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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 32859
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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I work with a dog rescue and am in process of rehoming a dog

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I work with a dog rescue and am in process of rehoming a dog diagnosed with Endocrine Pancreatic Insufficiency. 2 y/o GSD bitch: currently on Lypex (one capsule sprinkled on food twice daily). Also receiving a B12 injection monthly. Diagnosis was made in November 2015 and although the dog is probably slightly underweight the condition seems to be under control.
Are there other supplements which would be likely to keep the condition under control and what is the pupose of the B12 injection? Is this injection related to the control of EPI and is it likely to be needed long term?

You're speaking to Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply.

Thank you for your rescue efforts. Supplementation with oral enzyme replacement therapy is the hallmark of treatment. No supplements other than vitamin B12 need be considered. B12 is only needed if my patient is B12 deficient (serum B12 levels are easily assessed by our reference labs) but 80% of dogs with EPI are B12 deficient. Vitamin B12 is absorbed mainly through the ileum - the "middle" of the small intestine. Malabsorptive disorders aren't uncommon in associated with maldigestive disorders such as EPI; hence, so many EPI patients being B12 deficient.

Oral antibiotic therapy such as with tylosin is indicated in patients that don't respond to enzyme replacement therapy. That doesn't appear to be the case with Bella, however. A premium highly digestible maintenance diet is sufficient and dietary fat restriction is neither necessary nor recommended. Please respond with further questions or concerns if you wish.

I regret that my state board of veterinary examiners doesn't allow me to speak to customers by phone in this venue but other experts in this category may be able to assist you in this regard. Please let me know if you'd like another expert to do so and I'll opt out of this conversation. Please stay in the conversation if you wish.

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