https://www.vetsurgeon.org/f/clinical-questions/25157/exocrine-pancreatic-insufficiency Do many dogs with EPI, who are on enzyme supplementation, show pain or nausea? Does anybody routinely add in B12 (to start with or ongoing)/antibiotics for small intestinal bacterial overgrowth in a dog that appears to be responding well to supplementationen-USTelligent Community 10https://www.vetsurgeon.org/thread/170192?ContentTypeID=1Wed, 07 Dec 2016 09:38:47 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:a040d77c-f56d-4981-88b5-40a20ac762f0Nicola Cole<p>Thanks.</p> <p>Is it expected for dogs to wax and wane slightly?I have a dog who has ravenous episodes every few months then settles back down again with no reported change in faecal consistency.</p><div style="clear:both;"></div>https://www.vetsurgeon.org/thread/170163?ContentTypeID=1Mon, 05 Dec 2016 23:07:14 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:609c4a32-e495-45e3-ac47-3e7f90259252Darren Long<p>I use b12 regularly in these patients. parenterally initially then with oral supplementation (trinfac-b) and behepan 1mg if that helps in any way?&nbsp;</p> <p></p><div style="clear:both;"></div>https://www.vetsurgeon.org/thread/170158?ContentTypeID=1Mon, 05 Dec 2016 20:45:41 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:739a6770-5c37-426f-80e0-2901e7ab4559Kate Richardson<p>I would routinely add B12,, even if serum levels haven&#39;t been measured as it is commonly low and supplementation does no harm, but not antibiotics if dog doing well; any diarrhoea even with pancreatic enzyme supplement and B12 then yes, I would probably add some metronidazole for a period them withdraw once treatment for EPI was more established</p><div style="clear:both;"></div>