EPI * Exocrine Pancreatic Insufficiency

Hello everyone.   Have a rescue dog just diagnosed with EPI.  What is the best food you have found and what are the best treats?  Thank you!

Hi there!    Best foods are 100% grain free foods and NO treats until stable (approx 3 mos of good poops).   Here is a link which details some of the foods used - scroll down on the link  http://www.epi4dogs.com/dogfoodoptions.htm

Please keep in mind that treating EPI is more than just finding the right food.   It is using the proper enzymes (and amt), it is treating SIBO which is often present (Tylan used) and it is generic B12 shots.    

Best wishes!   Any further questions, pls ask...

Thanks so much for the information!  We have the enzyme powder to sprinkle.  We are using Royal Canin LF food.  We have heard conflicting information on whether the food should be low fat or not.

Some have had success with that food and others not - it's a matter of finding a food that agrees with your specific dog.  It took me approx. 4 foods before I found one that REALLY agreed with Jackie.   What kind of enzymes are you using?  Recommended dosing is 1tsp per C food.    When you sprinkle - are you wetting it slightly and letting it incubate for approx. 20 mins?   Otherwise pup may develop mouth sores.   I'll let the experts chime in with the technical facts, but new data shows low fat is not necessary.

Scroll down on this link to Detailed Effective Management - lots of great info!!   http://www.epi4dogs.com/

Hi,

As Michele mentioned, grain free seems to suit EPI dogs the best.  Some folks have also done ok with some of veterinary diets too.  It really depends on the dog.  My dog only does really well on one food, Natural Balance Fish and Sweet Potato.  I have tried a variety of others, but she just doesn't not do as well (she has had EPI for 8 years). 

What food are you feeding now?  What enzymes and how much?

If you can give some more details, we can help a bit better in pointing you in the right direction. 

And also, I forgot to say 'welcome' to you and your dog.  Lots of great info and great people here, don't be afraid to ask lots of questions. 

Lisa

Hi and welcome.

The food you are using is not what is recommended for EPI dogs. Most do better on a no grain food and the one you are using has rice, ground wheat and corn gluten meal. The enzymes actually work better with a higher fat food. Finding the right food can be a challenge for some dogs, mine does well on many different ones. As Michele mentioned, no treats, everything the pup eats has to have enzymes, no exceptions until stabilized.

Hi Jen and a very warm welcome to you.

EPI dogs tend to do better on food with no grain, or another way to put it is food that has very little poorly-digestible fiber.. or if the EPI dog also has food sensitivies THEN some of the prescription "hydrolyzed" foods seem to work best (this is where they process the food to the point where they break the proteins down and the body no longer recognizes the protein so the dog will not have a negative reaction to foods that it cannot tolerate.

Fiber (such as what is found in corn, wheat, rice, etc, etc)...inhibits pancreatic lipase activity by more than 50%. THis lipase enzyme is what the dog needs to digest fats.  Restricting fat in the diet is not advised anymore.... for two reasons: (1) fat doesn't need to be restricted if the dog is receiving the proper enzymes--the replacement enzymes processes the fat (2) fat actually aids the enzymes in the replacement enzyme to digest the food better.

SOoooo long story short.... there are many variables with the food, but what seems to work best is grain-free.

THese dogs may also differ widely from which brand of no-grain food works best with whom... but overall.... on the forum, we noticed that Taste of the WIld seems to suit many of these EPI dogs... Taste of the Wild is a middle ofthe road grain free (you can buy this at feed stores and places like Petco) food and the cost is not over the toip like some of the grain free foods are. If you have to be economical, Costco carries a grain-free brand called  Nature's Domain that also seems to work well with many of these dogs.

Treats are a no-no until the dog is stable. WHen we say stable that means the dog has been delivering normal looking poo (just think of a tootsie roll !) for about 2-3 months.... and then you can try "cheating" with a treat.... somedogs can handle treats, while others cannot.... we suggest when you get to this point to give the "treat" near a meal... Best to stick with high protein treats like freeze dried liver. WHen you get your rescue to the stable point... post for a recipe... many folks make their own and will gladly share what they do with you.

Is the dog on antibiotics? 100% of all dogs when diagnosed with EPI have SIBO also...the theory is that once the dog starts receiving enzymes that the enzymes will correct the imbalance in the gut flora and the SIBO will diminish and go away.....unfortunately..... this usually dosen't happen.......and the dog needs antibiotics ...for 30-45 days to start with. Tylan is the drug of choice. TYlan can be purchased thru your vet, at a feed store or thru Amazon.com.

THen there is the B12... 82% of all EPI dogs have insufficient B12 and need to be placed on a B12 regimen.... once the B12 levels come up... thne this just has to be maintained periodically. Generic B12 injections are recommended....B12 pills from the drugstore don't work. If you cannot get the B12 injections, then you can use special B12 pills with the intrinsic factor in them .. but we strongly recommend doing the injections first to get the dog's B12 levels to the right place...... and then if you want to "try" switching to wonderlab "Trinfac" pills  you can try them at a later date. 

One of the best tools to managing EPI is to keep an EPI log. You can download one (free) from the download page.  THis will help you notice trends and what is or is not working for the dog.

Hope this helps a little.

Food... We use Natural Balance Venision and Sweet Potato ....both dogs we have love it and their coats are beautiful.  Possibily you may want to try this food. Best of Luck and pray for your dog and you. 

Hello, Welcome to you and your pup.....lovely of you to rescue...

You have been given excellent advice so far.  There are a lot of people here to help you through the EPI treatment.  It is a manageable condition, but a balancing act as you have probably already discovered.   Each dog is different in how she or he responds, which is why you will get many suggestions as to what can work. 

One of the best suggestions I received when I first got here was to write everything down, either on one of the log downloads from the top of the page or in a notebook.   Keep track of everything you give your dog --the amount of food,  enzymes, antibiotics, and B12.    Also record how many poops a day and what they look like (I know, this is the only place that will actually ask you for pictures of poop!) All this information will help you to find out what works for your pup and what causes problems. 

We invite you to ask any questions you have.  The people here are knowledgeable and generous with their knowledge.   Each person  remembers what it is like to be where you are, so try not to feel overwhelmed.   You love your dog and you want to help him back to health.  You have already shown that by coming here.

Let us know how your pup is doing.

Barb

Hello and Welcome to the Forum

You have been given tons of great advice already on EPI.... so besides "welcome" all I have to add is  "thank you for being involved with rescue"!

I just want to give an extra special THANK YOU to Jen who is the rescue lady / caregiver for Rilind, the rescue dog for this thread. This is Rilind.... and thank you from the bottom of my heart Jen, for opening up your home and your heart to RIlind. (with permission from Jen):

If anyone would like to follow Rilind's story, Jen has set up a Facebook page:

http://www.facebook.com/pages/Rilind-Reborn/323392057681786?sk=info

Oh great heavens... Jen you are a lovely person for taking this dog into your heart.

I can't add much to the advice you have been given... so WELCOME from UK.

The only thing I can offer and you probably know this already is to feed as many small meals as you can.... all with enzyme pre-digested (incubated) in it.

You can do a larger amount and put the right enzymes in it.. let it stand for 20 to 45 mins (you will find the best time for your baby) then put it in the fridge and take out as much as he wants and warm to room temp by standing in warm water. That way he can eat a small amount every couple of hours and it will be easier on his gut.

I hope you all the best with this baby.

Val

hello Jen

we are from the UK too

for once i am stumped for words!!!!!!!!!!!!!

i have just looked at your facebook pictures and cried i am a total wuss

you are one special person to have taken this on and we welcome you here with open arms 

the one thing to remember is the before and after pictures at the top of the forum and the journey these dogs have made

anyway i have only a small piece of advice

deep breath,keep a diary of everything you do and keep us up to date with pictures and results

jeanxxxxx

Okay.... what happened to Rilind is really bothering me.....this is right up there with some of the worst EPI cases that i have ever seen.  The pitsisters.org rescue org, who are sponsoring Rilind right now have not asked for help.... but I am asking. If anyone would like to make a contribution in Rilind's behalf..to help with the expenses, please do so (this following was posted on his FB page):

"If you are able to donate to his care, you can do so directly to Lakewood San Jose Animal Hospital (904) 737-2011 or via PayPal from the link on the website www.pitsisters.org. Please follow Pit Sisters on Facebook to follow Rilind's progress."

This is Rilind's story (from his FB page)

Location: Jacksonville, FL

Update : Rilind was diagnosed with EPI, a pancreatic disorder. He is now on special food and enzyme supplement that should help him start gaining weight very soon.BiographyRilind's name appropriately means rebirth or reincarnation. He has earned this name as he has begun the long road to recovery. This poor boy was literally at death's doorstep before Pit Sisters rescue stepped in to save him. What we know about this boy is he was seen by shelter workers being tossed over the fence like garbage. Shelter volunteers voiced their extreme concern for this boy's life and their pleas finally made it to Jennifer Watson, founder of Pit Sisters Rescue in Jacksonville, Florida. She had no idea the condition she would find this pup in was so severe. The pictures prepared no one for what they were about to see. Through tears and prayers Jen and helpers rushed him to the vet. He was covered in urine, feces and fleas. Every single bone of his skeleton was visible. It was all he could manage to lift his head and give Jen one single, solitary kiss showing his appreciation. The staff at Lakewood San Jose Animal Hospital had never seen such an extreme case of neglect and abuse. Rilind's temperature was so low it would not register, his gums were completely white and his red blood cell count frighteningly low. Dr. Morley advised that Rilind immediately undergo a blood transfusion. Jen knew the perfect donor; one of Pit Sisters' own rescue pups, Alta, who coincidentally was being boarded at the same vet awaiting her new home. Alta was eager to do her part to help Rilind.

The blood transfusion appears to have been successful although Rilind's red blood cell count is still less than half of what it should be. He has a moderate to severe case of heartworms. Due to his extreme condition it is unknown whether his hair loss can be attributed to a skin ailment or if it's due to malnutrition.

The mounting cost of vet bills for Rilind is crippling for the newly-formed Pitbull rescue based in Jacksonville, Florida. If you are able to donate to his care, you can do so directly to Lakewood San Jose Animal Hospital (904) 737-2011 or via PayPal from the link on the website www.pitsisters.org. Please follow Pit Sisters on Facebook to follow Rilind's progress. — with Kimmie Johnston and Kathy McDonnell.Personal InterestsFOOD, Pit Sisters, SunshineWebsitehttp://www.pitsisters.org

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http/www.facebook.com/media/set/?set=a.323410764346582.78188.323392057681786&type=1#!/photo.php?fbid=323410774346581&set=a.323410764346582.78188.323392057681786&type=3

just incase you have not seen this

i am so angry!!!!!!!!!!!!!!!!!!!!!!!!!!!

this is the worst case of anything i have seen

will you keep him????

jxxx

Angry is right Jean......I read this last night and literally had nightmares!!!  Kudos to everyone helping Rilind   !!!!

This is heartbreaking. My heart goes out to that poor dog. I just hope they can get him on track quickly.

Gillian x

Oh dear oh dear, what a poor little mite but a big heartfelt thank you from the other side of the world for showing the way with your compassion and hard work! Look forward to seeing the 'after' pictures in the not-too-distant future!

Like Jean, I am at a loss for words.  That photo is beyond comprehension.  Amazing how he can fight on against all odds---his heart and will to live must be immense.  Thank you thank you to his rescue angels.

Lisa