EPI * Exocrine Pancreatic Insufficiency

Hey everybody, I have a 18month old Beauceron, Fleetwood. He honestly has had issues upon issues upon issues since almost day one, but I can't seem to help him get better. Let's focus on his EPI problem for this post!

Since he was a small puppy, he had loose stools, the ones that are characteristic of EPI (except never abnormally colored.). He didn't vomit much, until he was about 7 months old or so. Then he began vomiting at least weekly. From day one, he was calmer and less energetic than I thought was normal, but not so abnormal that most people would even notice. He still did the things puppies do, but he never got the stamina and energy I thought he would. I always thought something was 'off', but nothing could be found wrong with him.

Last september, He started vomiting one Sunday and couldn’t keep anything down (keep in mind he was eating the same diet he had been on for months, no changes). Within 48 hours, I started him on Hamburger and rice, and he couldn’t keep that down either. I began giving him flagyl and something else, and on Thursday, he was able to eat again. He had lost close to 10lbs. For weeks, he couldn’t keep anything down but hamburger and rice. Vomiting became a daily thing, so I began Tagamet. It didn’t help a whole lot.

A little over a month ago, The dr. did some tests and determined that he has EPI. I don’t remember what tests they were or what the results were, but I can find out if I need to. She gave me PancrePlus, and I started him on it right away. He got even sicker. He seemed to be sensitive to it. I found NaturVet enzymes and probiotics, which are vegetable based, and very low concentrate. Eventually, he got a little better. He used to be vomiting 3-5 times a day, with blood in it. It doesn’t seem like any treats in particular made it worse. Since then, He’s doing better, he’s not vomiting but maybe once or twice a week, and there’s not blood in it when he does. His stools look normal about 75-90% of the time, and the rest it’s diarrhea. He used to be 97lbs, but he’s hovering at 85 now despite eating much more than he’s ‘supposed’ to.

So I’ve started to slowly introduce the PancrePlus back into his diet, with the last couple days, following advice I’ve read here. I’m giving him not even 1/4tsp per 2 cups+ of food, mixing in fish oil and about ¼-1/2 cup water, and letting it sit for 20 mins. He threw up after the first day, but he’s been okay since then. It seems like he might be even more lethargic since I’ve been adding the pancreplus, but it may be my imagination.. I don’t know for sure. I’m going to start using the log I found on this site. So far no horrific side effects, at least. He’s also been eating Nutro Grain free Lamb formula, which falls within the acceptable range of fat and fiber for epi dogs. He’s doing pretty well on that.

Currently his symptoms are occasional vomiting, sometimes diarrhea,  lots of tummy noises (on and off,), poor coat and very itchy, general lack of energy and tiredness, and either a very aggressive appetite or a total lack of interest of food, never a happy medium.

So what can I do to help him get better? Any advice or recommendations are very appreciated, I’m at a complete loss. And I don't know anything about B12, I didn't know that was related until I visited this (amazing) website. Inform me?

Welcome to the Forum - If you can check with your vet regarding what tests were done and the results it could be helpful...  a TLI test is used to diagnosis EPI and a B12/Folate test is used to help check the two very common concurrent conditions to EPI of low B12 and SIBO (small intestine bacterial overgrowth).... from you description it sounds like B12 and SIBO may not yet be addressed with your pup.    If you have not already read it.... located on the OVERVIEW page of EPI4DOGS there is a section titled DETAILED  EFFECTIVE  EPI  MANAGEMENT  that does an excellent job of covering all the details of how to manage EPI... here is a link to that page http://www.epi4dogs.com/

Hi Fleetwood's mom... so sorry to hear that Fleetwood is struggling.....without having the test results it is kind of hard to give sound adivce.... but just from what you are telling us and if it is EPI it kind of sounds like it "might"  simply be EPI with SIBO that has never been fully arrested and (this sometimes causes vomiting and lethargy in some dogs)... and if excesive  vomiting happens in any dog, it can cause bleeding/or this could be a little bit of colitus going on with EPI or the bleeding could be something else..... OR......... low B12 can be behind all of this causing re-occuring SIBO and lethargy and off and on appetite and no weight gain and poor coats too.... OR..... this could also be EPI and possibly IBD (this is pretty common) or EPI and some other condition.... with EPI & IBD... we see a lot of dogs that have food intolerences which will cause the loose stools, vomiting, etc......

1. The first thing i would do is contact the vet and ask for the TLI results and ask if they also ran a cobalamin (B12 blood)  test at the same time. And let us know what the vet says.

Going on the assumption that you are dealing with EPI..... i would give the enzymes with EVERY meal.... For right now, i would continue with the pancreatic enzymes (PancreaPlus), BUT... try giving 1 level teaspoon per 1 cup of dry food with 1/4 cup of warm water.. let sit 20 minutes and then serve.

And.... you might want to try (if this works out with your schedule) to feed Fleetwod LESS food but more often during the day... if you cannot do this, don't worry about it.

2. Ask the vet for 45 days of Tylan and give during breakfast and dinner (see the SIBO page for the dose by weight recommendation.

3. Ask the vet if he/she would start giving Fleetwood generic B12 injections, once weekly for 6 weeks and gthen either once every other week for another 6 injections or wait a month and give an injection once every 30 days and then re-test.  PLEASE print the B12 page here and share with your vet.

4. DIET.... i do not know if this will or will not work for FLeetwood.... so i am just guessing here..... but talk to your vet and see what he/she thinks about putting Fleetwood on hydrolyzed food....this is special prescription food for dogs with allergies that is processed in such a manner that the dog's system will not recognize the protein that might be causing and allergic reaction...and.... allergic reaction in dogs often display with loose stools..... this is why i am suggesting this....

Looking forward to hearing more on Fleetwood..... and i'd love to see pictures.... Beauceron are such cool dogs!!!!!!

well.... looks like Becky & I were typing at the same time

Hello Fleetwood's Mom,

Welcome to you and Fleetwood.   It looks like Olesia and Becky have asked all the important questions and given some great advice.   But I wanted to give you a warm welcome.   Hopefully, once you get the results of the tests, you will have a better idea how to proceed. 

One of the things that was suggested here that really worked well for us was to keep a log/journal recording everything you give your dog and the results and/or symptoms you observe.   There is a blank log form that you can use(under the download tab at the top of the page).  We just used a notebook.   We kept it every day and  wrote down every meal, with the amounts, enzymes etc.  and all medications and how the poops looked.   This really helped us to see some patterns and gave us good information to take to the vet or present here for suggestions.

I hope that you get results of the tests soon so Fleetwood can be on his way to good health.   Try not to be discouraged.  The beginning is the hardest.

Barb

Welcome to you and Fleetwood !!!  We have all been in your shoes... so ask away...Take a deep breath and know we are here.

Hi and welcome to you and Fleetwood from us as well. I'd never heard of a Beauceron before so looked it up. What beautiful looking dogs! Please feel free to post some pics of Fleetwood...great name btw. Cedar had a bit of vomiting when she was first diagnosed and was so so full of gas all the time with SIBO raging. Once she was on enzymes and tylosin, it stopped. Hopefully you'll have some results soon. The log will be very helpful, as Barb suggested so I echo her on that.

I just wanted to add my welcome to you and Fleetwood.  You've already been given all the advice I'd be able to think of.   I'll just add good luck on being able to figure this out soon.  Feel free to ask any other questions you think of.

Know you have people that care for you and your dog most importantly.  Then just hang on and follow up slowly on all instruction ...praying for you and your dog. 

Wow, thank you all very much for your support and help. I left my vet a message yesterday to give me a call back about some other things, and when I get her on the phone I'll get a detailed report of what was tested.

He's doing well on the diet he's on now, and he's eating 3-4 meals a day. I tried to use 1tsp enzymes per meal last time, but he was not doing well on that at all. That's why I am only adding 1/4tsp. I haven't seen a drastic difference from the low-concentration plant-based enzymes.

I appreciate all the help, and I'll see if I can get some pictures up 

Hello

Well i dint know what they looked like either and if you had asked me to guess his breed i wouldnt have known.

What has your vet said about the blood and the throwing up all the time ???

When you increase the enzymes do the poohs go softer ???

Salmon oil didnt agree with my dog (non epi ) omega 3 tablets work though.

Lets see what the results say sounds like inflamamtion perhaps going on as well have they scoped him..

Ann

Handsome boy!!!

Welcome & what a handsome boy! Lots of great advice already given. Ask any question day or night-someone is almost always on the forum to answer & help you out.

He really is gorgeous! Looks like he's ready for a swim!

What a lovely looking little fellow, how I imagined Dobermans would look if they were cattle dogs. Actually I've never imagined that until now. Be that as it may - welcome! look forward to reading the data when you have it...

The vet will be faxing me all of the test results in the next couple days. She did indeed to a B12 as well. The vet says that the blood was probably from vomiting so much.

I stopped his pancrezyme today, he was just having an awful time. He woke up this morning with horrible tummy noises, and wouldn't eat at all. His poop went from perfectly solid to liquid and dark. At such a low dose and such dramatic results in 4 different trials... I'm done with that.

What other enzymes might you all recommend that isn't porcine? I'm not sure if he has a sensitivy to the enzymes, or pork in general-- he doesn't seem to have any problems with any other pork products, but I haven't tried straight-up pork yet.

Is there a vet teaching hospital near you?  Or can you get a referral to an IMS (internal med specialist) for a consultation?  I think there is more going on than just EPI and an IMS or teaching hospital would be a good idea right now, JMO.  They are more versed in a lot of things.  There are so many things it could be and sometimes a second opinion will help tremendously.  Here is a  link to IBD that you may find useful.   http://www.peteducation.com/article.cfm?c=2+2090&aid=305   

Just out of curiosity, where in MI are you?  I am  in Mid Michigan, not far from MSU, which has a good vet hospital.