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Enzymes

By Rania Gollakner, BS, DVM, MPH

Medications

What are enzymes?

Enzymes are substances in the body that regulate chemical reactions important for basic life functions. Examples of enzymes include digestive enzymes, enzymes that store and use energy, and enzymes that create or breakdown essential molecules. Enzyme supplements are taken to support body process that needs additional support.

"The most commonly used enzymes in pets are digestive enzymes."

The most commonly used enzymes in pets are digestive enzymes such as lipase, amylase, and protease, used to treat exocrine pancreatic insufficiency (EPI), small intestinal or pancreatic disease, or allergies. Other enzyme supplement examples include bromelain, papain, and cellulase.

Dietary supplements are substances that can be used to supplement the diet, such as vitamins, minerals, amino acids, herbs, botanicals, enzymes, and probiotics. While many supplements are sold over the counter, they still contain ingredients that have biological effects that should be managed by your veterinarian. Follow your veterinarian’s directions and cautions very carefully as their directions may be significantly different from those on the label.

There are differences in how countries regulate supplements. In the United States, these substances are not as vigorously regulated by the FDA as other medications, which means they can be sold without the manufacturer proving their effectiveness, safety, and without a guarantee of consistent or accurately reported ingredients. In Canada, products that have been evaluated for quality, safety, and effectiveness by Health Canada and authorized for sale will have a license number on the label.

How effective are enzymes?

When replacing an enzyme, enzyme supplementation can be helpful in treating the deficiency. However, evidence in companion animals is lacking to support the general use of enzymes. Limited studies in food animals have been performed, but there is some anecdotal evidence that digestive enzymes may help digestion by helping the body break down and process food molecules.

Limited studies in both animals and humans have been performed, but there is some anecdotal evidence that bromelain may help with inflammation and pain.

How are enzymes given?

Enzymes are given by mouth in the form of a powder, capsule, or tablet. Digestive enzyme powders are mixed into food for 15-20 minutes prior to feeding. Digestive capsules or tablets are given immediately prior to a meal. Other enzyme supplements should be given on an empty stomach, while others should be given with a meal; therefore, please follow the specific instructions provided by your veterinarian or on the package label.

What if I miss giving my pet the supplement?

If you miss a dose, give it when you remember, but if it is close to the time for the next dose, skip the dose you missed and give it at the next scheduled time, and return to the regular dosing schedule. Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

Studies are limited for enzyme supplementation and therefore information regarding side effects is also limited. Side effects depend on the type of enzyme taken. For digestive enzymes, side effects, especially at high doses, may include ulcers in the mouth, vomiting, and diarrhea. Serious side effects include allergic reactions such as facial swelling, hives, or difficulty breathing. This short-acting supplement should stop working in 24 hours.

For other enzymes, side effects may include stomach upset and diarrhea, restlessness, as well as allergic reactions.

Are there any risk factors for this supplement?

Studies are limited for this supplement and therefore information regarding risk factors is also limited. Enzymes should not be used in pets that are allergic to it. If using digestive enzymes of porcine origin, do not use if your pet is allergic to pork. Enzymes should be used cautiously in pregnant or nursing pets, as safety has not been established. They should also be used cautiously in pets with liver or kidney disease. For some enzymes, use cautiously in pets with high blood pressure or bleeding disorders.

Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with enzymes: antacids, antibiotics, anticoagulants, antidepressants, blood pressure medications, H2 blockers, proton pump inhibitors, or sedatives.

Vitamins, herbal therapies, and supplements have the potential to interact with each other, as well as with prescription and over the counter medications. It is important to tell your veterinarian about any medications (including all vitamins, supplements, or herbal therapies) that your pet is taking.

Is there any monitoring that needs to be done with this supplement?

There is no specific monitoring that needs to be done while your pet is taking this medication. Your veterinarian may monitor your pet to be sure that the medication is working. Monitor your pet at home for serious side effects.

How do I store enzymes?

In general, store this supplement in a cool place, protected from light and moisture. There are many different manufacturers and formulations of enzymes, so always follow the storage instructions on the label.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.

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