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Forum Home > General Discussion > EPI or Not-EPI

Emily
Member
Posts: 2

Hi there!  I have a pure bred German lines female GSD ("Harlow") who is 14 months old.  When she was 8-9 months old, she became very sick and had terrible diarrhea.  I took her to the vet several times and she was treated for round worm.  No matter what meds were tried, she just couldn't firm up.  She was so weak and thin, down to a mere 34 lbs.  And she had a bad habit of eating her feces.  (I'm sure this was because there was undigested food in her feces, but unfortunately she was most likely reinfecting herself with roundworms as well) She had all the telltale signs of EPI.  **Although the vets felt that she most likely suffered from EPI, I did not have her officially tested for EPI, I just began treating her as if she did.

I started her on 1 tsp of enzymes (6X) and a grain free dog food and saw an almost immediate improvement.  (It was unbelievable how quickly she began to respond to the enzymes and become more lively.) Within just a few months, she has improved dramatically! She is now a healthy 70 lbs! Solid poops, great disposition, no problems.

Here is her daily feeding routine: (She gets this mixture twice a day)

2 Cups of Victor Grain Free Dog Food (Treated with enzyme and incubated for 1 hour)
1/4 tsp of 6X enzyme (we have steadily decreased from 1 tsp to a light 1/4 tsp over the last 5 months)
1 B12 with Trinsic Factor capsule (broken and sprinkled over her food)
1 Joint pill
1 Probiotic Chew
1/2 cup of dry (untreated) Victor Grain Free Dog Food (sprinkled over top of everything)

My questions that I would love to get some input on are these:

1. How low can you go on the enzyme treatment before it isn't really enough to be making a difference? (i.e. Is the 1/4 tsp to 2Cup ratio really doing anything?)

2. Is it possible that her body (pancreas) could have been traumatized by the roundworm and have healed itself? (i.e. Is the pancreas now working again?)

3. Could it be that she did not have EPI? But if so, how is it that she responded SO WELL to the EPI treatment plan?

My goal is to completely stop the enzymes, B12 and/or probiotic (if she doesn't need it) but only if it is safe to do.  (Looking for advice from anyone who has gone through this...)


Thanks in advance!


Emily


April 2, 2018 at 8:06 AM Flag Quote & Reply

Emily
Member
Posts: 2

Correction:  I began with 1 TABLESPOON of 6X enzymes, now down to 1/4 TEASPOON.

April 2, 2018 at 8:25 AM Flag Quote & Reply

Jill
Administrator
Posts: 3719
Hi Emily. It is great that your pup has responded so well to your plan. Is there a reason that you did not have the vet do the fasting cTli test on your pup? It is ok to use the enzymes for a short while but if your dog does not have Epi and the pancreas is still producing enzymes it is not great in the long run. There are a lot of conditions that can have the symptoms of EPI so in my opinion I would strongly recommend the test. Also the 4 cornerstones must be met for EPI to be treated properly: Enzymes of non plant make up, 1 level teaspoon per 1 cup dry kibble. Diet: grain free food 4% fiber or less. Antibiotic for if your dog has SID or SIBO. B12 shots protocol. Dogs with Epi need to have a B1w level in the high normal level around 600. You cannot stop the porcine enzymes altogether if your dog has been diagnosed EPI by the cTli test. The enzymes are not a SUPPLEMENT but a NECCESSITY to keep the dog alive.
--

   Jill-  Washington State

Mickey 6/21/99 - 8/29/2014 

17.5 lb  jack russell, chronic pancreatitis, hyperuricosuria,high blood pressure, hypothyroid, spinal stenosis

diet of  hard boiled eggs, macaroni,  RC Hepatic, mashed potato

2 #2 Dianes enzymes 6x premeal

 2.5 mg Amlodipine, .15mg soloxine am/pm, 100mg ursodiol started for gall bladder thinning

arthritis:  6.25mg tramadol 1x/day, 12.5mg gabapentin every 12 hrs,  Assisi soft loop used on back and elbow, 1- 540meq potassium citrate nightly

Denamarin once a day, 1/16 t tylan (150mg)  2x/day ,  Senilife started 12/14/13, Trixsyn sirup for arthritis, .1mg Adequan weekly by shot. 75mg Tylan 2x./day for SIBO

Optimmune for Dry eyes

 Kiya is Mickeys sister, 3/4 aussie, 1/4 blue heeler born 9/2006.  She thinks she is a 44 lb jack russell who tries to heel Mickey!!

TJ is the newest addition.  He is in the bottom picture with Kiya.  He was born 7/05/2015. 

I am not a vet, just a pet owner sharing what experiences I have had in helping my dogs with other pet owners.  If you have an emergency please call your vet.





April 2, 2018 at 10:13 AM Flag Quote & Reply

maddie ann
Administrator
Posts: 3658

Hi Emily personally as Jill said you really need to get the testing done with what you are saying it could be that the there was a stomach issue that the enzymes may have remedied...but we dont advocate  there use long term in  a dog that doesnt have epi...to be honest if you took him off the enzymes for a couple of days then you would see..SIBO on its own can give the same syptoms.

--

 ANN (UK).

Maddie DOB 01-10-2007 she is now  10  DX 04/11 .B12 140 now 644 TLI <1.00 Folate 14.2.

After 15 months on the B12 tablets with the intrisic factor she was retested and her b12 was 902 which gave me the confidence to continue without injections.

Weight was 22.3kg now 33.2kg (04-05-12) she is a small GSDbut she gained .(24lbs)

Feed a mixture of foods she does better on fibre 3% and below she has  b12 tablets daily (imported from the USAhttp://www.wonderlabs.com/itemleft.php?itemnum=6881) now changing to the uk version from http://www.chemeyes.co.uk/

She has panzym altough over the years we have had to increase the dose she currently has 1/2 tsp per feed.


April 2, 2018 at 3:12 PM Flag Quote & Reply

Terry Bin
Member
Posts: 2059

I know I am just adding to the choir, but without full testing you really don't know what you are dealing with: SID/SIBO? Low B12? EPI? Or a combination?  Many dogs can decrease the enzymes after they are stable...and then as they age they need to increase.  I know cost can be a factor but if possible please do a food fasting (12 hour fast) blood test for cTLI, cobalamin (B12) and folate.  Is 70 pounds the ideal weight?  Or should she weigh a bit more as she gets older?

--

Terry

Mom of three EPI Shiloh Shepherds: 

Pharaoh born Nov. 2007 and dx with epi December 2009.   Pharaoh weighed 62.4 lbs. (15 lb. weight loss) when diagnosed in 12/2009.

Weight 10/31/11 was 76.6; 85lbs on 9/22/12; 85.5 lbs. on 11/13/14.

Received six weeks of B12 shots Jan-Feb 2010 but his B12 on 8/10/2010 was only 232. So started weekly shots at home, which we continue to give. 

His older half sister is Taiko born Sept. 2006  and was dx with epi June 2010.  Since she has severe bilateral hip dysplasia she had always been on the thin side.  Taiko's weight was 70.7 lbs. in June 2010 (time of diagnosis; about a 10 lb. weight loss).

Weight on 10/31/11 was 80.4 and on 9/22/12 was 82.4 lbs.  Weight 11/13/14 was 83 lbs.  B12 was 211 in June 2010 so started six weeks of shots and was only 293 on 8/10/10.  She receives B12 shots weekly at home.  B12 in September 2014 was over 1,000.

Both are fed twice a day and we use Merrick BG brand: 1 1/2  cups kibble in the morning with 1/2 can dog food with 4 crushed tablets and in the evening 1 1/2 cups to 2 cups kibble with 1/2 can dog food  with 4 crushed tablets. 

Moku was born 4/15/14 does not have epi.  His grandfather is Taiko's and Pharaoh's father (through his mother).  On 11/05/14 his weight was 78 lbs, on 12/11/14 he was 85.7 and on his first birthday 15 April 2015: 90.2 lbs.

April 2, 2018 at 6:01 PM Flag Quote & Reply

Barb
Administrator
Posts: 3951

I am jumping on the bandwagon of having your pup tested with the fasting cTLI test. Getting a correct diagnosis is always the best way of helping your pup.  Otherwise, you can be giving her treatments that may work for a while, but if the diagnosis is not correct, will ultimately become ineffective.  Once you have a correct diagnosis,  you can proceed in confidence with treatment.


Barb



--


April 3, 2018 at 1:08 PM Flag Quote & Reply

Doc's Mom
Administrator
Posts: 3134

Hi Emily - welcome to our EPI family!  Wow down to 34lbs I'm sure you were out of your mind with worry - we have all been there.  I'm so glad she has gained so much weight.  I wanted to share with you my experience - Doc had coccidia when he came home at 7 weeks - treated with antibiotics - TWICE to get rid of it.  At 3 months old he still had chronic diarrhea - cow pie, pale and he was eating it - so my vet tested him for EPI as she was aware of the symptoms.  He did not have EPI but had SID (formerly SIBO) - which as stated above by itself mimics EPI.  He was treated with antibiotics and thrived reaching 95lbs.  

While it's okay to treat as EPI for a short while, it is recommended to get the test to confirm EPI.  EPI can mimic many other diseases and we have had a case where a dog was not tested for EPI but treated as EPI and passed away two years later - the autopsy revealed the dog did not have EPI but had a tick disease that could have very easily been treated and cured.  If you are unable to afford the test right now, you can order the Schebo test from Enzyme Diane - it's about $50 - it's a poop test you do at home and is about 95% accurate if your dog does NOT have EPI - however if it indicates EPI then we strongly recommend having the cTLI test done to confirm.

You can stop the enzymes and see what happens - obviously if she begins to lose weight or you see signs of SID you should have her tested for EPI.  The one thing I don't recommend is stopping all three (enzymes, B12 and probiotic) at the same time because then you won't know which one was working.

Keep us posted on how you proceed.

--

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)


April 3, 2018 at 1:41 PM Flag Quote & Reply

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