EPI * Exocrine Pancreatic Insufficiency

Welcome Marilyn!  You posted on a couple other threads looking for help so I thought maybe if I started a new thread for you and copy/pasted some of your other posts that it might help out

My Ruby 1 year old rough collie has EPI just recently diagnosed. TLI test 2.0 Tried her on Viokase next day great stool I was amazed. Gave her 2 tsp to 2 cups of kibble. However, a day and a half her mouth is pink around her lips. Could she be allergic to the powder substance or is it the hog stuff??? A little bile or water is being throw up not too much really. Stracthing here ears. She doesn't want the food Viokase on it and backs away and barks. She never does that when she doesn't like her food. Found out Viokase is not FDA approved since 2010 yet still being sold and on the shelves until it runs out...I spoke with the company that makes it.

QUESTION: I would like to consider starting her on Creon but my vet does not know much at all about this disease. And is trying to find out how much to give ladeedaaa. Anyway, I read some comments here and think that Creon capsules10 might be a good place to start.

Ruby and I would be very grateful for any help you can give us. Bow Wow Bow Wow folks.

From Becky-

Hello Marilyn - Welcome to the Forum.  Sorry to hear Ruby has been diagnosed with EPI.  Glad you were able to dig around on the Forum and find this old thread with information on Creon that may be of help to you.  I think many try starting with Creon 10's.  We did, but eventually ended up with one Creon 25 per meal (2 cups of kibble).   Have you been mixing in a little bit of room temp water with the Viokase and kibble, stirring well and letting it sit for at least 20 minutes?  Some have found letting it sit awhile longer helps with the mouth sores.  If she can drink some water directly after eating to help wash the enzyme residue off the muzzle, it may help.  Also, some have found that adding a little bit of an enticer to the top of the meal right before serving helps jump start pups that dislike the enzymes.

Response from Marilyn-

I finally found all your responses... Thank you thank you I don't feel so alone  I am going to try Ruby on the Tablets since I can not use the poweder..had a reaction very dry mouth, throat hurt..Was told by the Pfizer Animal Health folks not to use it... When I use the tablets I should wear gloves. 

Ruby doesn't like her food much with the powder but she is doing fine on it.. Hope the tablets work just as well.

If not we may go on to Creon.  Seems like alot of you use this ...if it's good for people it must be good for our dogs.

Thanks so much for all your input.  Now I will know how to get back to this spot to see comments again.

From Donna -

Hi Marilyn,

Glad you found your post! I knew you had posted to another, so I knew it wasn't an introduction...You sometimes have to go into second and third pages if it's been busy here and you haven't been here in a few days.

While there are a few folks here that are able to use the tablets, they are very few and far between AND they crush their pills to make a powder.  If you cannot use the powder, I would suggest Creon, or pilling her the powder in capsules before a meal.  Are you soaking the food and letting it sit for 20-30 minutes in the powder before feeding?  This is needed to lessen the chances of mouth ulceration.

From Marilyn -

Yes, I added room temp water with the Viokase and kibble stirring sitting the whole deal.  I wipe her mouth off with plain water and it helps with any reddness. Viokase worked for her in one days time.  However, I can't handle the powder form..it makes my throat sore and my mouth very very dry.  Nurse at Pfizer Animal Health contacted me and said to wear gloves and use the tablets instead.  If this doesn't work I will look to using Creon if it is alright for people I would think it will be alright for Ruby.

Thanks for your support and sharing.

From Marilyn -

Hi Donna,

No I was not put off by the smell ...it in fact, made my mouth very very dry and throat sore and tongue tingle.  Pfizer Animal Health said I had a reaction to the powerd...even though I handled it very carefully. 

Right now Ruby is on Viocase-V and is doing well my husband is the one to handle this...however, we will be trying the tablets soon.

Thanks for your care and response....Best to you...and your furbaby....

From Becky -

Hello Marilyn,

I think there are a few that use the tablet form enzymes but have found that to work best they need to be crushed up and treated very similar to the powder form enzymes... hopefully one of them will chime in with details for you.

Since you are having a reaction to handling enzymes, the Creon may be the way to go for you... they are very convenient.   While a human drug they do work for dogs... thankfully so, as it is the only choice for enzymes for dogs in some places like Australia.  The best pricing we have found for it is ordering online from Canadian pharmacies (1/3 the cost compared to here in the US).  It used to be that it only required a prescription in the US and we were able to order online from Canada without a prescription, but regulations changed earlier this year and it now requires a prescription from the vet for us to get it in Canada also.  

If you decide to try them, you could order Creon 10's and see how Ruby does with one per meal. If more is needed you could then increase her dose to two per meal and in subsequent orders purchase Creon 25's.  Good luck and please do let us know what you decide and how she does.

And from Marilyn on another thread-

I am new at this...I can'f find my original post. Dogs name Ruby Posted about 3 days ago.  Any help out there??? Thanks

Okay... all tidied up in one thread... let the help begin

Hello....I don't know if you have seen the threads I have written on about the tablets.  We are one of the few that have successfully used tablets.  We have 2 dogs with epi and both now weigh more than they ever have with good poops!  We do crush them and add the crushed tablets to the kibble with water.  We use one tablet more than cups of food (so 2 cups  food gets 3 tablets)...Ruby may need more or less than this.  Stir when first putting it all together and mix before serving.  I have found 3 crushed tablets is less than 1 tsp. so I think the pups don't notice it as much as the powdered enzymes (which would usually be 2 tsp. for 2 cups of food).  Don't know if you will react to it like you do the powdered enzymes.  Good luck and keep us posted on this thread!

Thanks for than Becky, hopefully Marilyn will happen along soon and see it all in the one spot, I'll bump it up if not.

Marilyn, be sure to keep a written log (you can download one here) and if you need anymore info on Creon let us know...

Craig

HI Marilyn.... welcome to our family .... i will try to find your original posts and write you privately so that you become aware of the fact that we put all your posts in one thread.

Becky... thank you SO much for doing this!!!!!!!!!!!!!!!!!!

Hi Marilyn,

A very warm welcome to you and Ruby.   Once you get everything in balance, you will find that EPI is very manageable, although little blips happen along the way.   Even posting can be confusing! 

I think you may be going the Creon route which others who use it can chime in on, and which sounds to me like a very good choice given your allergic reaction to the powder.  As far as Ruby's reaction goes, it is common for dogs to not like the enzymed food.  Kolby kept giving us heart palpitations every time we would feed him and he would put his nose up in the air and walk away.   He eventually got used to the enzymes and put on 25 pounds over the course of a year since diagnosis.  

He also was the sensitive type who got ulcers, so we ended up incubating his food for a full 45 minutes before giving it to him.  The pink and the ulcers eventually went away from his gums, but we still do a 45 minute soak.   If you go to the Creon, you won't have to worry about it, but I just wanted you to know that some dogs have this reaction and it does go away. 

At the beginning you are dealing with so many issues it is hard to focus on one at a time, but eventually it will get easier.  How are Ruby's poops?  Strange question, I know, but this is the only way we tell what is going on inside our dogs.  We even encourage you to post pictures of poop so we can help you better.   We also encourage you to post pictures of your pup, which we like even better. 

Ask any questions that you can think of.  There are lots of good people here with an enormous amount of experience to share.

Welcome, again and let us know how Ruby is doing.

Barb

Hi Marilyn - welcome to you and Ruby!   When Dexter first came to us he had a red chin (no hair under it) and the rescue group said he was allergic to his food - I felt it was from them not letting the enzymes incubate long enough and sure enough - since we took him in a few mos ago no red chin!   I do no use the Creon but many do so they can give you better advice on that.    Is Ruby on any other supplements/meds?   B12?   Tylan?   anything - just curious...

Again - welcome to you and Ruby and all the best to you guys!

Hi, Marilyn - just a thought, since the Viokase worked so quickly - I know there used to be a member that had to wear a mask to mix the enzymes. Even Enzyme Diane (from whom many of us get our club-priced powdered enzymes) apparently has a reaction (and she handles TONS of it) - so she wears a mask.

Thank you all for your input and sooo caring.  Ruby is doing good on the powder but doesn't really like the food that way. Anyway, her poop is great.  Hope the tablets we ordered will work as well if not it is on to Creon. But, we will take our time.

I have read that sometimes......the pancrease needs some rest and will start to function on its own once again.  I know it may be a long shot but it's worth the hope and prayer.  As for all of you I am glad that things are working out for your dogs.  I will be sharing EPI withing my next newsletter for our organization Have A Heart for Companion Animals, Inc. If there is something special I should share with our readers please let me know.

Thank you for being their for me and each other.     

AK GSD at June 18, 2011 at 5:12 PM

Okay... all tidied up in one thread... let the help begin

I don't really understand why doesn't the tablet work and why does it have to be crushed?  Does it not break down in the dogs system?

AK GSD at June 18, 2011 at 5:11 PM

And from Marilyn on another thread-

I am new at this...I can'f find my original post. Dogs name Ruby Posted about 3 days ago.  Any help out there??? Thanks

Thanks for putting it all together.

Miss Lulupants at June 19, 2011 at 5:56 AM

Thanks for than Becky, hopefully Marilyn will happen along soon and see it all in the one spot, I'll bump it up if not.

Marilyn, be sure to keep a written log (you can download one here) and if you need anymore info on Creon let us know...

Craig

I am keeping a written log on Ruby it is very helpful.  If and when we decide to go with Creon I will post it.  For now we are hoping that the tablet form will work for her since the powdered form work sooo fast for Ruby doo bee.

Thanks for caring and sharing I guess you know not many people or vets are aware of this problem I am going to try and spread the word around where we live. 

Do you really hold a convention ...or was that a joke someone posted????