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Complications Associated with EPI
The most common physical complication of EPI is SIBO (small intestinal bacterial overgrowth), a proliferation of the "wrong" bacteria in the intestine, causing yet again diarrhea and weight loss. It requires a course of antibiotics of a minimum of 30 days, and sometimes a lifelong daily low maintenance dose. Most effective is Tylan or metronidazole (Flagyl). Daily use of probiotics helps to re-populate the gut with beneficial bacteria and to keep their level high.
The financial and emotional burden of EPI can be overwhelming. The enzymes are very expensive (we recommend joining www.epi4dogs.com for information about EPI and a buying co-op). Top quality, grain-free or raw foods put a large strain on many people's budget. Constant vigilance necessitates regular weigh-ins and an increased number of visits to the vet.
Food preparation becomes time-consuming. Kibble needs to be soaked in hot water until soft (about a half hour for some), then ground, mixed with enzymes and let "incubate" for 20 minutes before it can be fed. Even though most veterinary text claim it's not necessary, most epi-dog guardians have better results by letting food sit, the theory being that "incubation" gives the enzymes a chance to start the digestive process. Similarly, raw food needs to be warmed, again 10-15 minutes, then mixed with enzymes and "incubated." At minimum, the dog needs to be fed twice a day, and some need three or four small meals a day.
This task alone impacts family life and vacations greatly: longer time for the pet sitter, higher boarding costs, or, esp. in the case of raw food, difficulties in taking the dog along. It's a lifelong task, and you can't just skip a meal treatment.
Dealing with an EPI dog can be an emotional roller-coaster ride. Some dogs take 6 months to gain back one pound; many donít want to eat; they have relapses, or recurring bouts of SIBO. It usually takes a lot of trial and error before the dog stabilizes. And some just die.
It's no wonder that an EPI diagnosis often spells euthanasia, between the financial, time, and emotional commitments. More and more dogs are being diagnosed with this insidious disease, in part, certainly, due to higher awareness among vets, and guardians being able to research the condition online.
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