EPI * Exocrine Pancreatic Insufficiency

This very helpful guide for folks who cannot use porcine based enzymes due to pork allergies. This "How-To" use plant enzymes was put together by one of our members,  (THANK YOU JULIE!!) Julie workled closely with her vet monitoring Angel's stats while on plant enzymes and recorded all the values available. This is extremely helpful and valuable information, especially for those that encounter a similar pork allergy situation.

In addition, Julie's inclusion of vital stats greatly aid all EPI owners in better understanding the effects of diet and enzymes on EPI.

Angel, GSD, 7 years & 8months old upon EPI diagnosis -14th August 2009

Total-Zymes, plant-based enzymes analysis to help EPIdogs allergic to pork

Introduction

Angel fell seriously ill early August 09 and underwent emergency exploratory stomach surgery. Diagnosed with distemper with subsequent pancreatitis, resulting in EPI.

Weight: 30 kg / 66 lb

Clinical tests

• Liver, spleen and stomach lining biopsies
• Full biochemistry and haematology blood profile
• TLI / B12 / Folate  

Results – UK laboratory measurements

• Moderate, partial fibrosis of bile duct (liver).
• Slight inflammation of intestinal lining,
• Remarkable biochemistry and haematology, notably elevated liver enzymes of Alkaline Phosphatase (ALP)
• Elevated white blood cell count
• Heavy E.coli infection.

• TLI score *2 / EPI
• B12 *30 – Severe
• Folate *10.9 – Normal range.
• Amylase  *708 - lower end of normal range  

Treatment

• Metronidazole – 14 days with combination of Synulox/amoxicillin – 28 days
• 10 days probiotic of e.faecium post antibiotic therapy
• Vitamin B12 (0.6 ml) injection every two weeks for 6 weeks
• PANZYM - Porcine enzymes. 

Diet & supplements

• Vegan dog food kibble – non-GM /additive-free Soya based with whole grains.
• Booster Concentrate
• L-Glutamine

Summary

Used porcine enzymes for short period and then switched to plant-based enzymes – Pro-Vegan enzymes with 71% absorption.Experimented with using both PANZYM and Pro-Vegan together. Later reverted to solely using PANZYM for short period but reverted to solely using Pro-Vegan when Angel encountered side-effects of the porcine enzymes.

Angel steadily gained weight.

Angel suffered two set-backs with minimum weight loss but soon responded to Metronidazole and a short period on Hills i/dkibble. She soon made up the lost weight and continued to gain steadily.

Total-Zymes– plant-based enzymes

21st October 2009 switched to usingT-Z, which claims to be high potent digestive enzymes and suitably treatingthree EPI dogs.

Successful result, supported by the following 3 sets of laboratory re-tests.

Early November 2009:

• Biochemistry and Haematology all within normal range, including Alkaline Phosphatase (ALP)
• TLI score *2 - unchanged
• B12 *184 – remains under normal range but greatly improved
• Folate *12.5 – Normal range.
• Amylase  *604 - lower end of normal range  

20th November 09 – onset of regular use of Total-Biotics; 11 species of friendly gut bacteria (excluding e.faecium).Started Orijen Adult dog food – diet change info below.

23rd November 09 – start of 6 consecutive vitamin B12 (0.6 ml) weekly injections

Weight: 37.4 kg / 82.2 lb

Late November 2009 - urine test and results:

• Glucose - negative
• Keytones - negative
• Bilirubin - negative (Bilirubin evaluates liver disease)
• Protein – negative 

5th January 2010

• B12 level *727 – near top end of normal range
• Blood Pressure – conclusive false hypertension – unrelated to EPI
• Amylase *504 – low end of normal range
• Lipase *22 – low end of normal range
• (Nb: no available test for Protease level)

Weight: 38.85 kg / 85.4 lb. EPI veterinary evaluation: excellent overall condition and certified stable.

Diet change – 20th November 09

Angel became intolerant to her vegan dogfood diet, of which symptoms were intermittent increase of stools and colour changes.

Switched to Orijen Adult – grain-free,antibiotic-free, botanical composition. Immediate improvement.

Total-Zymes assimilated the following major food composition of Orijen Adult:

• Crude Protein                        42%
• Crude Fat                              16%
• Carbohydrate (Max)             18%   
• Crude Fibre (Max)                3%

4 x 625mg T-Z per 250 grams of Orijen Adult. Incubation period of 50 minutes.

Assessment

Total-Zymes is effective if a stringent administrative method is followed and all other EPI treatment protocols are in place – vitamin B12, SIBO and diet. T-Z is the most suitable alternative EPI treatment for dogs allergic to pork/porcine enzymes. However, T-Z might not be effective in young dogs with Pancreatic Acinar Atrophy, as there is no pertaining available data.

NB. Amylase and Lipase blood reading has shown to be within the lower end of normal range. However, collated data of amylase and lipase from EPIdogs on porcine enzymes, fasted/non-fasted, is required for comparative values.

Total-Zymes preparation method

For best results:

• Minimum recommendation for EPI use is to double the amount of manufacturer’s recommended single use of 1 x 625 mg scoop per 130 gram of food or 1.5 scoops per 200 grams of food. You can safely double T.Z with no issues.

• Use boiled water to soak kibble, cover and leave for minimum of 10 minutes
• Use pepper shaker to evenly cover every piece of kibble with T-Z
• Incubate for 50 minutes before feeding  

I have not encountered any side-effects and the following claim from Dr. John Taylor,Naturopath and CEO and Founder of Total-Zymes, Ultra-Pet Products, is thus:

“My product will digest any food as overdosing the enzymes does nothing, but under dosing is not effective. So I made sure my formula is well above the mark to digest anypossible combination of food. There should be no need to change the dose based on food composition, the food itself and the incubation time will be the variables.”

My experience withT-Z is in keeping with Dr. Taylor’sclaim, as I found that T-Z was not the problem for Angel’s intermittent increase of stools and colour changes but was due to her former two year vegan diet, to which she had become intolerant. Once I placed her on Orijen Adult, grain-free, her symptoms immediately disappeared. Diet change has produced perfect stools in form and colour with a consistent normal volume.

Compiled by Julie Hamilton – UK– owned by Angel.