EPI * Exocrine Pancreatic Insufficiency

HI All!

my 5 yr old GSD has been skinny and having bad poo for 4 years! it got to the point where he moved outside to a heated doghouse last year.

JUST TODAY i was reading a craigslist ad about someone wanting to get rid of a GSD because he has EPI - so I started researching and OMG! that is our GSD's symptoms to a T.  Why a vet hasnt told me about this before now,...after all the tests we've done is beyond me.

So after reading this morning I immediately took him to the vet to see about testing - of course, you know he has to fast for 12hrs so it was a no go for today. Test is $190!

My question is - and dont beat me up - can I treat this by myself with over the counter products and diet changes - or MUST I get the test and prescription meds from the vet? I am 100% this is the issue.

please be gentle,..just asking a question,...any tips or advice is greatly appreciated

A Smith

OMG... where do YOU live???? $190 is rather steep for a cTLI test. They usually run about $100 - $125. Might want to check around ........

And yes, we do advise to get the test done....however, if you really cannot afford it right now, talk to your vet about possibly giving you a small amount of prescription of procine pancreatic replacement enzymes. See if it works. If you do over the counter stuff, it is usually plant enzymes and they are usually not effective enough ... some dogs respond somewhat to plant enzyems, others don't respond at all. SO this is really not a good way to go at the onset.

If the porcine enzymes seem to work, you most likely have a dog with EPI... BUT.... and this is a big BUT... sometimes other things are going on,  and the dog will respond poositively to the enzymes, but it does not have EPI.....you really should test to verify this... since you certainly don't want to keep the dog on enzymes forever (as you would if it does have EPI), if they do not need it long term......

Also.. if/when you get the cTLI blood test done for EPI... be sure to ask the vet to draw enough blood at the same time to test for B12 Deficiency... trust me, you save lots of money doing it this way (submitting together and paying the little extra) rather than having to test later for B12 (and you'll get an indication if SIBO is also involved)  ...  both  secondary conditions that affect 50-70% of all EPI dogs.. that all need to be treated at the same time.

Okay, that's the extend of my beating :wink:... hope it wasn't too painful....by the way, your GSD looks like a sweetie... name???

Beemer -- He is a good dog - super ,.to the point obsessive ball drive, good with the kids - but PETRIFIED of any dogs outside of his pack (to the point of anal expression if the rush him) But his fear manifests as a crazy barking dog that sounds like he will rip you to shreds - we are always a big hit at the vet's office lol

Thanks- the more I read the more I figure we are going to have to bite the bullet and get the test done. I think he did mention that it was for a combo of things including B12 for the $190 price

Another problem I will have is controlling food as I have 4 others here at home right now. Beemer is fed by himself outside at night - but there is always food in the dog bowl. I have been feeding him puppy food for awhile now just trying to keep weight on.

thanks for your reply!

Amy

BTW I am pretty good at taking pics that don't show his ribs. He has been down to 55 lbs before,...today at the vet 66lbs,..he should be about 80 lbs at the least. It the dogster pics youcan see striations in his coat that look like he was just brushed with a rake (even though he wasn't). Seems like we think he looks better for a few weeks,...than just as quick terrible again.

So happy to have a name for the problem and start working towards fixing it!

Beemer is fed by himself outside at night - but there is always food in the dog bowl.

Hi Amy, you have been given some good advice so I'll pick up a few other things, if that is OK?

If you are dealing with EPI its much better to feed 3/4 small meals a day than one at night and EVERY bit of food must have added enzymes so leaving out a dog bowl 'free feed' isn't a good way off working.

Many here have mulitple dogs and can give you all the tips and hints that work for them.

but PETRIFIED of any dogs outside of his pack(to the point of anal expression if the rush him) But his fearmanifests as a crazy barking dog that sounds like he will rip you toshreds

That is common with some EPI dogs (including my own GSD Razzy before EPI showed and for a long while after) I think its because they feel weakened and are afraid that other dogs will take advantage and attack them... attacking and showing aggression is to make the other dogs keep away. Once stable this often gets better but it doesn't always disappear completely. A fear becomes engrained and it affects their confidence. This is a condition where the pancreas has been dying slowly over a long period before it shows true symptoms.

I would agree that you need a TLi test to be sure of what you are dealing with and porcine enzymes are the best thing to get the dog stable... Good luck, new friend and keep us posted on the progress.

Val

Hi Amy and welcome to you and Beemer, although sorry you may need to be here...:( I agree 100% with Olesia in that you should get the test done, but if you need to wait a bit due to finances, you could try some enzymes if your vet is willing... This breed is notourious for GI conditions and IBD, Colitis and others could also be at play here...Trust me, if it is EPI, the cTLI test will be the cheapest you'll have to do...

As for cost to manage, many of us here use generic enzymes, which are about 1/3 of the prescription and many of use here use commercial (not prescription) food, but it's 'top shelf' food and is not  cheap. What kind of makes me wonder if you are really dealing with EPI is that you can feed him puppy food?? The fat/protein content of puppy food would weak havoc in an EPI dog, I would think... I'm interested to hear others thoughts on this...

Good luck and let us know what his score is!!

BTW, the GSD w/it's double coat is pretty good at hiding weight loss... Tara went to under 50 pounds, but today, she's nearly 80 and on a diet...

Most vets don't know a lot about EPI as they only see maybe a case or two in their lifetimes. That and the fact that most cases don't follow the paragraph in their textbooks...

Good call Val (you must have been posting at the same time as I) about the fear/aggression temperment thing... I had completely forgotten how they turn into Dr. Jeykl/Mr. Hyde personalities.

Also, I wanted to clarify to Amy when I say generic enzymes, not prescription, I definately mean porcine lab produced enzymes - not over the counter plant enzymes used as a digestive aid...

Thanks for the replies

Do I understand correctly that some people do enzymes with a RAW diet?

I know we will have to change our free feeding ways and am ok with that. I am a stay at home mom so I have the ability to do several small meals a day. And if we were to change to raw then I think we would change over all the dogs.

Hi Amy,

Yup, some do a raw diet, others do a cooked diet and some, like myself, do and enhanced comercial diet (so I don't have to worry about balancing it)...As long as the diet is balanced, it's all good if it works for the dog!

Yeah, the free feeding will have to come to an end in a multi dog household, but since you are home, the adjustment of getting fed more frequently should go over pretty well. I feed all my dogs twice a day, but in the beginning when Tara was trying to get stable, I fed all my dogs 3 times a day and as I worked, this was a challenge to say the least!   Also, all my dogs stopped having treats in solidarity of Tara...If Beemer does indeed have EPI, in the beginning, he cannot eat a morsel of food that has not been intubated in enzymes. You kind of have to re-learn how you feed these guys...I found it easier to think about the fact that they are no longer able to digest food inside their bodies, so the enzymes have to do it for them, outside their bodies, inside the food....Makes about as much sense as mud, right?

" If you would like to try using raw pancreas;  beef, lamb or pork pancreas may be used"

Where does one inquire about such a thing? at a butcher? Just curious

Hello Amy,

When I tried to locate raw pancreas, I called a local butcher shop.  They told me they receive their meat already butchered in quarters and such, not the whole animal.  But they gave me the name of the people that actually go to the farms and do the butchering of the live animals and deliver it to them at the butcher shop.  I called those folk and they actually had heard of another person looking for raw pancreas for an EPI dog, so I did not sound like a total crazy person to them.  But unfortunately, here in Alaska, they do not do much butchering of animals in the winter, so I was out of luck.  Not sure where you live, but that was my recent experience here.

I hope you can get Beemer on the road to good health soon.  He is a handsome looking fella!

Becky

Amy,

I believe that only a slaughterhouse would have access to raw pancreas and here in the US, most places cannot sell it or give it away due to USDA rules. That said, there are a few who do feed raw pancreas, but they haven't posted in a while (do a search).  I myself did try it as a last resort when Tara wouldn't eat food w/enzymes, but because of the difficulty in extracting it (they are normally waste material), they charged me $30 per pancreas, which was much more $$ than the lab enzymes.  Big warning though....The stuff stinks to high heaven and needs to be put through a food processor.  When I used it (in the summer with the windows open even), I wanted to move out of my house in the worst way!!!  

Hi Amy,

Just saw that you & Beemer are new here & wanted to say a very warm welcome to our group. 

I see you've already had lots of great advice already.  I agree about getting the Tli test done.  At least that

way, you will know exactly what you're dealing with & you will get lots of help & support here.

Again welcome;  we are happy to have you here.

Lynn & girls.   

HI Amy ~

Everyone has given you some great suggestions.....and My dog Izzy is like what Val described too....

By the way, the $190 price for BOTH the the TLI and B12 is a decent price

Ahhh... Beemer is a beauty as is your other pups!!!!!  I re-did your pictures...because for me they did not show up. And just in case they didn't show up for other also, this is how it did it   put the link in your browser,  it will bring you to your picture on dogster then put your curser over the picture, select "copy image location"

and then past that  "copy image location  in the little blue box in your "Post a Quick Reply"

Beemer

Bailey

Koda

Poco

Hi Amy:

I'm a little late but wanted to welcome you to the forum.  You have a beautiful critterkid family and I'm sorry that Beemer is having problems.  How very sad that your sweet boy has been suffering so long and that you had to put him outside.  Hopefully we can help you get on the right track, and he can once again share your home with the rest of the family. 

You've been given some very good information already.  I'm truly sorry for your sake and Beemers, that your vet wasn't able to figure out that EPI could be the problem sooner.  As everyone has said, you could go ahead and put him on enzymes to see if they help, but ultimately you'll need to get the tests done even if they work.  Most of us have had to change how we feed our dogs but it soon will become second nature.  You'll need to start keeping an eye on his stools because it's a guage on how they are doing, even before they start gaining weight back.  Once they are stable, it's still important because it'll tell you of any body changes, if they've gotten into something, if you need to change enzyme amount or even possibly food.  Another good idea is to keep a log of "everything."  It's a wonderful tool as you make changes to be able to one day look back if necessary and know exactly what happened as you changed, added, or deleted one thing or another.  Also remember to make only one small change at a time...this is very important. 

Did you say what food you have Beemer on?  Like Donna, I feed kibble but I add veggies, meat, yogurt, cottage cheese...whatever I decide to add that particular meal. My dogs (epi and non epi) eat twice a day.  As far as raw pancreas...it's difficult to get in the US, and kind of a stinky pain to deal with lol.  A few people have found sources to get it but I'm not sure what they are.  

Please keep us posted... 

i feel very much the same as I did the first week/months I realized my son was autistic - very overwhelmed with info and choices. But I muddled through that with a lot of help from friends on the net and we will get through this too.

He is schedule to get blood drawn the first of the week

thanks all:)

Welcome to you and Beemer!  I am one of the ones with a small dog with EPI, but I will say the people who have responded have given you excellent advice.  Perhaps I've missed it, and I know you are busy, but please keep a journal.  It does help, if you can swing it.  Looking back over my notes and receipts from the vet(s) I've been to, the $190 is not far off from what I paid seperately for both the cTLI and the cobalamin tests.  You can just get the cTLI done, but most likely you will also need to know his B12 levels........been there, paid for that.........:D

Good luck and definitely keep us posted!

Hi again Amy,

Just a FYI... the EPI Log can be downloaded (free) from this page:  http://www.epi4dogs.com/downloads.htm

.. just scroll down a bit until you see a box labeled "EPI Log"

Hi Amy,

What an awsome pack of pooches you have there! I loved all the photos!  Ahhh..so you're a working/herding dog fan too, huh?  I've had a gSD my entire life and I love them!  My Bridge dog wanted a Corgi, so we got one...That said, zeke has never been much of a "working" dog... I'll let you all be the judge.

Mmmmmmm., doesn't look like Zeke is working too hard to me Donna.