EPI * Exocrine Pancreatic Insufficiency

Hey all, i've not been around for awhile - hope your all well?

Daisy was doing really well on the enzymes - so well infact she put a whole Kg on in a few months and got to be 15.3kg instead of the 14.27kg she was.

However for the past 6 weeks she hasn't been responding at all - i haven't changed anything in her diet nor has the brand of dog food changed after a phone call to them.

We've tried increasing the enzymes we've tried decreasing them - she tried different enzymes that made her worse. Shes started on B12 injections and has had 2 lots of anti-biotics - nothing is working.

Her weight today is 14.1kg

I really don't know what to do now and our vet has been reasearching to no avail. She has no idea what to do next.

Me and my husband have no idea what to do for the best. 

Does anyone have any ideas?   I'm honestly getting to point where this is turning into a huge battle and i feel like i'm not going to win.

Is she eating?   What do her poops look like?   Can you describe what you mean by "she hasn't been responding at all"...

Very sorry to hear this...hopefully the beautiful people here can help...

Ahh Mandy, i am so sorry  to hear this.. but like Michele said....... we need more details  of what you are seeing.... the poops... how often what do they look like, how often. mushy hard, color?  is she eating everything or losing her appetite... is she burping, gagging, vomiting anything??? listless, gassy

this will help us better understand what might be going on.......

It could be SIBO kicking in and the anti's need to be changed or doubled

it could be that she is not holding B12 even with teh injections and might need B12 supplements to hold her until the injections

It could be that she has developed a food sensitivity and that is what is causing all the issues..

it could be so many other things..............*sigh* .................

you have kind of ruled out any enzyme issue.... so the above is what jumps to mind for now...... but still not sure until we have more details....what antis are being given... for how long.... how often has she been receiving the b12.... etc.

waiting for you to write back..........

Yes indeedy as many details as possible, poop quality (feel free to post a picture here), diet, meal frequency anything you can think of. Better still if you've been keeping a diary or EPI log now is when it can come in handy seeing patterns etc. If not you can download a template here . 

My first thought is SIBO but that's our experience with Lulu talking. Like Olesia said it could be many things. I'm often amazed at the depth of knowledge and experience on these forums so chin up! with a few more details there's a good chance you'll get pointed in the right direction.

Craig

Hello Mandy,

Sorry to hear of your recent problems with Daisy... I can hear the distress in your post... but hopefully with a few more details from you, some folk here will have a few ideas that can maybe help.   She was doing so well earlier this year until I think back in May you indicated she started some vomiting and you were unsure what was causing that (thought UTI maybe).  Has she still been vomiting?  If so, is their undigested food in it or just empty bile?  

HI Mandy,

Sorry to hear Dasiy isn't doing well, but we really do need more information....Can you tell us a bit more?

Hugs to you,

I'm very anxious to hear more about your babe. Everyone here is so helpful, and some have had years of knowledge after dealing with their own pups. Without these fabulous people on this forum, my Bella would probably not be here today.

I hope all is well. Thinking of you!

Hi Mandy,

It is frustrating to feel like things are not working.  If you can give as much information as possible about the food, antibiotics and poos, there are so many good people here to help you.  The journal/log entries are really helpful.  I have been keeping one since  before Kolby was diagnosed and it can give you so many pointers when you look at the information and patterns that may emerge.

Pleas keep us posted.

Barb

Hey,

she is still eating - her poops are completely solid and dark as they should be - but shes ocasionally vomitting (this seems to happen if i leave it longer than 6 hours between feeds - she now gets fed small meals every 4 hours and 6 hours on a night)

I guess she is reacting to the enzymes its just for some reason shes losing weight again and losing it quickly. Shes showing no signs of SIBO.

I'm not sure whats going on - she was putting so much weight on and now shes lost it all and i dont understand why.

She was on oxcy something for antibiotics - sorry cant find my receits at the moment, i'll have a look for them in a second.

Shes been having b12 injections since she started losing weight which was 6 weeks ago - shes having them weekly - shes also been having vetzyme b&e vitamins since March.

Shes currently going to the loo twice a day and they look perfectly "stable" dark and solid.

Vets are now thinking of steroids - would these help?

oh and in herself she seems fine - still playful doesn't look poorly at all, no burping from either end, she just seems happy.

Hi Mandy...It very well could be the B12.  Some dogs, like my Tara, will need to be on it for life.  She's only ever had one setback where she lost weight and it was because I was giving her expired B12.

As to the vomiting, can you ask the vet about using antacids?  I still occasionally have to give Tara Pepcid AC.  Here we have Tagament and Plilosec also.

So if i keep her on the weekly B12 she should eventually start gaining weight?

Is the B12 the generic B12 - not the multivatimin?    

HI Mandy,

Tara dropped like 10 pounds on me, but yes, she did gain it back and then some!!!  I give her a shot a month and it works for us!!!!

I should also have mentioned that we had to restart the B12 protocol first weekly, then bi-weekly to monthly...That was a few years ago, I think and we are now doing fine on monthly injections.

HI Mandy~

My thought is "YES" to have the vet try steriods... ask her if she can do "short-term" steroids... The reason why i am saying this is not becaus i have any expereince with this but because Daisy's case sound strikingly similar to another EPI case we had here on the FORUM. Onza.

It was a combination of things that helped....additional B12 finally helped Onza  vomiting become greatly reduced... but... what stopped it completely was that the vet put Onza on ":short-term steriods"  that completely fixed the problem (weight loss and regurgitating/vomiting) and has been fine every since.

And it sounds very similar.... same food, enzymes were fine, they tried Pecid AC, pumpkin, smaller portions, no activity after meals etc... all these efforts "helped" but didn't completely fix things until they did the "short-term steroids".

Please feel free to share this with your vet, let us know what she thinks  and  please keep us posted.

Ok i will definately give steroids a go.

The one thing that pops into my mind, since you have been doing the B12 since this started, and doing them weekly, is SIBO.  Sometimes the only sign can be weight loss.  Here are a couple of links.  Maybe a longer term anti (don't know how long you did them for) and/or a different type.  Along w/ the B12, maybe you will start to see some improvements.  I know of another case like this, which is why I thought it. http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2002&PID=2580&Category=414

 http://www.upei.ca/~cidd/Diseases/GI%20disorders/small%20intestinal%20bacterial%20overgrowth.htm

Both of these articles do mention weight loss alone. (1 is failure to gain)  Maybe print these out and share w/ your vet?  Just another thought.  Also, not sure if it would help, but possilby an ultrasound or Xray to rule anything else out?  When is the last time the B12 and folate were tested?

Hi again, Mandy.  Forgot to add, SIBO can and does cause throwing up in some dogs.  Many of us going through the SIBO have noticed it.  It can be the first sign, or the last, but for many of us, it has been there.