EPI * Exocrine Pancreatic Insufficiency

My Sascha had a TLI come back at 2.5 today. He had not been right since Christmas. Diarrhea, severe appetite and rapid weight loss brought me to the vet this monday. The blood panel revealed his liver enzymes elevated, we were sent home with denimarin and amoxicillin. He fasted for the TLI Tuesday and we got the results this afternoon.

About two weeks ago, I started eliminating things from his diet. Right now he is only on kibble and brown rice and some sweet potatoes for the pills.

He has a beef and Chicken allergy and is on this food:

solid gold holistique blend

Protein, Min 18%

Fat, Min 6%

Fiber, Max 4%

Moisture, Max 10%

Calories per cup, 336

Oatmeal, Cracked Pearled Barley, Millet, Ocean Fish, Potatoes, Canola Oil, Tomato Pomace, Flaxseed, Natural Flavor, Salmon Oil (source of DHA), Choline Chloride, Taurine, Dried Chicory Root, Amaranth, Parsley Flakes, Spearmint, Almond Oil, Sesame Oil, Yucca Schidigera Extract, Kelp, Thyme, Blueberries, Cranberries, Apples, Lentils, Quinoa, Vitamin E Supplement, Iron Proteinate, Zinc Proteinate, Copper Proteinate, Ferrous Sulfate, Zinc Sulfate, Copper Sulfate, Potassium Iodide, Thiamine Mononitrate, Manganese Proteinate, Manganous Oxide, Ascorbic Acid, Vitamin A Supplement, Biotin, Calcium Panthothenate, Manganese Sulfate, Sodium Selenite, Pyridoxine Hydrochloride, Vitamin B12 Supplement, Riboflavin, Vitamin D Supplement, Folic Acid

I fear the vet will just send me home with a bottle of enzymes and let me figure it out.  He didn't have the enzyme I'm supposed to mix in with his food. He is having it overnighted for me. I guess I will keep him on his restricted diet, add the enzyme and start slowly adding his salmon oil and probiotics back into his food.

Ugh. Im saddened my poor guy has EPI but III'm happy I finally know whats wrong. I will help him through this and back to himself again!

thanks for listening, Catherine

Hello Catherine

Welcome to your new EPI family!  So sorry you have to be here.

My Basia was diagnosed at the age of 7 this last September.  She had lost 19 pounds and was having the famous cow patty poops.  Thanks to all the great advice on this forum and having a fabulous vet that learned about EPI with me, my "baby" girl has gained back her weight and is holding steady.  You will find a wealth of information on here from the more experienced.  (They should be typing in shortly )

Top 4 things I advice:

1.  Change food to grain free and rice is a grain.  We've been on DVP Venison and Sweet Potato

2.  Enzymes - http://www.enzymediane.com/ - Diane is our angel - The cost is about 1/3 of what the vet will charge you - I think just about everyone on here in the USA goes through her

3.  Incubate the enzymes with room temp water for 15 - 30 minutes

4.  KEEP A LOG!

The others will have more questions. 

Just know that you are not alone and we are all here to support you.

p.s.  Sascha is a handsome looking boy

Hi Catherine & Sascha,

It's late here in Oz, but I just wanted to pop in for a minute to say 'welcome to our group'. 

I know it's a relief once you get the diagnosis, although no-one wants their babies to have EPI. At least we can all

now help you as much as we can, so please don't hesitate to ask any or as many questions as you can think of.

Also feel free to post some pics. of Sascha.  He looks beautiful in your profile pic & we all love pics. here.

Again welcome.

Lynn & girls.

Thank you so much, this is a little overwhelming! I guess Im not sure what to do first. Ill get the enzymes today, then change his food and request a B12 test next? 

thank you!

catherine

HI Cathrine and welcome, although sorry you need to be here...  You have been given some good advice already by Shanon, but I wanted to welcome you to this crazy world of EPI...Sassha is very pretty!  I think one of the most important things in the beginning is to stay calm (I know - easier said than done) and be pateint, which is another tough one for me anyway...  For some dogs, it seems like they turn around overnight and for other, like my Tara, it takes a bit of time...If you have not already, download the chart and start keeping track of the changes you've made and only make one at a time, otherwise you'll never know what worked and what didn't...Take a deep breath and remember to breathe...We'll help you out along the way...Just ask!

Hi again Cathrine,

I forgot to ask, has your vet prescribed either Tylan or Metro for Sashcha to combat SIBO? Does she have a rumbling belly and/or a lot of flatulance?  What country are you located in? These will also help us answer some questions. 

Hello and welcome.  Finally had a break here at work to check the Forum.  I think that Sasha should also be given Probiotics with a couple of hour space between his antibiotics to help put good flora back in his disgestive tract, correct Donna?   And yes, you will get him and you through this.    That's the spirit! 

Leslee (and Jed)

Hi Catherine and Welcome to our family but so sorry you have to be here. 

By the way, Sascha is a very handsome fella!

Unfortunately the food you have Sascha on is probably not agreeing with him because it does have grain in it.... and a lot of grain in it...especially since grain is the very first ingredients "Oatmeal, Cracked Pearled Barley, Millet,"

 Some EPI dogs can tolerate "some" grain, others cannot.... Not sure which one Sascha is, but since the majority cannot tolerate grain, what we suggest at the beginnng of EPi diagnosis is to try a food that is pretty much grain free. There are many brands. Are you in the US?

Also, Please let us know what brand of enzymes your vet sent you home with.

Others have already suggested some good things for you...but most importantly take a DEEP BREATH!!! and just know we are here for you and will walk you thru this one-step at a time.

1. Get the dog on the right enzymes(let us know what brand you have, how you are giving the dog the enzymes)

2. Get the dog on the right antibiotics (if SIBO is suspected) AND for the right duration.

3. Have the B12 levels checked with a fasted B12 Deficiency blood test

4. Try avoiding food with lots of grain in it (keep the fiber content to 4% or less..if possible) 

5. Try feeding smaller portions but more meals a day (totaling 150% of what the dog supposedly needs)

6. Download an EPI LOG  http://www.epi4dogs.com/downloads.htm and start keeping track of EVERYTHING you give the EPI dog.

7. After starting the enzymes, antibiotics and B12 (if necessary), and changing to a grain-free food... ONLY MAKE 1 CHANGE AT A TIME.. WAIT 3-5 DAYSBEFORE MAKING THE NEXT CHANGE - - RECORD ALL REACTIONS

Welcome Catherine,   I am saddened also that you have to be here, but you have come to the right place.  Many here have lots of experience with EPI.  You will find that many actually know more about this illness than most Vets do. 

Just a not about your food.   My Suzie has been living on Solid Gold Holistic Blend kibble (and only that) for 4 yrs. now.  She is stable and in great shape.  I mix Diane's enzymes and warm water with it, like everyone else here, and she is at her normal weight and has been since 2006.  You might just give the enzymes a try, and not change anything else in her diet to begin with.

Most of all, keep it simple.  Only change one thing at a time, and keep a journal.  Hang in there, and be patient.

,

Brenda ~ So Salin Suzie is doing well on the above food...."Solid Gold Holistic Blend"  kibble even with the "Oatmeal, Cracked Pearled Barley, Millet," in it?.  That is good information to know... but as i said to Catherine....some dogs can tolerate grain, others cannot.

Catherine ~ In light of what Brenda said (that her dogs uses the same food your dog is on and does fine) .... and since you are already using the "Solid Gold Holistic Blend"food.... maybe Sascha will be like Salin Suzie....  SOooooooo let me revise what i recommended...maybe you should not change the food just yet.... but rather wait to see how Sascha does on this food but with enzymes, etc.  Wait 3-5 days... if still no improvement, maybe then would be a better time to look at changing the food to a no-grain food, like I recomemnded.

This is how EPI is... there are a few basic rules.....but unfortunately not every EPI dog is going to respond the same to all the " EPI rules" so we all come together and offer what works for us in hopes that what someone does with their dog will work out well with your dog.

Please let us know what you decide to do with the food and how Sascha reacts to it after a  few days......and we can go from there

Sorry Olesia,         I didnt know you had recommended a change in food for Sascha......   Catherine, I didnt mean to contradict Olesia.  She is a wealth of information and her advice is great.

Yeah Olesia,   Pat from New Hampshire with Spirit recommended Solid Gold Holistic Blend for Suzie when she was refusing EVERYTHING in the world and would not eat.  This is what Spirit (Doxie also) eats.  I figured what the heck, I had nothing to loose, as she was starving herself to death FAST.  It worked.

Yes, Catherine, you just never know what will be your dog's winning touch.  If you dont get good results with the enzymes and the Solid Gold, then it is prolly the grain that is your problem.  Lots of these EPI babies cant tollerate the grain.   

If you do change, I suggest you slowly change over to the new food a little more each day.  Sometimes a sudden change can upset their tummys too.

Keep up the good work, you will make it thru this.

Brenda... heavens,... don't ever apologize for a suggestion!!!

Besides, I am so used to saying try "grain free food" since that is what works "most" of the time.....(but not always!!!)  that i don't give enough mention about those EPI dogs that do well WITH some grain in the diets.  And that is why we are all here... to offer anything and everything to folks just beginning this EPI journey.....and share whatever worked for our dog.

So, in short... i thank you very much for sharing what worked for Salin Suzie!!!!! 

Catherine -  Welcome to our EPI world -- and like the others have said, so sorry you have to be here -- but to be honest with you, without this website, Olesia's tremendous help, and this Forum, I don't know where we'd be today with our Onza. Onza was also 4 yrs old when diagnosed w/EPI - just last April of '09. Our vet was on top of things in getting us started with enzymes, treatment for SIBO, etc., but things still weren't great with Onza. In June of '09 friends in our Schutzhund Club, who also had an EPI dog, hooked us up with Olesia .. and finally, finally we got the hope we desperately needed and did not feel so "alone". We had never heard of EPI and were totally unaware of all the sweet pups out there affected by this horrific disease. Even tho our vet had switched Onza to a "better" food, it still was loaded w/grain. We switched her cold-turkey, as they say, to Dick VanPatton's Fish Formula. When we were getting low on the $170 bottle of enzymes from the vet, we ordered from Enzyme Diane - has worked great and much more economical. We gave her B12 pills at first, and then switched over to injections. One thing we do is grind her food, let the enzyme sit for 20 min; we are now giving her 4 meals a day.

Shannon gave you very good advice above, as well as Olesia, and the others. Even tho you just want to cry b/c you want your baby to be healthy, just know you are not alone. We have had ups and downs w/Onza -- even recently. It's all a matter of tweaking and balancing. Sascha is a beautiful boy and I know you love him. The log is very, very important. I keep ours in the kitchen and log daily - sometimes numerous times during the day. Just recently when we had a glitch w/Onza, I pulled out my first entries -- back from April of 09 and looked back over everything. So much to tell you and you'll have so many questions. Just know we are all here for you - anytime day or night. Only a click away.  

Donna W.   (and William and Onza)

Donna at 03:32PM on Feb 05, 2010

Hi again Cathrine,

 

I forgot to ask, has your vet prescribed either Tylan or Metro for Sashcha to combat SIBO? Does she have a rumbling belly and/or a lot of flatulance?  What country are you located in? These will also help us answer some questions. 

He is on amoxicillin. I do think he has SIBO because he does have tummy rumbles and gas ( sometimes he scares himself!) . Some times worse than others! Im in Massachusetts USA near Boston. 

Leslee Hoober at 04:46PM on Feb 05, 2010

Hello and welcome.  Finally had a break here at work to check the Forum.  I think that Sasha should also be given Probiotics with a couple of hour space between his antibiotics to help put good flora back in his disgestive tract, correct Donna?   And yes, you will get him and you through this.    That's the spirit! 

 

Leslee (and Jed)

Before all this, i had him on a supplement with probiotics in it. i dont know if i can go back now he has EPI. I also had him on salmon oil

Product Facts

Active Ingredients per scoop*:

Glucosamine sulfate (shell fish).......................... 800 mg

Chondroitin sulfate (shark cartilage)................... 800 mg

MSM (Methylsulfonylmethane)........................... 750 mg

Calcium Ascorbate (as Ester C®,

Chelated calcium ascorbate).............................. 360 mg

Digest-All Plus™ Enzyme Complex (Amylase, Bifidobacterium longum, Bromelain, Cellulase, Lactase, Lactobacillus acidophilus, Lipase, Maltase, Peptizyme SP®, Protease, Protease II, Protease III, Sucrase)............................................512655 FCC units of activity, 10 billion cfu’s/gm

*(Scoop included; 1 scoop = 1 tbsp)

Inactive Ingredients:

Organic Ascophylum nodosum (kelp), Organic Bee Pollen, Hydrolyzed White Fish, Organic Stabilized Flax Seed, Organic Garlic, Lecithin, Organic Spirulina.

OLESIA...........I LOVE YOU!!!!!

Catherine,   I am thinking that SIBO is prolly present in your Sascha.  You need to check with your vet and get him on Metro, or better yet Tylan..........AND.....even if your Vet protests, INSIST on a 30 day course.  On the usual Vet perscription of 14 days, you will THINK  the SIBO is gone, but about a week or so after you stop the antibiotics the bacteria will have grown back enuf to put you right back where you started. 

SIBO can make smelly poops, lots of gas, runny poops, and terrible breath.  Oh, and it can also kill appetite.  DOG HELP US.  In Suzie, Metro also had a appeitite killing effect, but the Tylan did not. 

When Suzie and I conqured SIBO, the EPI was a breeze. 

Good luck,

Hi again Cathrine from a fellow MA EPI'er!   I live in North central MA. I'm sorry I called your boy a girl... While I knew by that face he was a boy, I used to have a GSD named Sasha and well....

The amoxy may not work well for SIBO...The typical med for this is a 30 day course of tylan or metro (brand name Flagyl). You should probably ask your vet about the possibility of SIBO as it does go hand-in-hand with EPI, as well as B12 deficiencies.

Also, you should really check into the Pancreatin generic enzymes:  http://www.enzymediane.com/  I have been using these for years after I got the sticker shock when I found out it was going to cost me  about $300 a month for the prescription Viokase...

Tara never had a problem with grain, while many others do, so I think I would wait on the food change...Again, it's real important that you change one thing at a time so you know what works and what does not.

I know, this is tough... I can remember falling asleep at the keyboard at 2:00 AM  while reshearching EPI, SIBO and everything else, then getting up at 5:00 AM...Tara was difficult to stabalize and she went to under 49 pounds - at which point I quit weighing her out of depression...Today, she is 79 pounds and on a bit of a diet...

Lessle is right in that a good probiotic should be used with the antibiotic to combat the antiboitic killing off good gut flora...They do need to be taken at different times as well (thanks Leslee ).

This horrible condition can be conquored...Trust me if I can do it, anyone can!!!!

Sailin Suzie & Brenda at 05:00PM on Feb 05, 2010

Welcome Catherine,   I am saddened also that you have to be here, but you have come to the right place.  Many here have lots of experience with EPI.  You will find that many actually know more about this illness than most Vets do. 

Just a not about your food.   My Suzie has been living on Solid Gold Holistic Blend kibble (and only that) for 4 yrs. now.  She is stable and in great shape.  I mix Diane's enzymes and warm water with it, like everyone else here, and she is at her normal weight and has been since 2006.  You might just give the enzymes a try, and not change anything else in her diet to begin with.

Most of all, keep it simple.  Only change one thing at a time, and keep a journal.  Hang in there, and be patient.

epi4dogs at 04:53PM on Feb 05, 2010

Hi Catherine and Welcome to our family but so sorry you have to be here. 

By the way, Sascha is a very handsome fella!

Unfortunately the food you have Sascha on is probably not agreeing with him because it does have grain in it.... and a lot of grain in it...especially since grain is the very first ingredients "Oatmeal, Cracked Pearled Barley, Millet,"

 Some EPI dogs can tolerate "some" grain, others cannot.... Not sure which one Sascha is, but since the majority cannot tolerate grain, what we suggest at the beginnng of EPi diagnosis is to try a food that is pretty much grain free. There are many brands. Are you in the US?

Also, Please let us know what brand of enzymes your vet sent you home with.

Others have already suggested some good things for you...but most importantly take a DEEP BREATH!!! and just know we are here for you and will walk you thru this one-step at a time.

1. Get the dog on the right enzymes(let us know what brand you have, how you are giving the dog the enzymes)

2. Get the dog on the right antibiotics (if SIBO is suspected) AND for the right duration.

3. Have the B12 levels checked with a fasted B12 Deficiency blood test

4. Try avoiding food with lots of grain in it (keep the fiber content to 4% or less..if possible) 

5. Try feeding smaller portions but more meals a day (totaling 150% of what the dog supposedly needs)

6. Download an EPI LOG  http://www.epi4dogs.com/downloads.htm and start keeping track of EVERYTHING you give the EPI dog.

7. After starting the enzymes, antibiotics and B12 (if necessary), and changing to a grain-free food... ONLY MAKE 1 CHANGE AT A TIME.. WAIT 3-5 DAYSBEFORE MAKING THE NEXT CHANGE - - RECORD ALL REACTIONS

the enzyme the vet gave me is PanaKare. Im mixing it well into his dry food with water. one cup three times a day, one teaspoon per cup..and let stand for 20 minutes before he eats

PANAKARE™ PLUS POWDER

Neogen

Pancreatic Enzyme Concentrate Plus Fat Soluble Vitamins

Each 2.8 g (1 teaspoonful) contains a minimum of:

Lipase

71,400 USP units

Protease

388,000 USP units

Amylase

460,000 USP units

Vitamin A

1,000 IU

Vitamin D3

100 IU

Vitamin E

10 IU

You are on your way!!!!!

Your boy is beautiful........even tho I have a much smaller dog, in Suzie, she is big at heart.

I had a wonderful GSD named Duke many years ago.  He was the love of my life when I was a teen.