EPI * Exocrine Pancreatic Insufficiency

I am so worried now that sophie is allergic to the enzyme meds.  Yesterday she started itching all over and I noticed today it was getting worse.  I looked in her ears and they were so red.  Sometimes she gets ear infections so I have this cleaning medicine that I use to wash her ear out.  HALO.  I used some and all of the sudden half of her face was swollen and her ears keep getting bigger and bigger.  On the side I put the HALO her eye started to swell shut and her mouth looked like it had swollen sores.  I quickly put her in the tub and started washing her eye and ear out.  All day I have been keeping an eye on her but she keeps itching and her ears are getting bigger.  

When she was a puppy I switched food because I thought she was allergic to meat based food because she would get hot spots.  She has been on Wellness fish and rice until we were diagnosed with EPI.  Could she be allergic to this medicine?  I called the vet to see if I can give her an antihistamine.  Would that be okay with her enzymes?  The vet office told me to come in and get a shot.  Has anyone had problems with allergies to the enzyme medicine?  

HI Katy,

While it is possible that she's having an allergic reaction to the enzymes (it would be a pork allergy), it's pretty rare...You have said that she's had issues in the past with allergies, right?  Often times food allergies come on quickly and hit hard... Could you try another protein for her food?  BTW, I would think that Benedryl would be fine, but of course run it by the vet, first...Did they give her a steroid injection?

Katy,

Another thought was could she have been bitten by a spider?  Remeind me again of how long she's been on the enzymes??? I would think if she was going to have that severe of a reaction, it would have happened immediately...Please keep us posted!!!

Hi Katy ~

Although rare, yes, if she is allergic to pork then she can have a reaction to the enzymes since they are pork enzymes.

I hope while i am typing this you are on your way to the vet........for that shot..... which I have not heard would cause a bad reaction in an EPI dog.... of course, there is always a first time  *sigh*

But i have to agree with Donna, every time i have heard of a dog's face starting to swell up, it has almost always been a spider or insect of sorts kind of a bite....

PLEASE keep us posted.... let us know what the vet says, and when you come back, and feel like things are more under control, tell us again the kinds of things sweet Sophie is allergic too..(like proteins/ various meats).. and we will help you work thru this if it is an allergy to pork....

Our 8yo bulldog is allergic to Pork and all dairy products, so it could be possible. My vet has me give her Benedryl, then again she is 65lbs. Also allergies can show up at anytime, at least with humans.

I hope you can figure it out soon. I know how frustrating it can be.

Right after I posted we went right to the vet.  I could tell it was getting worse.  They gave her a steroid shot and Benedryl shot right away.  She had to stay for awhile because she was so swollen in her face.  Now she is on some meds for this  plus one Benedryl every 8 hrs.  I am just praying that it is not the enzymes that are causing this.  She has been on the pork enzymes for one week.  

Right before she started itching she was at the dog  park though so maybe she got bit there.  We are still going to keep her on the enzymes for now and see what happens in a week.  The only reason I am leaning towards an allergy is because before she was on wellness she was eating meat based food and I noticed she would start losing hair on the end of her ears (like hot spots)  and her ears are bothering her now.  SO I switched her to fish and rice when she was 2 so ever since then she has been on a fish and rice diet (she is 6 now).  

Bella's mom do you give him/her Benedryl all the time now?  

Another question:  Has anybody ever dealt with a fungus infection?  I was talking with a lady at the pet health food store who was asking me questions about sophie.  She asked if soph licks herself a lot.  She does.  She told me I should also have a fungus test taken.  

My husband and I were talking about getting health insurance for the dogs.  Does anybody have this?  

HI Katy ~

Keep us posted on Sophie... and if she has anymore reactions .....i too hope it's not the pork enzymes... but if it is, we'll help you deal with that also. There are plant enzymes, and although no where near as effective, if you double the dosage + and also with the additional help  via the right balance of a diet... you should be able to manage her EPI.... it is just a heck of a lot easier to do with pork enzymes...

My Lulu (non-epi gal) started licking herself constantly along with the typical "red" feet and chewing and  biting of her feet. It seemed to happen most when the grass was wet. Anyway, Vet tested Lulu for fungal infections, and she was fine, so he determined it was "allergies" and placed her on "Atarax" for allergies..... it did not help.

Then he placed her on an antibiotic "Keflex" and that worked  beautifully.... so go figure...................

Folks in the UK have much success with pet insurance.... for us personally it would cost more to carry the insurance, rather than maintain the expenses out of pocket. Hoepfully otherse will chime in with their experience.

You can do a search on "Pet Insurance" because I know there is a thread about it where members gave examples of who they use, cost., and their experience with different companies...........

Hi Katy,

We are from Australia and have pet insurance with the RSPCA. I learnt the hard way with my 7yo Staffy who had an allergy break out a few years back and had to have surgery to remove lumps that it caused on her ear, ankle and side of her gut. One month later, she blew her ACL so it was a very costly few months!

When we got Kobe, I didn't hesitate in getting pet insurance - You never know when you need it, so I learnt the hard way. And just as well I did because he was diagnosed with EPI in October 09.

It costs us around $450AUS a year, that is accidental and illness cover. So it covers him if he gets a sore foot or ear and also if he were (touch wood) to get hit by a car or have an 'accident'. There are usually 3 different cover types available.

If you are looking into it, make sure you have a look at the total claim amount - Each insurance provider offers a certain limit per condition/disease/disorder. So for us, we actually have a limit of $6,800 for EPI related claims - Once it reaches that point and above he is no longer covered. Different providers have different limits.. a new one came out in 2009 (That I didn't discover until after Kobe was diagnosed with EPI, so I couldn't change over) has a limit of $13,000 per condition!! They all provide different cover levels as well - Some offer 100% money back on each claim, but usually there is an excess attached to that. With Kobe's policy we get 80% back from every claim we make.

So definately do your research and look at things like that. All in all though, it's saved us a lot of money over the past 4 or so months. Just remember though, if there is a condition which your dog continually suffers from and the vet has noted it in your pets medical history, there is a chance that particular condition will be excluded from the policy.

RSPCA are generally good to deal with - I've had one hiccup with them since October and that was relating to receipts which I posted to them that magically disappeared and I was accused of not sending them to begin with. After speaking to the manager and having him look at the actual claim form which shows the cost that the receipts were for, I was reimbursed.

Hope this is of some help to you.

It took us a long time to isolate the allergies.

She gets a benadryl when things get real bad. The vet also has another anit-histimine she can take, more expensive but works a little better.

Abby is also allergic to plastic and a lot of fibers have plastic, beds, blankets etc....so we are always battling her skin being red, raw and Yeasty. She is on a special Shampoo and Cephlexin for 90 days during bad flare ups. I had to change her bowls to glass or metal. She is on Dick Van Patten's Venision and Sweet Potato, that works best for her.

you are in my thoughts during this trial and error. It is very hard to isolate allergies w/o expensive testing. But we just eliminated one thing at a time to figure it out.

I love my bullies, even though they have health problems. I have checked into Insurance, however the small print states it does not cover congenital conditions, that rules Bella and her EPI out.

Good Luck

Ah....Allergies...They are tough to figure out and I've been told the testing for it (food allergies anyway) is extremely inaccurate...It's trial and error...The best way to figure out a food allergy is through an elimination diet where you choose a single, novel protein and carb and then ever-so-slowly add ingredients to the diet to balance it.  Keep in mind you could also be dealing with contact/inhailent allergies too...This is what my Corgi suffers from...

As far as pet insurance goes, it's too expensive and of course if I had bought it, we never would have used it...I sure wish I had now, but they don't cover pre-existing conditions.

Thanks everyone for your advice.  Sophie is doing good now.  However, I feel that she is losing more weight.  She has not gained any since being on the enzymes but her poops are doing better and she is only going around 2xs a day.  

Am I being paranoid about the weight?  It has been one week since she has been on the pork enzymes.  

Now she is on steroids because of the allergic reaction to something.  Should I be doing some things differently?

This is our schedule:

6a.m.  Breakfast 1 cup Orjen Kibble with 1 tsp of pork enzyme incubate for 30 min.  1/4 tsp of Tylan powder on top 

12 p.m.  Lunch  same minus the Tylan

6 p.m.  Dinner same as Breakfast

I am just so scared.  She is so thin....  I am wondering if I should go to a vet specialist out here???  I know that I might be overreacting but I just want to make sure I am doing everything that I can.  Today I was going to grind up her lunch to see what that does.  I noticed that this Orjen does not soak up water that well because it has no grain.  

I just don't want to see her lose anymore weight.  Thank you for all your advice on the insurance also.  We were just curious.  I think we are way past that though at this point.!!    

Katy and Sophie

Hi Katy...I hear the fear in your voice...Don't panic...As long as her poop is good and she's eating, she will regain the weight...Some dogs take longer than others. It took months before my Tara even started gaining weight back, although her stools were good.  In some dogs it happens right away...Each EPI dog is so very different.  If she'll eat it, could you add a bit more food to each meal?

Over the past couple of days, I've read and re-read your posts, thinking that I'm missing something.  No great lightbulb has gone off...sorry, but I do have a couple of thoughts.  First of all as far as Sophie gaining weight...3 cups of food a day may not be enough for her...especially right now.  Akira, when not on a diet, gets 4 cups of kibble a day with additions (meat, veggies, yogurt, cottage cheese...whatever is on the menu that day) or 2 cups of kibble a meal with additions since she eats twice a day. 

My first thought when I read your post, was that Sophie either got a sting or spider bite.  A gsd I had years ago, did very much the same thing and it was a sting on the roof of her mouth actually.  However, I've also dealt with food allergies in both human children and critterkids.  Your best bet is an elimination diet if you're trying to figure out exactly what the problem is.  I do think though that one of the first things I'd do is switch her back to the fish/rice food that she did well on. 

Katy,

Are you feeding the Orijen Fish?  Looking at the bag I have here, around 3 cups would be the normal amount for her size.  But I believe when trying to put weight on it helps to try and increase the recommended amount by 50%.  So maybe try giving her a little more with each meal.

Becky

p.s. If you decide to switch kibble and want to stay with a grain free fish based formula, EVO recently started making one and Wellness Core has one also.

Katy ~ You poor thing, it IS scary isn't it... but as others have said, you are heading in the right direction.... It took Sophie a long time for her body to become so depleted and it will take a time for it to replenish what it lost before she will start to gain....take a deep breath!   she'll get there... First goal  is to stop the loose stools...Second goal is to reduce the amount of times they eliminate... Third step is to stop the weight loss and hopefully get better looking stools.... after all of this happens... then we anxiously await the weight gain ....although some do take longer than others ...by listening to others it seems that sometimes the weigh starts to come back for some in a mere few weeks, while other can take up to a year or longer.....

I didn't  do any research like Linda did (thanks Linda!!!!!) regarding the weight /food ratio of Orijen.... but just from reading your post, i too was wondering if, like Linda and Donna suggested...... maybe you should consider increasing the amount of food you are feeding Sophie....

Izzy and Sophie are about the same ... around 46 lbs... yes? Whenever i want to increase Izzy's weight, i add 1/4cup more to each meal.... but in addition to that, if possible, since Sophie was just diagnosed and she is at the beginning stages of recovery, they do recommend feeding EPI dogs (at the beginning of recovery) 150% of what they need. (for a little while).... once their body replenishes what they lost, you can cut back as soon as they  start to leave food in their dish. But you do have to be careful not to turn her off of food by over-feeding for too long... 

Becky, EVO has fish grain-free food??? WOW and THANKS!  I am going to ahve to check that out... all my dogs love EVO grain-free red meat, small bites.... even tho i had to stop feeding it to my big guy 'cuz he has A-typical Cushing and it has too much protein for him now......but my others still enjoy EVO.

Olesia - The new EVO Fish formula showed up in stores here in Alaska this fall.  But be prepared for sticker shock when you see the price!  It only comes in one size, which is small bites.   Where many of the grain free foods use potatoes as the binder, this one uses peas.  If your dogs like the smell of fish they will be happy when you open the bag because it does have a strong fish odor.  EVO has supposed added the Red Meat and Fish flavors to their grain free treats lineup also - but I have yet to find anything but the Chicken flavor here.

Becky

Thank you all so much..just reading your quick responses and thoughtful advice brings tears to my eyes.  I will up her food a bit and see what happens.  I just get so worried about her and sometimes I tend to get very paranoid (as my husband and family would attest to  )  Plus I am not working now and that gives me a lot of time to think which can be good or bad   

Linda,  I know no lightbulb has gone off in our heads either!!  I am waiting though   We will find out once sophie is off the steroids and Benedryl if she is allergic to it.  I do think it was a bite though because she is not itching since at all. (Unless the steroids would help that?)  We will see.  I am praying that it is not the enzymes.  

I did grind up her food today and noticed that it soaked up great!  I am pumped about that.  Thanks again everyone.  You are all so sweet!  

katy and sophie

Katy,

When Tara was dx'd, I did work and trust me, I was up until 2:00 in the morning researching, reading and absorbing everything I could about EPI, only to get up at 5:00, go to work and come home and do the same... It was awful!! Today I'm out of work, so have the time to help.

Forgot to mention - As you increase the food, make sure you increase the enymes with the new portions....I'm sure you know that, but wanted to make sure!

Hi Katy,

My EPI girl Megg was very slow to regain her lost weight, in fact it took her just about the whole first year.  She would gain some, lose it, gain a bit more, lose it again.  As long as Sophie is not continuing to lose, then I think all is going fine.  Two poo's per day is excellent, so she is doing wonderfully well in that department. 

I see that you've got so much great advice already.  Hang in there.  It will all start to come together for Sophie very soon & we are all here to help in any way we can. 

Take care

Lynn & girls.