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I am new to this website. I am just trying to figure out how this works. We have a 2 yr. old German Shepard diagnosed with EPI this past August. We feel so lost at times. There always seems to be something popping up.  We have managed to get her weight almost back to normal. It appears that she has developed sensitivities to food so we have limited her to one type of kibble, wet dog food and fresh cooked chicken all the same protein - chicken. However before we can even begin to introduce anything new she seems to develop symptoms such as gas, redness of her skin, frequent chewing, regurgitation etc.. Many nights she seems to be in distress, panting, moaning, restless and sits in front of us staring at us. We just don't know what is going on. Most of the time the symptoms go away on their own only to return.

We feel so bad because we cannot give her ANY treats. She is a finicky eater and almost always has to be cajoled into eating. This is really hard when you cannot use anything "interesting" to add to her food to make it more appealing.


Glenys & Dean

November 10, 2017 at 2:24 PM Flag Quote & Reply

Posts: 110
Hi and welcome, I know how hard it is ,it's all so overwhelming. You need to take a breath and take a step at a time. I was lost until I found this amazing website. You will get all the advice you need right here. The main thing is you have a diagnosis. What are your gsds blood results and what enzymes are you using? It will get better. Kenzie still does exactly as you describe, restless, staring at us and all you want to do is make it all better. What's your dogs name?
Kenzie dob 5/06/2010. Bood tests June 2015 TLI 4, vets started us on Panzym and changed to home cooked diet. 1/2 tsp on all meals, gradually reducing to 1/4 TSP per meal. Responded well until Sep 2015 very bad runs, nothing staying in and vomiting. After finding this website, re quested copies of blood tests - B12 v low 154 and folate high!!! Antibiotics, B12 weekly injections, steroids and one B12 with intrinsic factor per day. Runs stopped, started extra meals of Canagan grain free game kibble in between home cooked mainly Turkey chicken, mince, organ meat in small amounts, fish, sweet potatoes, carrots, green beans, apple, banana, sardines, eggs. All previous trials with kibble had immediate bad effect . Pre Jun 2015 weight 34kg Sep 2015 weight 26.9 kg. Sep 2015, upped enzyme to 1 TSP enzyme on kibble and 1 TSP on home cooked, huge improvement.


Jan 2016 stopped home cooked, 3 kibble meals, introducing Yorkshire grain free. Doing fine till early Feb, pooing more and on and off mushy. Changed food to Millies Wolfheart, immediate improvement. Blood tests end Feb 2016 B12 - 810 Folate - 11 TLI - 3.9 March 2016 - 3/4 tsp Panzym per meal (150g) 1/4 tsp Tylan twice a day one B12 with intrinsic factor per day. Bloods May 2017, TLi -3.2 folate - 24 B12 1000 poos not good Upped enzymes to 1 tsp per meal, b12 tabs down to one every 3 days, still 1/4 tsp Tylan twice a day. Within a few days, poos vastly improved and consistent. Aug 17 Anal glands infected, two lots of anti biotics, stopped tylan. Tried slippery elm, no good, back on Tylan 23 Sep, poos better.
November 10, 2017 at 2:32 PM Flag Quote & Reply

Posts: 958

Hello Glenys  and Dean and welcome to the forum,

In  beginning, EPI seems overwhelming, but once you address all the elements of it, things start to turn around and the new normal begins. I had a very picky eater to, so I know that added stress...

First, did you run a cTLI test along with a folate and cobalamin test? What were the numbers?

You mentioned regurgitation,but does your dog also have a gurgling tummy? What do the stools look like and how often? What type of enzymes are you using?

Having these answers will help us to help you.


November 10, 2017 at 2:41 PM Flag Quote & Reply

Marilyn Marinelli
Posts: 878

A quote from you "One type of kibble, wet dog food and fresh cooked chicken all the same protein - chicken."  This mixture of food can be causing her to have problems with her digestive system, moaning regurgitation.  Is she chewing on herself (can be an allergy like chicken) if he is then redness from irritation will occur.    It seems that there is two much of a mixture of food that can be causing this problem.  Her digestive system is already under distress.  Have you tried just to feed one particular kibble?  Many EPI dogs cannot handle chicken.      

My epi dog had a problem with sweet potato. I didn't know it till later.   

Anyway, Donna's questions regard the cTLI test etc. is very important so that all of us may be of some help to you.

If you haven't already ...go to the top (orange) and see "Downloads"  then click on "EPI Quick Guides" this will give you a good overview of what to do for an EPI dog    Also, see "EPI"  and click on "Diet" this should help you.

Take care hope your sweet dog will start to feel better.   EPI takes some time and patience but you will work it out.  

November 11, 2017 at 2:14 AM Flag Quote & Reply

Posts: 3936

Hello and welcome!  The early stages of treatment are the hardest so try not to be discouraged.   You are trying to get everything balanced while worrying about your pup.  In addition to answering the questions Donna and Marilyn asked, I am wondering if your pup has what many of our dogs have at diagnosis....SID/SIBO.   This is due to bacterial overgrowth from undigested food and requires an antibiotic.   You will see it mentioned in the Quick Guide and Overview.  We recommend a mild antibiotic called tylan (tylosin) for 45 days.   It has the least amount of side effects and seems to work well for most EPI dogs.  The SID/SIBO could be the reason your pup is uncomfortable and is having all those gurgling noises.  

When you give us the results of the tests, we can also see if the B12 (cobalamin) level is low.  This can also affect how she is feeling  and can affect her appetite.  Our Kolby did not really start to enjoy eating until we got his B12 levels up.   They should be in the high normal range (600+) for EPI dogs.

I know this all seems overwhelming, but once you find the right food and get the B12 and antibiotics balanced you will start to see a difference.   What do her poos look like?  

We all remember what this stage was like, so feel free to ask any questions you have.



November 11, 2017 at 1:20 PM Flag Quote & Reply

Site Owner
Posts: 17148

Please keep us posted on how things go.... and of course, feel free to ask us any questions you might have, we'll do our best to answer them.......


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.

November 12, 2017 at 5:49 PM Flag Quote & Reply

Jean and Kara
Posts: 7433

hi there

i will e-mail you to say you have comments







From Liverpool England

born 21st July 2009

Adopted at five months old 26th December 2009


EPI dx August 2010

tli<1.00 folate 8.3 cobalimin 611

Antibiotics  2 Oxytet antibiotics 3 times a day also if we cannot fit the Oxytet in she has Tylan 1/8th teaspoon before her meals as a maintenanance dose

Food- Ashenbank Lamb Casserole  twice daily equalling 3 cups per day possibly more

Zantac (ranitadine) 75 mg 30 minutes before each meal as too much acid was being produced, causing shedding of bowel lining

Enzymes-Panzym 3 gram per meal twice daily ( 3/4 teaspoon ) 

B12 injection once every three weeks

One Chemeyes B12 with intrinsic factor of 40 daily

One Antepsin before bedtime

Allergies to beef, pork, chicken. and white fish confirmed by blood test

33.6 kilos in weight as of 5th May 2013

37 kilos as of 10th June 2014

40.65 kilos, 89.6 pounds as of 3rd March 2015

Vet says she is now processing her food correctly

Very proud of all of us



I am not a vet, nor have veterinary experience, but have lived and breathed EPI for 51/2 years, and hope I can bring some support to others, as others have to me.


November 13, 2017 at 12:58 PM Flag Quote & Reply

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