Sorry to read that Sam is sick
.
Seriously, find the healthiest dog in your hood who hasn't been on antibiotics for at least 3 months, collect the dog's turds and feed these to Sam one turd at a time over a span of several days. It's called
FMT
What Is a Fecal Transplant for Dogs and Cats? | petMD Also, up the probiotics to the max for a healthier gut flora for the SIBO.
As for the EPI, that's what Zoe had all her life. It's difficult to manage, but it's doable. Feeding Zoe a homemade/RAW diet kept her alive, happy and well for almost 12 years. The ER doc at the end of her life was amazed that she lived as long as she did, considering that the average EPI dog lives to about 8 yo. Zoe didn't have diarrhea, but she'd vomit from time to time. Zoe also had 2 ultrasounds done to finally diagnose the EPI, bloodwork doesn't do it. Symptoms speak volumes, tests don't. Zoe was also on digestive enzymes and homeopathies which worked wonders.
Sending you and Sam all the best wishes that you can manage this.