EPI * Exocrine Pancreatic Insufficiency

Hi, Some of you may know CC (female boxer) and me from the Epi forum. CC has been stable with her EPI for a few years now. Last month she had some issues where she would throw up and wouldn't eat. After running a CBC blood panel, eh determined that she had a bleeding ulcer. She was treated and her bloodwork improved. But now she will not eat. She will try, she is hungry. but if she does she throws is up.She  is down to about 40 lbs. Friday, I had her at a specialist. She ran more bloodwork and is running a preliminary test for Addison's. She also took x-rays that showed no blockage or growths. First CC would not eat her enzyme treated food, and she would eat cooked chicken, so I have Creon and I thought that was the answer. Yesterday, she had 2 small meals (starting small since her stomach has shrunk so much). and she didn't throw anything up. I thought things were turning around. This morning she had her Sucraflate and threw it up. Now she doesn't want to eat her chicken. I tried again, she ate a few piecs and she has thrown them up. The specialist mentioned in passing, Esophagitis, but I don't think CC would do well at this point under anethesia. Is there anyone out there that there baby has Esophagitis or even Addison's. Are any of these symptoms something you've been thru? CC is on Sucraflate, Cerion (sp) Famotidine, Metro, Soloxine.

She also has this licking thing going on sometimes like she's trying to lick something from the roof of her mouth. I've looked and don't see anything. Could her throat just be so irritated that she will eat once, then her throat hurts, then she wont' eat again? Several members on the Epi group have been SO helpful, and I do appreciate everyone, I'm just looking for more thoughts on this. Tomorrow I will call the specialist back, but I'm afraid she's not finding anything.

Renee and CC

Hi Renee.  I am sorry you are going thru this still. I was hoping the specialist could have found something.  Did you get the sibo results back yet?  I just looked up esophigitis.  It is a possibilitiy.  I think Donna? has dealt w/ Addisons'.  Not 100% sure.  I don't know what else to say at this point.  But get back into the specialist.  Good luck, and again, keep me posted.  And if it is suggested, my thought would be to have the scope done, even though that would be scary for you.  They need to find out what is going on to help her and you both.  Again, I'm sorry you are still going thru this.

Thanks for replying. Her SIBO came back ok, but she is still on Metro anyway. I do worry about all these meds going down her throat on an empty stomach.  She just tried to eat  a couple of pieces of chicken breast. She's trying  to eat it but her tongue is pushing it back out. It seems that now she is having trouble swallowing it.  Same with water, she's not drinking as much.I felt around her throat (outside) and their could be a small bump in there. I felt my other boxers and didn't feel it, but they are more meaty than her. Tomorrow I'm going to ask for the endoscope, hopefully her vet's clinic can do it, I think it will be cheaper than the specialist.... 

renee and CC

Ahh Renee, I am so SO sorry to hear that CC is going through this. Poor thing. She is such a sweetie!

If I understand it correctly, the drugs that CC needs to be on for the bleeding ulcers can lower her B12 levels..low B12 levels can cause some of the symptoms you are describing. I don't know if this is what is going on but maybe it would be worth a try.... it wouldn't hurt to give her some B12 (Metagenics Intrinsi B12/Folate pills) or the B12 injections....(not sure if she is on B12 regimen or not).

I feel so bad for you...once they are afraid to eat, that is SO hard to deal with and get them back on track....

Hmmmmmmmmm... trouble swallowing????  I think I would call  the vet.

Is there any way you can make the chicken into like mushy so she can lap it up and see if she can do that?  I think others here have use pedialyte also so they don't get dehydrated. 

We tried yogurt, which she usually loves, but she wouldn't try. She quit eating mushy foods a few days ago. That's when we got Creon, she ate those 2 small meals (chicken breast) yesterday with the Creon and didn't throw it up, I can't figure this out..

Hi Renee:

I don't know a great deal about Esophagitis, other than what I just looked up because of your post, except where acid reflus occurs or there is a hiatal hernia.  I do know that there's been some success in using gastric acid inhibitors and a regime of antibiotics.  Chest X-rays can be done to evaluate the esophagus, in case something like megaesophagus present and if it is, it's often secondary to Myasthenia Gravis, Thyroid, Addisons or other Neurological disorders.  Karen is right,  Donna has experience with Mega so she can maybe offer some thoughts when she checks in.  Please keep us posted...and in the meantime, do whatever you can to keep her hydrated.  Pedialyte is a good choice and you can get the unflavored variety so it's more appealing.  We also have a recipe for it listed somewhere here.  If you can't find it, let me know and I'll see if I can find it.  Keeping my fingers crossed that you can find answers quickly and get her back on track.  I'm sure she's feeling miserable and I know this is horrible for you. 

Hi Renee,

Busy day and my first chance to log in here...While I have never heard of Esophagitis, I'm wondering if you're referring to Mega-Esophogus??? Mega-E would show up in an xray (at least Tess' did) and the first clue is usually an aspiration phenomonia as the food they are trying to eat ends up in the lungs.

Nope, thankfully I've never had a dog with Addison's, but my understanding is that it is the complete opposite of Cushinng's disease (which I have dealt with) in that the pituitory or adrenal gland does not produce enough cortisol... I have know a few Addisionian dogs and the first symtom, besides vomitting is shaking...

I agree with everyone here, you may be best off with an emergency vet right now...

She has been drinking" some today," just not a lot. It seems like she's not drinking because it hurts her throat or tongue/ Yesterday she drank a lot and also ate 2 small meals. She does have a thryroid problem that showed up in the blood work, but she was just started on her meds Saturday.. I'm not shoving any more pills down her throat until I see the vet.  tomorrow. even the sucraflate she is throwing up

Hi Renee,

Licking things, like the tile floor, the walls, and smacking of lips is generally the sign of an upset GI...This is what brought me to the GI specialist with Zeke, who has IBD. Yup, even water doesn't go down well. Hopefully your endoscopy will help iron things out in terms of treatment options.

I would definately keep up the antacids as they cannot hurt, IMHO

well, come to find out, she isn't having trouble drinking. I just gave her some of the chicken broth from when I had her chicken in the crock pot. She drank it like nothing was wrong. the water she doesn't want. she also just ate an ice cube which she's always loved. Hopefully the vet her will be able to do an endoscope tomorrow.  i will withhold drinks after 10 tonight. 

Olesia, they did a recheck of her Cobalamine and Folate. It was ok, I did just give her a b-12 earlier shot this week.

do you ever have the feeling that the specialist has a pretty darned good idea what it is, but is running EVERY test for the $$$$ .

It's been 20 minutes, and she hasn't thrown the broth/water mix  up. hopefully that will make her feel better. I only gave her a little . My daughter just came by and CC wanted to go for a car ride! I think she thought they could go get something to eat. She's still sniffing the other dogs bowls...

Hi Renee,

One thing that Addisonian dogs cannot process real well is sodium. Of the dogs I know who are addisonian, salt (sodium) needs to be added to their diet...Hmmmm....Broth???

Please do keep us informed as to what your GI doc tells you!!!

she did just throw it up. I'm sorry for posting these little updates, but I know that the sequence and time frame of what she does has some significance, I just don't know what?  I have kept a detailed log over the weekend for the specialist.. One thing that she was asking me was when she threw up if she just threw up quickly or if she had that jerking thing going on right before. (like when a child cries and does the thrusting of the stomach) well, she just throws up, so I don't know what that means...

Yes, I was thinking about the salt content when I gave it to her and the grease. But wanted to see if she was "able" to drink something. I did only give her a about 3 ounces mixed with water. She would have kept lapping if I would have gave her more.

Hey Renee,

Please don't EVER feel sorry for posting anything here!!! We all know the terror of not having a well dog!! I happen to be here and I care a bunch about all dogs!  I'm wondering about her desire for sodium, but again, I'm not a vet...

Again, PLEASE keep us posted on what you find out tomorrow!!!!  CC will be in my prayers tonight.

thank you

Hi Renee~

Just checking in on you and CC.... I have to echo what Donna said, please don't ever feel bad about posting here... no matter what or how many times.That is why we are here... to lend support to one another, even if we don't have the answers.

I am so SO sorry CC is going through all this.

But glad to hear that the B12 is okay at this point. Just keep in mind  that peptic meds can cause B12 deficiency... sometimes folks forget this and scramble to find out what in the world is going on.

As others recommended, Pedialyte is an excellent suggestion to avoid dehydration until the vet can see CC.

The home-made recipe is:

7 tbsp sugar

1 tsp salt

1 tsp baking soda

2 quarts water

Please keep us posted on what the vet says tomorrow. WIll say a little prayer for CC tonight!

Everyone.... this is CC: