Our customer asked:
Hello my german shepherd with has EPI. I would be really grateful if you could offer me some advice on what to give my dog he is 7 years old ie vitamins etc my vet doesn't seem to be very helpful at all. I may also add he has anal furunculosis, which isn't to bad at the present time. I seem to get conflicting information from other vets I have spoke to and I would appreciate anything you could advise me with.
Your dog is unlucky to have both EPI and anal furunculosis, I am not aware of a direct connection between them, other than they are both more common in GSDs than other breeds and generally involve problems with parts of the immune system.
EPI is usually a simple digestive problem, which can be treated quite effectively with adequate enzyme supplements and a suitable diet. There are commercial diets which help, such as Purina EN Veterinary Diet, which has all the most beneficial nutrients added in the correct proportions, so you do not need any vitamin supplements. There are also various enzyme products to add to the food. I would recommend Panzyme Enzyme Powder, which is available in various sizes. If you add enough enzyme, it is usually effective. There is no fixed dose, you just give as much as you need to. (Years ago, it was easy and cheap to go to a slaughterhouse and buy pig or beef pancreas, frozen in bags. It could be used as a cheap type of meat, but is absolutely packed full of enzymes and was the best treatment for EPI by far. This was stopped by the regulations which came in with the Mad Cow problem. It might be possible to buy pancreas again, I am not sure, but I have not heard of this at all recently.
Anal Furunculosis is normally treated with the drug Atopica these days, though other medical treatments can be tried and surgery is occasionally needed. About 95% of dogs can be treated successfully with medication, but it is expensive and requires careful monitoring to avoid side effects.