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Kelly
Member
Posts: 3
Hi All. I'm new to this site and new to EPI. My 16 mo GSD just got diagnosed a couple of months ago and I'm completely at my wit's end with feeding issues. We have blown through a full bottle of Viokase and about half a bottle of the generic brand enzymes, thankfully discovering that she can still have solid poops on the cheaper generic one. BUT I'm still having lots of tummy upsets. She seems to do OK for a week or two and then starts not finishing her food, hunching down with eyes squinted and ears down after a few bites, then eventually actually throwing up on occasion. I have had her on a prescription food for allergies since before she was diagnosed with EPI (Hill's brand z/d food) because the vet suspected allergies first with her symptoms. Her gut was so torn up by the time we got the diagnosis, we didn't want to change the food right away even though we figured at that point that she did not have allergies. So, she stayed on the z/d food until we had stable stools and positive weight gain for about a month. Then the tummy upsets started again but not the diarrhea. So, the vet wants her on a prescription "Purina Pro Plan EN" kibble for GI problems but it's $100 for a 32 lb bag and I'm already absolutely squeezed dry with this dog financially. I HAVE to find some food that will be easy for her to digest, preferably without a bunch of cancer causing additives, that I can afford along with these expensive enzymes. I have six kids at home and I sometimes feel like I spend more time and money feeding and caring for this dog than them! Over the past month or so I have already VERY slowly tried to integrate some other suggestions by other people, such as Holistic Select Lamb and Oatmeal, Natural Balance Limited Ingredient Lamb and Rice and Natural Balance Limited Ingredient Chicken and Sweet Potato and every time I try she gets sick and stops eating. Before the EPI diagnosis I spent months and months on and off of special diets and cooked foods, you name it, and I thought I would finally be done with all that when we got a definitive diagnosis. Nope. It's like I'm back to square one every other week still, I'm broke and completely fed up, feeling like I do not have the time or money to care for this dog anymore. But we adore her and she's part of our family and therefore I feel trapped. Any suggestions????? Sorry for the LONG post! Thank you!
May 12, 2017 at 8:27 AM Flag Quote & Reply

Epi4Dogs
Site Owner
Posts: 16521

Hi Kelly and welcome to our EPi family.

Can you please post for us the TLI test results that confirmed that she has EPI... as that will help us better help you AND

if you had a Cobalamin blood test also doen, this will give a B12 level and a Folate level.


Those tummy upsets... tummy noises? farting?  What does the poo look like, color, size, frequency firm/loose, "iffy" consistency???  Burping?


Has she ever been given any antibiotics since being diagnosed with EPI, such as Tylan or Metronodazole, and if so at what dose and how often did she have to take it and for how long.


WHere i am going with all of this is that is may not be the food, but rather a secondary condition, either low B2 or SID, that has not yet been addressed, although the food you have her on and the reecommended Purina Pro EN doesn't always work with EPI pups... "usually" (but not always) a prescription food is NOT needed . Most (but again, not all) EPI dogs appear to do much better on over-the-counter dog food that is made with potatoes (usually sweet potatoes are preferred) and we suggest... in the beginning... to avoid all grains in food....like rice, barley, corn, wheat, oatmeal, quinona, etc. etc.....and try a food that doesn't appear to use too many "peas" in it's ingredients..  Since our dogs are not cookie cutter dogs when it comes to diet... we also recommend buying the smallest bag possible of dog food to "try" AND to keep really good notes on how your dog reacts (poo results, tummy noises, burping, etc.  All you have to do is try the food for 3 to 5 days...jsut to see how it is tolerated.... and after a while you will start to see what type of foods your dog best responds to.


Also..... please read the Epi4Dogs "quick-guide"  as it explains in short order (cuz there is a LOT of info here on the website and it can get confusing!) ANyway... the quick guide basically explains how managing EPI is more than just putting enzyems on the food.  you have to also make sure that the B12 levels are optimal (upper mid range) and that SID, whcih is almost always present in the beginning, but sometimes can resolve itself once you start implementing enzymes and the right food for your dog......but if after a weeks or two you are not seeing optimal results.... THEN you should go back to your vet and (depending on the signs) talk to your vet about antibiotics to clear up SID.... this is often what people are seeing after the Enzymes have been implemented.

And then you might want to change the food to something with 4% or less fiber content (from mostly carbs not grain) to help not perpetuate SID.

And last but not least... you want to make sure you are not only giving the right enzymes, but the right dose for your dog and preparing it properly.


ALl this to say that it is a process,, and there are 4 cornerstones of managing EPI:

Enzymes

Diet

B12 (if needed)

Antibioitcs (if needed)

............once you find the right balance of the EPI recommended protocol.... you will be amazed at how quickly your pup will bounce back.... and it does NOT have to be expensive either.... there are many cost savings resources, like commercial dog food vs. presecription food, generic enzymes, giving B12 shots at home that your vet can teach you how to do, or ordering special (however very inexpensive) B12 pills for maintenance, etc........ :)

--

Olesia, owned by Izzy, a 35lb SWD, Diagnosed at 1.5 years old - TLI results 1.3, Stable 9+ yrs! Once stable, was able to reduce enzymes to only 1/2 tsp of Enzymes (use EnzymeDiane's 6x) with each meal, but after almost 4 years of stabilization... had to increase the amount of enzymes to 3/4 teaspoon with each meal. Fed various grain-free kibble+real meat, 6x pancreatin enzymes from EnzymeDiane., gave 1 tsp of coconut oil one day and 1 tsp salmon oil next day, and also give canned sardines packed without salt or canned herring for extra omega oils.... until she developed Diabetes and now cannot tolerate higher fat foods.

In Feb 2013, Izzy developed a very serious condition called IMHA which she (thankfully) beat and is now in remission. We also discovered that now, at 8+ years old, she not only has EPI, but also Diabetes, Low Thyroid and High Cholesterol.  Izzy was able to receive excellent care because of the kindness of so many here on epi4dogs and  is currently  doing extra-ordinarily well. If anyone could spend a day with Izzy, they would never guess that she has any health problems!  Because of Izzy's concurrent conditions of Diabetes and High Cholesterol we had to make changes to our daily EPI routine. We had to alter the fiber, type of fiber and the fat content her diet. She is now on an all home-made diet which she does best on and has even been able to reduce the insuline (Vetsulin:pork-based insulin) . Because of the diet change to all home-made i no longer worry about hypoglycemia or hyperglycemia- -she is much more even-keeled with a diet of sweet potato, a lean meat/fish, sometimes a free range egg, cottage cheese,  fish oil+vitamins and bone meal. We tried Novolin N a human synthetic RNA insulin.... but Izzy did not do well on it. aside from all of Izzy's health issues.... she continues to wake up every day full of joy and a great sense of humor!

I am not a vet.  All of my suggestions/recommendations are based on personal expereinces, observations, information gleaned from EPI research, and information shared with me by EPI researchers....that hopefully may help others. Please always share anything and everything recommended on this forum with your vet.

May 12, 2017 at 9:57 AM Flag Quote & Reply

Epi4Dogs
Site Owner
Posts: 16521

oh....i also meant to say that even though many of our EPI dogs do just fine on over-the-counter commerical dog food....(low fiber/no grain)  sometimes.... (and especially if there is another concurrent condition going on) commerical dog food doesn't work and you do need special prescription diet after all to get the dog regulated.... so althou you cannot totally dismiss prescription foods.... it is well worth first trying over-the counter dog foods first (and it is a cost saver too) 

--

Olesia, owned by Izzy, a 35lb SWD, Diagnosed at 1.5 years old - TLI results 1.3, Stable 9+ yrs! Once stable, was able to reduce enzymes to only 1/2 tsp of Enzymes (use EnzymeDiane's 6x) with each meal, but after almost 4 years of stabilization... had to increase the amount of enzymes to 3/4 teaspoon with each meal. Fed various grain-free kibble+real meat, 6x pancreatin enzymes from EnzymeDiane., gave 1 tsp of coconut oil one day and 1 tsp salmon oil next day, and also give canned sardines packed without salt or canned herring for extra omega oils.... until she developed Diabetes and now cannot tolerate higher fat foods.

In Feb 2013, Izzy developed a very serious condition called IMHA which she (thankfully) beat and is now in remission. We also discovered that now, at 8+ years old, she not only has EPI, but also Diabetes, Low Thyroid and High Cholesterol.  Izzy was able to receive excellent care because of the kindness of so many here on epi4dogs and  is currently  doing extra-ordinarily well. If anyone could spend a day with Izzy, they would never guess that she has any health problems!  Because of Izzy's concurrent conditions of Diabetes and High Cholesterol we had to make changes to our daily EPI routine. We had to alter the fiber, type of fiber and the fat content her diet. She is now on an all home-made diet which she does best on and has even been able to reduce the insuline (Vetsulin:pork-based insulin) . Because of the diet change to all home-made i no longer worry about hypoglycemia or hyperglycemia- -she is much more even-keeled with a diet of sweet potato, a lean meat/fish, sometimes a free range egg, cottage cheese,  fish oil+vitamins and bone meal. We tried Novolin N a human synthetic RNA insulin.... but Izzy did not do well on it. aside from all of Izzy's health issues.... she continues to wake up every day full of joy and a great sense of humor!

I am not a vet.  All of my suggestions/recommendations are based on personal expereinces, observations, information gleaned from EPI research, and information shared with me by EPI researchers....that hopefully may help others. Please always share anything and everything recommended on this forum with your vet.

May 12, 2017 at 2:37 PM Flag Quote & Reply

Marilyn Marinelli
Member
Posts: 728

Please don't give up.  Stay with us here and you will get through. I am so sorry you have gone through soooo much BUT, now you know what your dog is dealing with it will all come together. You have great advice and direction from the owner of this site. Know all can work out for you and your do ...just  need to pull it all  together which you can do and you will see it will become very routine.

   FROM READING YOUR POST...your dog has been eating dog food with rice and/or chicken in it.  This is not good for a dog with EPI.  That may be one reason your dog is getting sick. Since, she doesn't have allergies...why not try something like Earthborn dog food you can get a large size for around $60 dollars . You can also get a coupon for $3.00 each month if you give them your e-mail.  Also, I don't know if you have an Petsupermarket where you live.  If you purchase the dog food from them, after purchasing 6 bags you get one FREE. Good deal. I use Earthborn (Great Plains Feast) for my both dogs...one with EPI and the other not with EPI.  Both love the food.  I get the largest bag for both.

The other thing is you can purchase Enzymes from Enzyme Diane...Others can tell you more about that and how much cheaper it should be for you.   I use Creon because I am allergic to the powder form.  But, you may not need to go there.

Also, as suggessted previously once you know about your dogs B12 level ...which should be 600+ ...always above normal for an EPI dog, you can even purchase B12 with intrinsic factor for around $17 a bottle really not expensive.  You can order it from www.wonderlab.com  You dog with need the B12 with intrinsic factor because the intrinsic factor is  needed for your dog's body to digest its food. 

Between the Food, enzyme (proper amt.) B12 with intrinsic factor. It will come together.    

Please share with you vet...important info and hopefully you vet will work along with you.  

Money is tight for me as well but once you get it together it can and will work out for you and your dog.

Hope some of this info I shared with you helps you to not feel too overwhemed and know we are all here for you and the best place you can be for help and best info you can receive.    


  

May 13, 2017 at 12:36 AM Flag Quote & Reply

Kelly
Member
Posts: 3
Thank you so much for your responses. It has definitely been the encouragement I've needed, although we've had a very hard weekend. I took Karisma into the vet on Sat morning because earlier in the week her on and off tummy upsets escalated into a full "episode" of vomiting and diarrhea that she hasn't experienced since before her diagnosis and enzymes. The vet gave her a B12 shot (her first one) and suspected IBD and/or stomach ulcer (she seems to be in pain when she eats, which is why she doesn't finish her food). So, Sat morning I started her back on Metronidazole 500 mg 2x/day and over the counter Pepcid. They had me fast her all of Friday and start her slowly on a canned prescription food (Canine I/D). In the past the Metronidazole has helped almost immediately but this weekend it just kept getting worse. She hasn't eaten much and she's been getting me up several times in the night with vomiting and bloody, mucousy diarrhea. I did notice lots of gurgling in the tummy/bowels but no belching. I've been shoving the Metronidazole down her throat because she won't eat it even with the peanut butter like she's done in the past. I'm going to call the vet in the morning and would love some more insight if possible for discussion. It sounds like maybe I should try the Earthborn food once I can get her back on Kibble and that we're on the right track with the B12 shots (we decided to try once a week for a month to see if it makes a difference) but right now we're in crisis mode and I just have to get her stable. These are her test results from mid-March when we got the diagnosis: TLI 1.1, Cobalamin 463, Folate 16.2, Pancreatic Lipase Immunoreactivity
May 14, 2017 at 11:56 PM Flag Quote & Reply

Epi4Dogs
Site Owner
Posts: 16521

with a TLI 1.1... yep... your pup has EPI... and the 463. is not really low, but not upper mid range either... glad your vet started the B12 because if these test results are from March... the B12 very well could have slipped by now (this often happens).  The Folate at 16.2 by itself is just an "indication" that there is no SID/SIBO.... HOWEVER.... we often see that the folate level is wrong when indicating no SID/SIBO... so you really need to look at the whole dog, and if you are seeing any SID signs... along with an EPI case, then it is suggested to try antiboitics. I was talking to one of the researchers last week, and even he said that too many times that the Folate score indicates no SID, and yet the dog did indeed have SID/SIBO.  


Glad your vet started your pup on an antibiotic.- - the rule of thumb is to give it 7 to 10 days and if you do not see any postive results...then ask your vet to swap out the anti for another.  What is currently recommended to start with is Tylan and if that doesn't work, then try the Metro.... because that Tylan is ccurently the drug of choice, maybe have a conversation with your vet about giving the Metro just another day or two and if you stil do not see any positive change, maybe ask him if he thinks it would be wise to try the Tylan sooner instead of waiting the 7-10 days.


On the flip side, this might be something other than SID, like colitis... and although Tylan will eventually work on colitis, usually Metro is better for colitus.... sooooooooo.... you are in a conundrum....not sure which it is, if either.... so best have the vet see her... not sure if you need to give a different antibiotic or if you should stay the course.


Yes... with an EPI dog... we strongly recommend starting with a food that does not have any grain in it.... and then adjust from there.....

--

Olesia, owned by Izzy, a 35lb SWD, Diagnosed at 1.5 years old - TLI results 1.3, Stable 9+ yrs! Once stable, was able to reduce enzymes to only 1/2 tsp of Enzymes (use EnzymeDiane's 6x) with each meal, but after almost 4 years of stabilization... had to increase the amount of enzymes to 3/4 teaspoon with each meal. Fed various grain-free kibble+real meat, 6x pancreatin enzymes from EnzymeDiane., gave 1 tsp of coconut oil one day and 1 tsp salmon oil next day, and also give canned sardines packed without salt or canned herring for extra omega oils.... until she developed Diabetes and now cannot tolerate higher fat foods.

In Feb 2013, Izzy developed a very serious condition called IMHA which she (thankfully) beat and is now in remission. We also discovered that now, at 8+ years old, she not only has EPI, but also Diabetes, Low Thyroid and High Cholesterol.  Izzy was able to receive excellent care because of the kindness of so many here on epi4dogs and  is currently  doing extra-ordinarily well. If anyone could spend a day with Izzy, they would never guess that she has any health problems!  Because of Izzy's concurrent conditions of Diabetes and High Cholesterol we had to make changes to our daily EPI routine. We had to alter the fiber, type of fiber and the fat content her diet. She is now on an all home-made diet which she does best on and has even been able to reduce the insuline (Vetsulin:pork-based insulin) . Because of the diet change to all home-made i no longer worry about hypoglycemia or hyperglycemia- -she is much more even-keeled with a diet of sweet potato, a lean meat/fish, sometimes a free range egg, cottage cheese,  fish oil+vitamins and bone meal. We tried Novolin N a human synthetic RNA insulin.... but Izzy did not do well on it. aside from all of Izzy's health issues.... she continues to wake up every day full of joy and a great sense of humor!

I am not a vet.  All of my suggestions/recommendations are based on personal expereinces, observations, information gleaned from EPI research, and information shared with me by EPI researchers....that hopefully may help others. Please always share anything and everything recommended on this forum with your vet.

May 15, 2017 at 9:08 AM Flag Quote & Reply

Kelly
Member
Posts: 3
Thank you so much!!!! This is immensely helpful and perfect timing. The vet opens in 2 min and I'll discuss all of this plus everything I've learned from this site.
May 15, 2017 at 9:58 AM Flag Quote & Reply

Epi4Dogs
Site Owner
Posts: 16521

good luck and keep us posted!

--

Olesia, owned by Izzy, a 35lb SWD, Diagnosed at 1.5 years old - TLI results 1.3, Stable 9+ yrs! Once stable, was able to reduce enzymes to only 1/2 tsp of Enzymes (use EnzymeDiane's 6x) with each meal, but after almost 4 years of stabilization... had to increase the amount of enzymes to 3/4 teaspoon with each meal. Fed various grain-free kibble+real meat, 6x pancreatin enzymes from EnzymeDiane., gave 1 tsp of coconut oil one day and 1 tsp salmon oil next day, and also give canned sardines packed without salt or canned herring for extra omega oils.... until she developed Diabetes and now cannot tolerate higher fat foods.

In Feb 2013, Izzy developed a very serious condition called IMHA which she (thankfully) beat and is now in remission. We also discovered that now, at 8+ years old, she not only has EPI, but also Diabetes, Low Thyroid and High Cholesterol.  Izzy was able to receive excellent care because of the kindness of so many here on epi4dogs and  is currently  doing extra-ordinarily well. If anyone could spend a day with Izzy, they would never guess that she has any health problems!  Because of Izzy's concurrent conditions of Diabetes and High Cholesterol we had to make changes to our daily EPI routine. We had to alter the fiber, type of fiber and the fat content her diet. She is now on an all home-made diet which she does best on and has even been able to reduce the insuline (Vetsulin:pork-based insulin) . Because of the diet change to all home-made i no longer worry about hypoglycemia or hyperglycemia- -she is much more even-keeled with a diet of sweet potato, a lean meat/fish, sometimes a free range egg, cottage cheese,  fish oil+vitamins and bone meal. We tried Novolin N a human synthetic RNA insulin.... but Izzy did not do well on it. aside from all of Izzy's health issues.... she continues to wake up every day full of joy and a great sense of humor!

I am not a vet.  All of my suggestions/recommendations are based on personal expereinces, observations, information gleaned from EPI research, and information shared with me by EPI researchers....that hopefully may help others. Please always share anything and everything recommended on this forum with your vet.

May 15, 2017 at 1:34 PM Flag Quote & Reply

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