EPI * Exocrine Pancreatic Insufficiency

My Terrier..Maisy has been loosing weight since just before Christmas. The vet diagnosed EPI on Monday. She has been put on 3 Tryplase capsules a day.. spread over 2 meals. The vet recommended that we feed her Chappie as it was low in fat. I have been given no advise about the mixing of the Tryplase on her food. Can anyone advise me ? Is Chappie the better food to help her gain weight again ?

Hi and welcome to our EPI family, but sorry you have to be here.

Most of us in the US use other brand enzymes, but we do have members in the UK that use Tryplase. From my understanding, you have to sprinkle Tryplase on the food. Incubate for 30-40 minutes. Mix and serve.

I have a FILE on various EPI products and I will cut and paste for you how two of our members have used Tryplase:

"(per Debra) Tryplase as an alternative is ok (I've usedthat) cheaper...but it is a bit of false economy as depending on the dog, you can have up to 5/6 capsules per meal (Debra used Tryplase for a German Shepherd dog) ...capsules opened and sprinkled on food and incubated"

Tryplase  is another pancreatic enzyme replacement that are capsules sprinkled on food. Tryplase needs to be pre-digested for about 30/40 mins because like most enzymes it is caustic at first and will cool as it works the food. Some can serve at once but most let it pre-digest to avoid thedog having a sore mouth.....

"(per Val)Tryplase are capsules and mus tbe opened and sprinkled on food... Rate for my EPI dog  (a German Shepherd dog) is 1Tryplase capsule sprinkled on 12oz raw... pre-digest 40 mins for best results. Iuse 1 1/2 capsules on 7oz Bakers soaked until soft...pre-digest 40 minutes for best results"

I am in the middle of cooking dinner, so i can't stay on line too long right now (i'll get back on later)... but i just wanted to get this information to you right away in case you were in the middle of fixing Maisy her meal

Oh one more thing... make sure the food is slightly warm or room temperature. DO NOT microwave the food or cook it with the enzymes in it. Enzymes are destroyed if in food that is too hot or too cold.

Hi,

Just popped in here & saw that you & Maisy are new.  A very warm welcome to our forum. 

I see you have already been welcomed by Olesia & given some great advice.

I'm in Australia, so am not familiar with your enzymes or food but many others are & I'm sure they'll pop in

here soon.

Again welcome.

Lynn & girls.

Hi again ...is your name Lucy ?

Anyway... i am "guessing" that 3 Tryplase should probably be about right for a border terrier. If not, you can always increase or decrease, depending on Maisy's reaction.

WHen you have an EPI dog there are 4 things that need to be managed, or rather, that you need to find the right balance for:

1.Treating each meal with ENZYMES

2. Treating for SIBO (small intestinal bacterial overgrowth) with the proper antibiotics

3. Treating  B12 Deficiency

4. Adjusting the DIET to mostly no or low grain food. Minimizing fat % is appropriate at the beginning of trating EPI, (especially is SIBO is really bad) but fat should be introduced back into the diet when the dog appears to be doing well.)

Looking forward to hearing more about you and Maisy!

Thanks for the advise. When you say I need to incubate the enzymes on the food..what does this mean ? I am putting Maisy's food in a tub (the food is indoors so hopefully the correct temp) She is having 2/3 of her meal at breakfast so I sprinkle on 2 capsules, mix it in, put a lid on and then leave for 40 mins - is this the correct action ? 

hi this is correct i used tryplase i also used chappie and my dog loved it

Hi:

Welcome to the forum, I'm very glad you've found us. It sounds as if you have gotten a very good start and now have been given some great information. To incubate the food, simply means to let it sit for a period of time so that the enzymes work on the food. A good starting place is 20 minutes for most enzymes, but each dog is different in what works best for them, and from what I understand 40 minutes is the suggested amount of time for this particular enzyme. I'm not personally familiar with the enzymes you're using, and with most adding water helps but maybe you're not supposed to with this one??? I'm sure Debra will be checking in soon, and I believe that she's used Tryplase so she'll be able to add more any information at that time and Kelly has used it as well I see, so I'm sure that between the two of them, they can help a great deal.

Please feel free to post pictures...we all love to see critterkids.

Linda at 10:21AM on Mar 04, 2010

Hi:

Welcome to the forum, I'm very glad you've found us. It sounds as if you have gotten a very good start and now have been given some great information. To incubate the food, simply means to let it sit for a period of time so that the enzymes work on the food. A good starting place is 20 minutes for most enzymes, but each dog is different in what works best for them, and from what I understand 40 minutes is the suggested amount of time for this particular enzyme. I'm not personally familiar with the enzymes you're using, and with most adding water helps but maybe you're not supposed to with this one??? I'm sure Debra will be checking in soon, and I believe that she's used Tryplase so she'll be able to add more any information at that time and Kelly has used it as well I see, so I'm sure that between the two of them, they can help a great deal.

 

Please feel free to post pictures...we all love to see critterkids.

I did try to put a picture on but for some reason it wouldn't upload.

Hi Lucy and Maisy,

Yep, it sounds like you are doing fine with how you are preparing the food . Whenwe say incubate byt that we meanto just let it sit ...with Tryplase, sit for 30-40 minutes... before serving. 

Regarding pictures. Load your pictures on the http://photobucket.com/

Once your photo is loaded onto photobucket... select the "direct link"

Copy it and then in your "post a quick reply" on the EPI FORUM.... while in your message box, click on the little blue box in the tool bar, and when it opens, paste that photobucket direct link to the picture you want to include in your message.

Looking forward to seeing pics of Daisy.

Maisey is on a diet of just Chappie for her EPI. Does anyone know if they have ever used this diet if this is enough on it's own or do I need to add anything. The vet told me to feed her the quantities of a 6kg dog. This only amounts to one 412g tin day. It doesn't seem to look much ? It seems easier to feed wet tin food to mix and incubate her enzyme.

Hi Lucy,

I'm unfarmiliar with chappie, but I'm assuming it's a canned dog foor?  Hopefully one of our UK members will set me strait!  Anyway, when usually when an EPI dog is started on enzyme therapy, the food (as well as the enzymes as they are proportionate to food) are increased to try to put some weight back on the dog.

HI Lucy~

I checked on the internet the Chappie food that I think you are feeding Maisy. It has Chicken, Fish and cereal in it with vitamins.

NORMALLY i would say, cereal is not good... HOWEVER, i strongly suspect this food is "Hydrolyzed" because it claims it is "easily digestable"....which means they process the stuff an EPI dog cannot have (grains & fiber) in such a way that the dog can eat it and do well.  This is what should be happening.

Is Maisy doing well on this food? If so stay with it..... for now........ If not... Then you will need to look for a different food and we can help you with that.

However, Donna is correct... with a newly diagnosed EPI dog, because their bodies have been starved from getting the nutrients that they need, you should do two things for now until Daisy gains back most of her weight or starts to refuse some food:

• Feed 150% of whatever the daily requirement to Daisy
• Feed her smaller portions BUT feed her more meals a day

Also..... the food you are feeding her is low in fat. That is okay for now, but she is going to need some fat in her diet.

After she is on this food for a few weeks and IF she seems to be doing well.... what we recommend is start introducing a little more fat to her diet ... and IF she can tolerate it now that she is getting enzymes, then give her normal amounts of fat as any dog would get.

In the meantime.... wait a week or two.... but if you want to, try giving her a tiny bit of wild salmon oil (or you can try giving her coconut oil) ... just a wee bit...see if she can tolerate it. THis will keep her skin and hair healthy and give her a certain kind of fat that she should be able to digest now.   However, If she gets diarrhea.... stopthe salmon oil and/or coconut oil.

Lucy,

Is Maisy getting any antibiotics for SIBO... does she have any gas or a grumbling stomach.. or is her poop rather yellow looking?

Also... did the vet check to see if she has a B12 Deficiency (this is done with the dog fasting and a blood test)

The reason why I am asking is because these two secondary conditions accompany EPI about 50-70% of the time... and if you don't fix everything all together... the dog never seems to really get completely better .......

epi4dogs at 10:21AM on Mar 05, 2010

Lucy,

Is Maisy getting any antibiotics for SIBO... does she have any gas or a grumbling stomach.. or is her poop rather yellow looking?

Also... did the vet check to see if she has a B12 Deficiency (this is done with the dog fasting and a blood test)

The reason why I am asking is because these two secondary conditions accompany EPI about 50-70% of the time... and if you don't fix everything all together... the dog never seems to really get completely better .......

Maisy had all the bloods done and everything else was fine. Her b12 was was good as well. We have only been on the Chappie since Tuesday so we won't be able to see if she is putting on weight for a couple of weeks. I did read about giving her 150% of her normal diet but the vet said if she is over fed it will just turn to fat. 

Phew... that is great news that she doesn't have SIBO and that her B12 is fine!!! WOW... Maisy is a lucky girl!!!

I can understand what your vet is saying but, at the beginning of treating EPI, giving them 150% is not a problem at all.

Once they gain back the weight they have lost (or if they start turning their nose up at the extra meal) then you can stop giving the extra amount of food because that is when they no longer need it. The sooner their body is replenished, the quicker they recover.

To put is simply...... it is okay to feed an EPI dog 150% for a little while (temporarily) ... but it is your choice. You ahve to do what you are comfortable doing for Daisy.

Would you believe it, Maisey stole and ate half a large piece of cheese out of the shopping when I took my eye off her this evening ! I suppose these are the problems with EPI dogs.

Hi Lucy,

Yeah, EPI dogs are great counter surfers...I've read stories here and elsewhere about dogs stealing whole roasted chickens, loaves of bread, an entire roast beef...The bottom line is that they are starving. Which is why they are usually fed more in the beginning...I don't think you'd have to worry about Maisy becoming fat for a while...She's just trying to restore the reserves her body has lost due to EPI depriving her of them.

Hi Lucy, I have posted a reply on the page where I put my first post abouit Tryplase, hope it helps, there are several prescription foods that are specific to EPI available in the UK, Hills ID, Purina EN, Royal Canine intestine and Eukanuba intestinal formula.   Although prescription I have managed to buy them off the internet without needing a prescription and saving around £8.00 per tray of food.    Each dog is different and with Gunner it is very much trial and error to see which food suits them best, Gunner has put weight back on with Hills ZD but this is not specific to EPI hence we are trying others, so far without success as he is losing weight and going backwards so back on ZD, so the only thing I can say is if Maisey is doing well on the Chappie then its a great start, the only thing she made need is some suppliements once she is stable as Chappie is not fortified with anything.   Hills,Eukanuba, Purina and Royal Canine all have websites that give you info on the food.

Gunner and Hayley x

Hi Lucy I should have added that I give Gunner wet (tinned food) with dry kibble mixed in,  Gunner should weigh around 15kg, the weight he was before becoming ill,  he has a quarter tin of wet food Hills ZD (which I mix the Trypase into, and then I add 125 g of Hills ZD kibble.  I have found this fills Gunner up more than just the wet food, and also it makes him eat slower as he has to chew, the wet food was gone in seconds, now he takes his time and chews the kibble and its lovely to hear him crunching again, before he just slurped and it was gone,  Gunner is permanently hungry so i have upped his amount of food, which I split into two meals.  Hx 

HI Haley ~

Excellent suggestions for Lucy,. Thanks so much for chiming in.

Hopefully Gunner will start to put weight on soon................keep us posted on him!