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Forum Home > General Discussion > Introducing Redy, new EPI-positive pup

MidwestFarmersDaughter
Member
Posts: 4

Hi everyone! Our pup, Redy, was diagnosed with EPI in January and I'm thrilled to find this forum! Just wanted to introduce ourselves and get your thoughts on what we should try from here? 


Redy is a West German working line German Shepherd born March 29, 2017 and diagnosed with EPI at 9 months old. We have a wonderful veterinarian, but he's currently the only EPI dog at our vet practice and, given our relatively close proximity to the NC State School of Veterinary Medicine, I'm wondering if (and when?) we should try to gain a referral? He was diagnosed 3.5 weeks ago and since then has gained about 3 lbs. About how quickly should dogs improve once treatment starts? 


His test results were: 

TLI    <1.0

Folate    >24

ALT   631


We are feeding him 2x daily. For each meal, he gets 3 c. Fromm Whitefish and Potato kibble, Petkind green tripe, 3.5 tsp. Viokase V enzymes, and 1 tablet Metronidazole 500 mg. For his evening meal, everything is the same plus about 3 squirts salmon oil.


He was on Tylan for two weeks before our vet switched him to Metronidazole, which he's been taking for 1.5 weeks. He has had two B12 shots. (Our vet has prescribed six total -- one every Friday for six weeks.) On the Poop Chart, he has improved from a Score 7 to what I'd call a Score 5.5 -- something between a 5 and a 6. In the mornings, he tends to have wetter poop; it seems to improve by the afternoon. 


He weighed in at 59 lbs when he was diagnosed. He now weighs 62 lbs. We're wondering how quickly he should improve, and if it's worth seeing an Internal Medicine specialist at NC State? We're fortunate to have Trupanion pet insurance (whew!!) so have the option fo exploring additional resources without worrying as much about cost. It's so hard to see him suffer.


Thank you so much! So happy to be part of this forum!


p.s. I've tried to attach an image below... Not sure exactly how? Here's a link to the same photo on Dropbox: https://www.dropbox.com/s/krseol4kcdzdax5/redy%20from%20side.jpg?dl=0




February 10, 2018 at 8:34 PM Flag Quote & Reply

MidwestFarmersDaughter
Member
Posts: 4

... I should've added that we add water to the enzymes, mix in the food, and let it incubate for minimum 20 minutes :) We give him the Metronidazole tablet whole. He takes meds like a champ! Always licks the bowl clean, too, so we're sure he's eating all of the enzymes. 


When he was tested in January, his Cobalamin level was 415.


Thanks again! :)

February 10, 2018 at 8:52 PM Flag Quote & Reply

Barb
Administrator
Posts: 3955

Hello and welcome to you and Redy!   It sounds like you are doing very well with Redy's treatment.  A weight gain so early in the treatment is a real plus.   Kolby didn't gain weight for many, many weeks and then he was a slow gainer, so you are doing great.  


We usually start off with 1 tsp per cup of kibble and you are about a half teaspoon above that. Sometimes, too much enzyme can give you the same results as too little, so you might try decreasing the enzymes, a little at a time (say by an 1/8 tsp for several days) until you get to the 3 teaspoons per 3 cups. If the poos get worse, you can reverse.    Also, if you are interested, many of us use Enzyme Diane's enzymes.   She is a member here and has been servicing many of us with an excellent product at reasonable prices for many years.  You can go to her website and check it out and/or speak to her on the phone.


Is there a reason your vet switched Redy's antibiotic from tylan to metro?  Research has found that tylan seems to work better for dogs with EPI, and it is milder and without side effects.   Of course, there are always exceptions.  I just wondered why he went from tylan to metronidazole.  


One thing that helped us enormously at the beginning was keeping a daily log/journal of everything you give your pup (food, enzymes, antis, and B12)  and the resulting poos.  It helps you to see what is working and what needs to be tweaked.  


Yes, good for your vet for doing the B12 protocol for 6 weeks.  Even though his Cobalamn level is 415, we like to see it in the 600 plus range, because it can drop quickly.   After the  you finish the injections you might want to switch to Wonderlabs Pet Factor tablets for maintenance.  They have Intrinsic Factor which helps EPI dogs to absorb the B12.   Without the intrinsic factor, it won't be effective.   These tablets are relatively inexpensive and Wonderlabs gives us a 15% discount.   


Please ask as many questions as you have.  You are doing a great job.  If your vet is willing to work with you and learn with you,  you may not need a specialist at present, but that is totally your call and what you feel comfortable with.  


Redy is a handsome boy.    We all recognize that thin look that all of our pups had......with your loving care, he will fill out in no time.


Barb

--


February 11, 2018 at 4:16 PM Flag Quote & Reply

Doc's Mom
Administrator
Posts: 3150

Hi and welcome to our EPI family!!!  Barb has given you excellent advice so I won't muddy anything up by adding to it except we recommend feeding 150% of the food for the weight your dog should be but in smaller meals throughout the day (say 2 cups 6am, 6pm and 8pm) until they gain their weight back. 

Ask any questions, we are all here to help you along the way!  Oh and as for your vet not having experience - if you like your vet I wouldn't switc - the best vet is one you trust and is willing to learn with 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)


February 12, 2018 at 9:15 PM Flag Quote & Reply

MidwestFarmersDaughter
Member
Posts: 4

Barb at February 11, 2018 at 4:16 PM

Hello and welcome to you and Redy!   It sounds like you are doing very well with Redy's treatment.  A weight gain so early in the treatment is a real plus.   Kolby didn't gain weight for many, many weeks and then he was a slow gainer, so you are doing great.  


We usually start off with 1 tsp per cup of kibble and you are about a half teaspoon above that. Sometimes, too much enzyme can give you the same results as too little, so you might try decreasing the enzymes, a little at a time (say by an 1/8 tsp for several days) until you get to the 3 teaspoons per 3 cups. If the poos get worse, you can reverse.    Also, if you are interested, many of us use Enzyme Diane's enzymes.   She is a member here and has been servicing many of us with an excellent product at reasonable prices for many years.  You can go to her website and check it out and/or speak to her on the phone.


Is there a reason your vet switched Redy's antibiotic from tylan to metro?  Research has found that tylan seems to work better for dogs with EPI, and it is milder and without side effects.   Of course, there are always exceptions.  I just wondered why he went from tylan to metronidazole.  


One thing that helped us enormously at the beginning was keeping a daily log/journal of everything you give your pup (food, enzymes, antis, and B12)  and the resulting poos.  It helps you to see what is working and what needs to be tweaked.  


Yes, good for your vet for doing the B12 protocol for 6 weeks.  Even though his Cobalamn level is 415, we like to see it in the 600 plus range, because it can drop quickly.   After the  you finish the injections you might want to switch to Wonderlabs Pet Factor tablets for maintenance.  They have Intrinsic Factor which helps EPI dogs to absorb the B12.   Without the intrinsic factor, it won't be effective.   These tablets are relatively inexpensive and Wonderlabs gives us a 15% discount.   


Please ask as many questions as you have.  You are doing a great job.  If your vet is willing to work with you and learn with you,  you may not need a specialist at present, but that is totally your call and what you feel comfortable with.  


Redy is a handsome boy.    We all recognize that thin look that all of our pups had......with your loving care, he will fill out in no time.


Barb

Thank you so much, Barb - this is so helpful! And encouraging, too :) I'm glad you think we're on the right track. Sometimes it just feels frustrating, like trying to find our way in the dark. 


I'm not sure why our vet switched us to Metro instead of Tylan. He was negative for SIBO, and we tried Tylan anyway for a couple of weeks, and when it wasn't working she put us on Metro. I'm happy to ask about it, if you think we should? We've noticed drooling, and that his urine has started to stink even though he's getting plenty of water -- no idea if those are related to the meds or, really, to anything at all. We've grown increasingly attuned to the dog's bodily functions, for better or for worse ;) 


Fantastic idea about the journal. Maybe that'll let me get some of the dog poop pictures and notes off of my phone... Haha! 


Thank you again!

February 12, 2018 at 10:13 PM Flag Quote & Reply

MidwestFarmersDaughter
Member
Posts: 4

Doc's Mom at February 12, 2018 at 9:15 PM

Hi and welcome to our EPI family!!!  Barb has given you excellent advice so I won't muddy anything up by adding to it except we recommend feeding 150% of the food for the weight your dog should be but in smaller meals throughout the day (say 2 cups 6am, 6pm and 8pm) until they gain their weight back. 

Ask any questions, we are all here to help you along the way!  Oh and as for your vet not having experience - if you like your vet I wouldn't switc - the best vet is one you trust and is willing to learn with you.  

Thank you so much, Doc's Mom! We'll start dividing the food into smaller meals and, like Barb suggested, decrease the enzymes slightly too. Really, really appreciate all the help y'all have offered!

February 12, 2018 at 10:14 PM Flag Quote & Reply

Marilyn Marinelli
Member
Posts: 885

Go top orange   and click on Downloads then click on EPI Quik Guides.  This will help give you an overview of what to do for your dog. 

February 13, 2018 at 12:52 AM Flag Quote & Reply

Jean and Kara
Administrator
Posts: 7462
Welcome from the UK, do you like the Beachboys by any chance ?........you have had great advice, my only addition is to keep a journal and record everything, i am not sure you need a referral to anyone else, sounds like you have a vet thats on top of things, and trust me, my girl looked like your picture, have a look at before and after tab at the top of the page
--



 

 

Kara

 

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

 

"UNCONDITIONAL LOVE WAS INVENTED BY DOGS"


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.

 

February 13, 2018 at 10:35 AM Flag Quote & Reply

Barb
Administrator
Posts: 3955

We all remember what it was like to be where you are .....at the beginning, trying to get everything balanced, and so worried about our pups.  Eventually, managing EPI gets easier, and before you know it, it will become just part of your regular routine.  So don't be discouraged if you feel overwhelmed at times.  


I am not sure why there is a foul odor to Redy's urine.   You might want to mention it to your vet to make sure there isn't a UTI or anything else going on.  Sometimes, our pups devoelop symptoms that have nothing to do with EPI that we need to be aware of.  


And yes, you will become acutely aware of your dog's bodily functions.  Most of us feel like we have earned the title, "poopologist" for sure, but we probably can have some other illustrious titles attached to our names.   :D


Barb



--


February 13, 2018 at 2:16 PM Flag Quote & Reply

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