a condition where the pancreas no longer produces enzymes to help a dog digest food and absorb nutrients.

You can read more about EPI in my post How to Feed a Raw Fed Dog with EPI. In this post, I want to share an update on how Rodrigo is doing, including the supplement that I give him, the resources I've found, and the changes I've seen in my dog.

What is EPI (Exocrine Pancreatic Insufficiency)?

EPI is a condition in which the pancreas ceases to function and no longer produces enzymes (protease, lipase, amylase). And because his pancreas isn't producing these enzymes, he's unable to digest food and absorb nutrients. My dog was slowly starving to death. What tipped me off that something was wrong was his rapid weight loss, the fact that he always seemed to be hungry, and he was becoming increasingly aggressive, especially around mealtime. Because I was familiar with EPI, I made a veterinarian appointment and he was diagnosed with EPI through a blood test.

I think that I was able to ward off this diagnosis for a few years because I was adding a digestive supplement to his diet. As I understand it today, dogs don't produce an endless supply of enzymes and this is why they need a digestive supplement. Whether this is true for all dogs or just some dogs, I'm not sure. But this seems to be the case with Rodrigo. However, the digestive supplement wasn't a permanent solution for him.

Symptoms of EPI in Dogs

  • Continued weight loss despite always being hungry
  • Pooping more often than the other dogs; poop is larger, yellow or gray in color, and soft
  • Dog eats his own poop (coprophagia)
  • Increased gas and tummy noises
  • Occasional diarrhea and vomiting
  • Increased anxiety, fearful behavior

Supplement for Dogs with EPI

There are a lot of supplements that have been created for dogs with EPI and I chose Bio Case Plus by Thomas Labs. It's a powder supplement that has to sit on Rodrigo's food (I mix it into ground raw) for 15-20 minutes before I feed him. I've had to make some changes to feeding the dogs, always keeping that 20 minutes in mind. I can no longer quickly feed the dogs. And it's a waste of food to feed Rodrigo without the supplement since he can't digest it.

UPDATE: in 2020, I switched from Bio Case Plus to Enzyme Diane after the former increased their prices. With Enzyme Diane, I use less of the supplement so not only is it less expensive, it lasts longer (7 weeks vs. 4 weeks with BCP).

Bio Case Plus

The Bio Case Plus isn't cheap. None of the effective supplements are, however, given the alternative (starvation), I'm happy to spend the money. I purchase Rodrigo's supplement through on a recurring order – a two-pound container every 8 weeks for $150 (Yikes!). A two-pound container lasts about 10 weeks with Rodrigo. Initially, I added five teaspoons per meal for several months. Today, I added 3 teaspoons per meal, which allows the Bio Case Plus to last longer.

Do Not Premix Food with Supplement

Someone suggested that I save time by mixing up several of Rodrigo's meals ahead of time, however, this is discouraged by Thomas Labs because although the food is refrigerated, the supplement will continue pre-digesting the proteins and fats. It's recommended that this is done at room temperature. Since I feed raw that is coming from the fridge, I mix in the supplement on my prep table and allow to sit for 15-20 minutes before feeding Rodrigo.

Changes in Rodrigo Since Being Diagnosed with EPI

I've been asked by several people why I chose to go with Bio Case Plus. This is a supplement I tried several years ago that Rodrigo did well on and I wish I would never have stopped, but the cost was intimidating. After it seemed like he didn't need it, I stopped buying it. Looking back, I realize that this was a mistake.

Since diagnoses and starting on Bio Case Plus, Rodrigo has gained half of his weight back and looks fantastic. There was a time when he was skin and bones and seemed so fragile. Today, he's a healthy 55-56 lbs. This is less than before he started losing weight, but his veterinarian is happy with here he is so I've reduced the amount of food he eats per meal from 20-25 ounces per meal to 15 ounces per meal.

Helping an EPI Dog Gain Weight

Initially, I planned to feed Rodrigo satin balls because I wanted to get him back to a healthier weight. However, it isn't necessary or recommended to rush the weight gain; once his body began absorbing nutrients, he started gaining immediately with the first couple of pounds returning within the first few weeks on Bio Case Plus.

All other symptoms (diarrhea, loose stool, aggressive behavior, constant hunger) vanished within the first couple of weeks and Rodrigo finally has raw fed poop – small and solid like our other dogs.

Helpful Resources for Dogs with EPI

The resources that I've found most helpful include:

Raw Feeding Group: EPI – K9EPIGlobal – there are at least two EPI groups on Facebook and I prefer this one to the other that I joined for a short time because EPI – K9EPIGlobal has a lot of raw feeders. I had many questions and couldn't know if what worked for a kibble fed dog would work for a raw fed dog. I'll list a few of my initial questions below.

Enzyme Diane: this is a website full of information about EPI for dogs, success stories to give us hope, and a supplement that people rave about.

EPI4Dogs Foundation: this is another website that has a lot of great information to help us learn about raising dogs with EPI.

My Questions About Feeding Raw to a Dog with EPI

1 – Do I have to use the supplement with every meal?

Yes. Without using the supplement, Rodrigo won't be able to digest his food. The supplement doesn't last a full day in his system. Instead, it pre-digests his food, making it possible for him to absorb the nutrients.

2 – Do I need to use the supplement when feeding raw meaty bones?

Yes. Every summer, my dogs enjoy raw meaty bones outside and I was wondering if I need to add the supplement or how to add the supplement. I was advised to mix up a small amount of ground raw with the supplement and feed it to Rodrigo 30 minutes prior to giving the dogs their bones. If I'm feeding recreational bones to my dogs for the purpose of cleaning their teeth and satisfying their chew drive, then the supplement isn't necessary.

3 – Can I premake meals with the supplement, saving time at mealtime?

Sadly, no. With Bio Case Plus, I cannot premake Rodrigo's meals. Although this would be ideal, the supplement doesn't work well under these conditions because it continues to breakdown the food, even if stored in the fridge.

What's Next for Rodrigo?

For the time being, I will continue to weigh my dogs twice monthly to make sure that they are at a healthy weight (not losing, not gaining). And I'm on the lookout for an affordable supplement that works and – fingers crossed – will allow me to premake meals for Rodrigo. This would be helpful for when I go on trips and someone else is making their meals.

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