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MomofGP
Member
Posts: 8

My 21 month old Labrador has had chronic problems for over a year.   I really need to get him well.  If I read  the EPI symptoms and they all perfectly lined up, I would not be posting.  I'll post his history, and then post my questions in an attempt to cover all bases  

History:  

*Had a severe bout of colitis immediately following his neuter at 7 months (3 days later) 

*Chronic bilious vomiting began soon after, at 7.5 months   The only thing I could do to stop it was a 10 pm feeding and 5 am feeding. This went on for 4 months before I figured out the key to stopping it.  He will still vomit white foam or bile with an empty stomach. 

*i tried a sensitive stomach kibble, and his stools were numerous and yellowish, and sloppy.  I had always noticed he seemed to poop all the time, as if things just ran through him  

*i tried a limited ingredient grain free kibble (whitefish based) and the stool was perfect two days later.  This continued for three weeks, then wham! He had his second bloody colitis bout   This was discouraging, because I thought we were on track

*He got into the bathroom trash, and I induced vomiting (being proactive to avoid an obstruction). He vomited two days until I got him a cerenia injection.  

*At this point, vet suggested rx food hydrolyzed protein to see if it helps him.  We both suspected IBD. So, we did that, and yes, it did help.  He pooped only twice a day, and they were smaller, yet not a great form.  Previously, he pooped 4,5,6,7 times a day. They were still a little greenish/yellow, but I've read the hp food can do that.  

*Even on the hydrolyzed food, he would intermittently have diarrhea (cow patty), and I would give loperamide. 

*Even on the hydrolyzed protein food, he would wake up and want to gorge on grass to make himself throw up a few times. 

*Then, I decided the hp food wasn't helping enough to warrant the expense and I put him on another grainfree food (salmon based)  His stools were very good immediately.  THEN, after 3 weeks the bloody colitis hit AGAIN.  We went back to hydrolyzed protein immediately .  We had one, glorious, symptom free month (July)  

*Within the last few months, he started something new, and that is vomiting of partly digested food.  He was more lethargic (but it was also the hottest part of summer) .  He had usually been your typical ravenous lab, but he started to eat slowly  and half heartedly. 

*Vomiting happened more and more frequently, and he was refusing food. We finally made appointment with IM vet.  He ordered the usual tests, but no endoscopy since he felt that was too aggressive at this point.  By now, we had been trying for a full year (and he is only 1.5) to get him lined out.  Throughout most of this time, he was very active, ornery, spunky Labrador pup.  October was different.  

*IM vet appointment last week, Oct. 30  

*Food had been sitting in his stomach 8-9 hours, the he would vomit, thus the IM vet put him on Reglan while we awaited test results of the GI panel. His stools are not cow patty (although he has had those from time to time), and they have always been yellowish. They usually start formed, then end up sloppy. 

*Last week, he had a GI panel (Texas A&M) done, and 3 day she later the IM vet called me and said his Pancreatic enzyme was very low. I did not even think to (or know to) ask the exact number, but I will do that soon. When he called, the IM vet  said my pup's presentation is unusual. His other blood tests showed a very high globulin protein. He said there is a large gamut of inflammatory diseases associated with globulins. He felt that a tumor doesn't fit, multiple myeloma doesn't fit, chronic liver disease doesn't fit, I declined an electrophoresis.  

*His treatment is enzymes, cobalamin injections 6 weeks, and continue the metronidazole he was already on for a few days. I've been reading about EPI all weekend long. His symptoms don't really line up, but I suppose the numbers don't lie.  Maybe the SIBO has just really blown up,  The vet said he definitely has the bacterial overgrowth

We have had two days of enzymes now. He has perked up a bit, and the vomiting of food has ceased. He has not had a cobalamin injection yet.

*We have had two days of enzymes now. He has perked up a bit, and the vomiting of food has ceased. He has not had a cobalamin injection yet.

Now, with the questions, (if anyone is still reading)  

1.Does this sound like EPI to you? He did not fast prior to his GI panel, though he was rejecting food food and was vomiting the night before. He had eaten a tiny bit that morning. .  He is thin, but not emaciated looking  

2.Why would he have perfect poop on a grainfree limited ingredient diet, then 3 weeks later have colitis? This is so baffling to me.

3. I  suspect IBD still.  Can the inflammation associated with that actually CAUSE EPI? I'd so, I would assume that the Pancreatic function could resume if IBD is brought under control.  

4. more technical question: right now, he is on Viokase enzyme. I have read it is 1 tsp per cup of food, and the vet told me 1 tsp per meal.  I've been feeding him 1.5 cups food, and hitting that "in the middle" with 1 and 1/4 tsp Viokase.  

5. For dogs other than GSD, is the cause usually something other than PAA?  My IM vet said he has seen this with other labradors , in that sometimes once we get the bacterial overgrowth taken care of, we can wean them off (I assume he means the pancreatic enzyme)  

I realize these are all questions I need to ask my IM vet; but, based on this, does anyone have any questions that I should ask him that I just don't know to ask?  









November 6, 2017 at 9:40 AM Flag Quote & Reply

ShelbyBelle
Member
Posts: 11
Wow! Your dog has something very important going for him: you being his very pro-active advocate! Excellent job! My dog is a new EPI diagnosis too so unfortunately I can't answer most of your questions. I'll leave that to people who have more experience. I have thoroughly reasearched both EPI and IBD because they were also concerned about IBD for Royce. I also called our dog food store, thinking we might need to change his diet, and talked to the owner who works with many clients that have EPI and/or IBD. He said, in general, that EPI dogs loose weight despite eating a ton of food (Royce lost weight eating 5200 cal/day). He said that IBD dogs usually loose weight secondary to vomiting and decreased appetite. I suggest keeping a diary. I had a long term, chronically ill GSD (paraplegic) and I kept a log of her daily issues. Helped us see patterns and to remember everything. Keep up the good work! Keep us updated
--

Nicolette 

GSD Mom of Royce, Eleanor, and Furbo

Royce (DOB 12/09/15): Clinical signs of EPI with a low normal enzyme level.  Symptom resolution and weight gain with enzyme replacement.  Fun loving, happy go lucky, handsome long haired German Shepherd

Eleanor (DOB 02/02/15): Royce's high energy but gorgeous "sister" who loves to swim.

Furbo (DOB 05/04/2011): Eleanor's dad who enjoys chewing his ball and bite work.

In memory of my beautiful girls, Cally and Shelby, who have crossed the rainbow bridge.

November 6, 2017 at 3:34 PM Flag Quote & Reply

Donna
Member
Posts: 910

Hello and welcome to you and your lab! Fasting is recommended, but many of us here, myself included, got a definitive EPI diagnosis even though we didn't fast (didn't know at the time). Was the cobolamin and folate tested as well?

Many here deal with EPI and IBD concurrently, but if your dog has a definative EPI dx, you can never take him off enzymes, they are required for life. The exocrine pancreatic function can not regenerate itself.

I would wait for the results, then go from there as to whether or not to scope. My current rescue dog does not have EPI (my Bridge girl did) and when I scoped her, I found out she didn't have IBD (I've had two Bridge dogs with this condition as well), and we were stumped. According to my vet, she simply had a ruined gut from dumpster diving to survive... I've had her for 1.5 years and it took me almost a year to heal her gut...

It will not hurt to start enzymes before you get your results back, and many of us here use Enzyme Diane (www.enzymeDiane.com) as her 6x Pancreatin is generic of what the vet will sell you at 1/3 the price...

Let us know how you make out with the results!

Donna

November 6, 2017 at 5:10 PM Flag Quote & Reply

Doc's Mom
Administrator
Posts: 2938

Hi and welcome to our EPI family.  Your dog is very lucky to have such a caring mom.  If you can ask the vet for the test results that would greatly help us in being able to offer suggestions.  Although there are "typical" signs of EPI not all EPI dogs present with the same symptoms and some don't have any symptoms.  My breeder did not believe Doc had EPI because he had weight loss before diarrhea.  Our saying here is if you've met one EPI dog, then you've met just one EPI dog as they are all uniquely and wonderfully different.

If your dog is clinically EPI then as Donna said the enzymes are for life and most of us get them from Enzyme Diane as it's 1/3 of the cost of rx enzymes.  Also, the recommended starting dose is 1tsp per cup of kibble so if you're feeding 1.5cups of kibble then start with 1.5tsp enzymes - most vets are unfamiliar with the correct dosing.  SID (formerly SIBO) can be very difficult to get rid of and we recommend a 45day course of Tylan and slowly wean off.  There is information above that you can print and share with your vet.  Please let us know as soon as you get the test results and know that you're not alone - we're all here to help guide you on this journey.

--

MADELON and DOC aka "BUBBY WUBBY"

Nashville, Tennessee

DOB: 4/3/2014 - Diagnosed EPI and SIBO: 5/22/2015
EPI Test Results: 1st test 7/2014 = TLI 16.5, B12 894, Folate > 24; 
2nd test 5/2015 = TLI < .4, B12 406; Folate >24; 3rd test 10/2015   TLI < .4; B12 >1000; Folate 14.4

Weight: 95 (highest 1/2015) - 76 (lowest 5/2015) - goal met 100lb (7/23/15) - 101.8LBS 12/3/15 - CHUNKY MONKEY

History prior to DX:  May/June 2014 (2mos old) - DX coccidia and bladder infection; July 2014 (3mos old) 1st EPI test = TLI 16.5, B12 894, Folate >24 - Diagnosed SIBO not EPI; Feb 2015 thru May 2015 - weight loss only; May  2015 vomitted several times, diarrhea and eating poop.

History since DX: has maintained weight between 95-101lbs since July 2015; extreme yeast and rod infection in ears; yeast infection paws (ongoing); bacterial eye infection; bacterial skin infection on legs; poops LIVE fly larvae; diagnosed with mild, focal superficial pyoderma (bacterial infection) - rare lesions on inner thighs; bacterial and yeast overgrowth lip folds; yeast overgrowth feet and left ear; metacarpal/metatarsal draining tracts/fistulae (infection and/or immune mediated disease; probable underlying allergy (food vs. environmental ); staphylococcus pseudintermedius infection in sores on paws; recurring metatarsal fistula - all issues resolved after NutriScan Food Sensitivity Test and switching foods.

NUTRISCAN Food Sensitivity Test (12/2015): reactive to chicken, turkey, white fish, wheat, white potato (mild), venison, soy (mild), pork (mild), duck (mild), corn - switching food based on test resolved all skin issues.

Serum Allergy Test (5/2016): Too many to mention

CURRENTLY :  6 cups Forza10 Legend Skin - Diane 6x 1tsp per cup; 1 WonderLab PetFactor B12 2x day; 2 scoops TotalBiotics 1x day; 600mg vitamin E; 1 Zyrtec 10mg 2x day; Milk Thistle during heartworm/flea/tick meds

I am not a vet.  All of my suggestions are based on my personal experiences, information gleaned from EPI research and information from other EPI owners.  Please always share anything and everything recommended on this forum with your vet

SO THANKfUL FOR OUR EPI4DOGS GUARDIAN ANGELS!!!!!!!!

YOUR PAWS LEFT PRINTS ON MY HEART (in loving memory of Bugsy aka Boo Boo - Boston Terrier 14yrs - not EPI but medically challenging and totally worth it)


November 6, 2017 at 8:20 PM Flag Quote & Reply

Riley's Mom
Administrator
Posts: 1964

Welcome to the forum

Madelon is correct, if your pup has EPI, the enzyme replacement will be for life. Although your dog didn't present with the typical symptoms of EPI, each dog is so different.

It would be helpful to post the results of the testing, it will help us answer your questions and make suggestions. 

I'm glad you found us! Ask questions as you have them and we will try to help....


--

Elisabeth

Riley's Mom from Chesapeake, VA

Riley, 8 yr old Labradoodle diagnosed September 2014 cTLI 1.6

Weight before diagnosis 40 lbs, lowest weight 33 lbs, ready for the Chunky Monkey club as she weighed in at a whopping 42 pounds on 12/19/14!

Update: as of 2/25/15 Riley weighs in at 44.2 pounds!

Update: as of 6/15/15 Riley weighs in at 45 pounds!

Feeding grain free kibble TOTW, 1 tsp of Diane's 6x enzymes per cup of food. (I mix the enzymes in something moist). She is a picky eater--lately feeding her on a flat plate is the way to entice her to eat. 1 cup in the am, 2 cups in the pm, 1 tsp of coconut oil per meal, 1 packet of FortiFlora probiotic in the pm meal.

Began weekly B12 shots 10/23/14. Holding on shots for now.

Began 1 Wonderlabs B12 in the morning, 1 in the evening. Capsule opened up and sprinkled on her food.


*I am not a vet, anything I share or suggest on this site is solely from my experience as an EPI dog owner. It is recommended that anything shared or suggested on this forum be discussed with your pet's vet.*

November 6, 2017 at 9:05 PM Flag Quote & Reply

MomofGP
Member
Posts: 8

Which results, specifically, should I ask for?  I know I need to ask for the TLI level.  Since the globulin level was "very high," should I ask for that?  Also, do EPI dogs typically develop bloody colitis, as mine has?  We just went out and fetched (vigorously) because he was feeling good.  Exercise causes him to vomit, and he did.  


Thanks, everyone, for your support and help.  I am confused a bit, though, when you are telling me it is for life.  I had read somewhere on the EPI4Dogs site (cannot find it now) that it is possible for the pancreas to heal and start producing again...but not in the case of PAA.  Again, many thanks.  I always hesitate to ask for help because I know people are so busy....but, this has me baffled and I like to know th answers. 

November 6, 2017 at 9:45 PM Flag Quote & Reply

MomofGP
Member
Posts: 8

6.2 cTLI.    


He did not fast prior, but ate very little (had been vomiting lots).  This was done at our initial appointment, and I had to drive some distance to get there, and GP felt so poorly.  I'm guessing this is why they went ahead with the GI panel without instructing us to fast. 


I also wrote 262 down, but now I'm unsure if that was his cobalamin number, or globulin.  I think cobalamin. 


I believe the low pancreatic enzyme is secondary to something.  I just do not know what. 

November 7, 2017 at 12:26 PM Flag Quote & Reply

Judy & Piper
Administrator
Posts: 678

Hi and welcome to the site.  I'll just chime in with these couple of things.  My EPI girl is a mix of many different breeds and was diagnosed with EPI at 16 months of age.  My point being that every breed or mix of breeds can have EPI.  To my understanding, and someone please correct me if I'm wrong, the pancreas cannot and will not heal themselves.  The Exocrine part of the pancreas atrophies and 85 to 90% have atrophy before symptoms start.    My non EPI dog does the throwing up bile thing if he goes too long without eating.  I will be very interested in seeing the test results when you have them.


--
Piper - Diagnosed 21 Jan 14 at approx 16 months of age TLI 0.3
            DOB - late Sept/early Oct 2012 (found as a stray in a remote Northern Labrador community at approx 3 - 4 months of age)
Using Enzyme Diane 6x 
B12 shots every week at home as well as 2 pills per day
 Eating Pulsar Lamb or Pork
67lbs at time of diagnosis, now 118lbs.
Diagnosed with Hypothyroidism Sept 2014, taking Thyro 0.6mg 2 x daily. 
Piper also has Cushings Disease, allergies and a host of other things but she's happy and we spend our time going for Quality of Quantity because, at the end of the day, that's what's most important
I am not a Vet.  Anything I share or suggest on this site is strictly from my experience as the owner of an EPI dog.  It is recommended that suggested on this forum be discussed with your Vet.

November 7, 2017 at 12:49 PM Flag Quote & Reply

ShelbyBelle
Member
Posts: 11

Pertaining to your pancreas questions: a 'classic' EPI dog who presents young usually has Pancreatic Acinar Atrophy.  This problem is described as being polygenetic, and from the scientific papers I read, it is likely autoimmune.  This makes sense since they have discovered that type I diabetes in humans is autoimmune so its not a far stretch to imagine this being autoimmune as well.  The problem is, there is no way to determine which dogs will have these issues so there is no way to stop the destruction of the acinar cells of the pancreas.  Once the acinar cells are destroyed then there is no regeneration.  The enzyme replacement is for life.  Older dogs who present with EPI it is usually due to a secondary medical issue, such as chronic pancreatitis.  Again, my understanding is once the symptoms of EPI have set in, there is so much damage to the pancreas that it cannot regenerate so the enzyme replacement is for the duration of the life.  These are generalizations.  Not every EPI dog is the same and there are probably some conditions out there where the dog may need supplementation for a short period of time.  Medicine has many gray areas and there is always a dog who will prove the generalizations wrong.  I would write down a list of questions to ask your vet.  Also, you can request printed or electronic copies of your dog's labs if you want them.  That way you don't have to try to write it down and you can keep them for your records.  I'm not a vet and am just doing this reasearch since my baby was a recent diagnosis as well.  


--

Nicolette 

GSD Mom of Royce, Eleanor, and Furbo

Royce (DOB 12/09/15): Clinical signs of EPI with a low normal enzyme level.  Symptom resolution and weight gain with enzyme replacement.  Fun loving, happy go lucky, handsome long haired German Shepherd

Eleanor (DOB 02/02/15): Royce's high energy but gorgeous "sister" who loves to swim.

Furbo (DOB 05/04/2011): Eleanor's dad who enjoys chewing his ball and bite work.

In memory of my beautiful girls, Cally and Shelby, who have crossed the rainbow bridge.

November 7, 2017 at 2:39 PM Flag Quote & Reply

MomofGP
Member
Posts: 8

I only know that his TLI was 6.2 (nonnfasting, but he had eaten very little prior and could not hold food down).  So, I see now that he cannot accurately be diagnosed as having EPI.  The vet said that the changes in his pancreas could be secondary changes.  He said there aren't studies out there (that he's aware of) to substantiate what he has seen, but he has seen labs do this.  There is a change the pancreas starts producing again.  This is all just anecdotally, of course,  he said German Shepherds don't do this.  


All this leads me to feeling icky because we still don't have answers.  Secondary changes in his pancreas due to what?   However, I do know he feels better since beginning the enzymes, Reglan, and metronidazole.  He had his first B12 shot today.  I will ask for a fasting cTLI in a few months.  

November 7, 2017 at 3:32 PM Flag Quote & Reply

Riley's Mom
Administrator
Posts: 1964

You are correct that a cTLI of 6.2 is not clinically EPI.

If you look in the EPI tab above and read about the TLI test, it gives some insight into the numbers. 

Since he is borderline and seems to be responding to the enzymes, I would wait a few months and repeat the test fasting. 

So....while an EPI dog will need enzymes for life, since your boy isn't clinically EPI he may just need help for a time and then be able to wean off. It all depends on the numbers you get with retesting. 

And your question "secondary changes due to what?", that is the big question. There are ongoing studies to help answer that burning question. What is causing our pups to develop EPI??

If the 262 number is cobalamin, that number is low and I"m glad you started injections. Whether or not he has EPI, his low B12 needs to be addressed. That in itself should make him feel a little better. 

--

Elisabeth

Riley's Mom from Chesapeake, VA

Riley, 8 yr old Labradoodle diagnosed September 2014 cTLI 1.6

Weight before diagnosis 40 lbs, lowest weight 33 lbs, ready for the Chunky Monkey club as she weighed in at a whopping 42 pounds on 12/19/14!

Update: as of 2/25/15 Riley weighs in at 44.2 pounds!

Update: as of 6/15/15 Riley weighs in at 45 pounds!

Feeding grain free kibble TOTW, 1 tsp of Diane's 6x enzymes per cup of food. (I mix the enzymes in something moist). She is a picky eater--lately feeding her on a flat plate is the way to entice her to eat. 1 cup in the am, 2 cups in the pm, 1 tsp of coconut oil per meal, 1 packet of FortiFlora probiotic in the pm meal.

Began weekly B12 shots 10/23/14. Holding on shots for now.

Began 1 Wonderlabs B12 in the morning, 1 in the evening. Capsule opened up and sprinkled on her food.


*I am not a vet, anything I share or suggest on this site is solely from my experience as an EPI dog owner. It is recommended that anything shared or suggested on this forum be discussed with your pet's vet.*

November 8, 2017 at 8:57 AM Flag Quote & Reply

MomofGP
Member
Posts: 8

Riley's Mom at November 8, 2017 at 8:57 AM

You are correct that a cTLI of 6.2 is not clinically EPI.

If you look in the EPI tab above and read about the TLI test, it gives some insight into the numbers. 

Since he is borderline and seems to be responding to the enzymes, I would wait a few months and repeat the test fasting. 

So....while an EPI dog will need enzymes for life, since your boy isn't clinically EPI he may just need help for a time and then be able to wean off. It all depends on the numbers you get with retesting. 

And your question "secondary changes due to what?", that is the big question. There are ongoing studies to help answer that burning question. What is causing our pups to develop EPI??

If the 262 number is cobalamin, that number is low and I"m glad you started injections. Whether or not he has EPI, his low B12 needs to be addressed. That in itself should make him feel a little better. 

Thank you so much for taking time to respond.  I do appreciate it.  He does feel better, but had some diarrhea this morning that he had not had since starting the enzymes last Friday.   However, the new bottle of enzymes arrived, which I began, and perhaps that is the difference. The first batch was some the vet had on hand to get me through until mine arrived.  (Both were VioKase, but the consistency and color were way different).  His transit time has ALWAYS been too fast.  It seems things run right through him.  What a challenge.  I would honestly rather have a clinical EPI diagnosis than be living on the edge with unknowns.  

November 8, 2017 at 1:49 PM Flag Quote & Reply

MomofGP
Member
Posts: 8

ShelbyBelle at November 7, 2017 at 2:39 PM

Pertaining to your pancreas questions: a 'classic' EPI dog who presents young usually has Pancreatic Acinar Atrophy.  This problem is described as being polygenetic, and from the scientific papers I read, it is likely autoimmune.  This makes sense since they have discovered that type I diabetes in humans is autoimmune so its not a far stretch to imagine this being autoimmune as well.  The problem is, there is no way to determine which dogs will have these issues so there is no way to stop the destruction of the acinar cells of the pancreas.  Once the acinar cells are destroyed then there is no regeneration.  The enzyme replacement is for life.  Older dogs who present with EPI it is usually due to a secondary medical issue, such as chronic pancreatitis.  Again, my understanding is once the symptoms of EPI have set in, there is so much damage to the pancreas that it cannot regenerate so the enzyme replacement is for the duration of the life.  These are generalizations.  Not every EPI dog is the same and there are probably some conditions out there where the dog may need supplementation for a short period of time.  Medicine has many gray areas and there is always a dog who will prove the generalizations wrong.  I would write down a list of questions to ask your vet.  Also, you can request printed or electronic copies of your dog's labs if you want them.  That way you don't have to try to write it down and you can keep them for your records.  I'm not a vet and am just doing this reasearch since my baby was a recent diagnosis as well.  


Thank you.  I appreciate you taking time to respond, as I feel so alone in this.  Since he does not have a clinical diagnos, of EPI, there are still unknowns, and I always feel we are living on the edge.  I will consider calling to ask for an electronic report of his testing data.  Good idea!

November 8, 2017 at 1:52 PM Flag Quote & Reply

MomofGP
Member
Posts: 8

Donna at November 6, 2017 at 5:10 PM

Hello and welcome to you and your lab! Fasting is recommended, but many of us here, myself included, got a definitive EPI diagnosis even though we didn't fast (didn't know at the time). Was the cobolamin and folate tested as well?

Many here deal with EPI and IBD concurrently, but if your dog has a definative EPI dx, you can never take him off enzymes, they are required for life. The exocrine pancreatic function can not regenerate itself.

I would wait for the results, then go from there as to whether or not to scope. My current rescue dog does not have EPI (my Bridge girl did) and when I scoped her, I found out she didn't have IBD (I've had two Bridge dogs with this condition as well), and we were stumped. According to my vet, she simply had a ruined gut from dumpster diving to survive... I've had her for 1.5 years and it took me almost a year to heal her gut...

It will not hurt to start enzymes before you get your results back, and many of us here use Enzyme Diane (www.enzymeDiane.com) as her 6x Pancreatin is generic of what the vet will sell you at 1/3 the price...

Let us know how you make out with the results!

Donna

CTLI was 6.2

Cobalamin was 262 


(see my reply, below :).  I do not want to have to scope him.  I would rather treat this sympomatically and I have always felt that we are dealing with IBD because those symptoms line up exactly.   Perhaps this low pancreatic enzyme, cobalamin and SID are secondary to the IBD.  I wish I just KNEW exactly what we are dealing with. 

November 8, 2017 at 1:55 PM Flag Quote & Reply

MomofGP
Member
Posts: 8

Doc's Mom at November 6, 2017 at 8:20 PM

Hi and welcome to our EPI family.  Your dog is very lucky to have such a caring mom.  If you can ask the vet for the test results that would greatly help us in being able to offer suggestions.  Although there are "typical" signs of EPI not all EPI dogs present with the same symptoms and some don't have any symptoms.  My breeder did not believe Doc had EPI because he had weight loss before diarrhea.  Our saying here is if you've met one EPI dog, then you've met just one EPI dog as they are all uniquely and wonderfully different.

If your dog is clinically EPI then as Donna said the enzymes are for life and most of us get them from Enzyme Diane as it's 1/3 of the cost of rx enzymes.  Also, the recommended starting dose is 1tsp per cup of kibble so if you're feeding 1.5cups of kibble then start with 1.5tsp enzymes - most vets are unfamiliar with the correct dosing.  SID (formerly SIBO) can be very difficult to get rid of and we recommend a 45day course of Tylan and slowly wean off.  There is information above that you can print and share with your vet.  Please let us know as soon as you get the test results and know that you're not alone - we're all here to help guide you on this journey.

Do you know if IBD can lead to low pancreatic enzyme levels?  He was at 6.2 (non fasting), with cobalamin 262.  He had a b12 injection yesterday.  He was already feeling some better, and feels pretty good today; however, he had some diarrhea, which he had not had since beginning the enzymes.  I feel the SID has been going on a long time, and just sort of blew up in October.  The mystery is his hyperglobulinemia.  

November 8, 2017 at 1:58 PM Flag Quote & Reply

Donna
Member
Posts: 910

I dont believe IBD can bring on EPI, but again, I'm not a vet... That said my two IBD dogs never developed EPI, so I'm going on experience...

There are two types of IBD, one affecting the upper GI and the other affecting the lower,so I would suggest a full upper snd lower scope as the vomiting  and diareah are from different areas. Until you know for sure what you spare dealing with, your throwing arrows in the dark...yes, they are expensive, but they are definative...

Of course this is just MHO, but a scope would be helpful here as there are many odd symtoms...

Donna

November 8, 2017 at 6:50 PM Flag Quote & Reply

Doc's Mom
Administrator
Posts: 2938

Thanks for posting the scores.  The B12 is definitely low and unfortunately there could be many different things going on one of which could be a bad case of SID (formerly SIBO), however, I also noticed the TLI is only .5 high than the range in which we say to treat as EPI and retest.  TLI between 3.5-5.7 is when we suggest re-testing for EPI if the symptoms continue or come back after a few months.  It takes time for the pancreas to atrophy and it's possible it's still working just enough to register as not EPI - yet.  When my boy was first tested at 3mos old his TLI was 16 - perfectly normal.  He was re-tested again at 13mos old when he presented with weight loss - not many vets think to retest but we were lucky and that time it was less than .4.  

I know how hard it is not having a definitive diagnosis and not sure exactly what to do.  I would suggest talking all of this over with your vet so that together you can come up with a strategy to rule things out or in.  I hope you get answers soon and please know that we are here for you!

--

MADELON and DOC aka "BUBBY WUBBY"

Nashville, Tennessee

DOB: 4/3/2014 - Diagnosed EPI and SIBO: 5/22/2015
EPI Test Results: 1st test 7/2014 = TLI 16.5, B12 894, Folate > 24; 
2nd test 5/2015 = TLI < .4, B12 406; Folate >24; 3rd test 10/2015   TLI < .4; B12 >1000; Folate 14.4

Weight: 95 (highest 1/2015) - 76 (lowest 5/2015) - goal met 100lb (7/23/15) - 101.8LBS 12/3/15 - CHUNKY MONKEY

History prior to DX:  May/June 2014 (2mos old) - DX coccidia and bladder infection; July 2014 (3mos old) 1st EPI test = TLI 16.5, B12 894, Folate >24 - Diagnosed SIBO not EPI; Feb 2015 thru May 2015 - weight loss only; May  2015 vomitted several times, diarrhea and eating poop.

History since DX: has maintained weight between 95-101lbs since July 2015; extreme yeast and rod infection in ears; yeast infection paws (ongoing); bacterial eye infection; bacterial skin infection on legs; poops LIVE fly larvae; diagnosed with mild, focal superficial pyoderma (bacterial infection) - rare lesions on inner thighs; bacterial and yeast overgrowth lip folds; yeast overgrowth feet and left ear; metacarpal/metatarsal draining tracts/fistulae (infection and/or immune mediated disease; probable underlying allergy (food vs. environmental ); staphylococcus pseudintermedius infection in sores on paws; recurring metatarsal fistula - all issues resolved after NutriScan Food Sensitivity Test and switching foods.

NUTRISCAN Food Sensitivity Test (12/2015): reactive to chicken, turkey, white fish, wheat, white potato (mild), venison, soy (mild), pork (mild), duck (mild), corn - switching food based on test resolved all skin issues.

Serum Allergy Test (5/2016): Too many to mention

CURRENTLY :  6 cups Forza10 Legend Skin - Diane 6x 1tsp per cup; 1 WonderLab PetFactor B12 2x day; 2 scoops TotalBiotics 1x day; 600mg vitamin E; 1 Zyrtec 10mg 2x day; Milk Thistle during heartworm/flea/tick meds

I am not a vet.  All of my suggestions are based on my personal experiences, information gleaned from EPI research and information from other EPI owners.  Please always share anything and everything recommended on this forum with your vet

SO THANKfUL FOR OUR EPI4DOGS GUARDIAN ANGELS!!!!!!!!

YOUR PAWS LEFT PRINTS ON MY HEART (in loving memory of Bugsy aka Boo Boo - Boston Terrier 14yrs - not EPI but medically challenging and totally worth it)


November 8, 2017 at 8:28 PM Flag Quote & Reply

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