EPI * Exocrine Pancreatic Insufficiency
managing EPI
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Member Posts: 449 |
Thanks Ann & Becky here is new thread. Was trying to handle this latest health issue on my own but I am a little too worried about Maezi & thought you all might be able to help. She has been stable with EPI since Feb 17 and doing great. Few weeks ago I noticed our male dog being 'attracted' to her as if she was in heat & she licked herself alot & behaved odd even though she was spayed @ 8months. Panting & bit tired. I emailed my vet asking what she thought & she suggested bring in a urine sample as sometimes spayed female with bladder infection let off a pheromone similar to that of one in heat. Urine sample came back with red&white blood cells-bacteria & crystals in it - our regular vet wasnt available - she was put on 2 wks of amoxicillin/clavulanic every 12hrs for 2 weeks & re-test. After 2wks urinalysis still showed the red/wht blood cells & crystals but less bacteria. So she had to see our Dr. Carrigan to discuss and have her checked out as during this time she got worse. She started eating grass more & throwing up--eating dirt- licking odd things such as any lotion etc.-shedding- Panting alot and tired too easily & only able to run for short while.Her poo quality became a bit soft but normal color and no odor but a bit of gas.Her appetite had been good but now it was bit less. She was put on Baytril every 24hrs for 2 weeks & re-do urinalysis just before done. We asked & got her 1st B12 shot as a cant hurt/might help-she has been on daily sublingual ( nov 2@739) but told vet I had recently ordered wonderlabs trinifac B12 w intrinsicfactor to switch to after seeing all the good results on forum. She said to let her know if any difference after shot and we would give her another shot in week if there was & to start trinfac when it arrives (hopefully anyday) Or if we really wanted she could run the $200 B12 test now or just treat as possibility while we wait out UTI issue. Upon examination she was found to have an extremely tender tummy - possible GI issue (IBD) was suggested to change food - did not think it was SIBO related. First to try adding a bit more vegee to her diet & look into hydrolized food or IAMS low residue or HILLs as was suggested to her by email from TAMU - eating grass & dirt & licking can be from lacking mineral in diet or pain /stress. Panting & tired can also be from pain/stress or low B12. Pain/stress can be from UTI or GI. So I started with adding some frozen pureed vegees to her kibble for last week while we waited to see what Baytril did for her before switching foods. She showed initial improvement & looked better as on her Bday but in last few days she has not been herself. She wont eat breaky at all but will eat 9pm supper with enticers. She will eat non-enzymed food no problem so I gave her meal yesterday & today with boiled chicken & cotazym pill. Her poo is still good. No gas. Threw up bit. Its amazing how quickly they can lose a bit of weight & look unwell. She will be getting her urinalysis done tomorrow to see whats going on there & then ....
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--Maezi is a female Australian cattle dog (blue Heeler) from BC Canada born may 11-2010 Dx with EPI july 27,2011 & Oxalate crystals june 2012.The story of her journey and struggles with EPI are featured on the EPI stories section above
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Member Posts: 368 | When the vet is testing the urine, are they doing it by cytocentisis((needle directly into bladder) or just a peed in a cup sort of thing? A sample directly from the bladder is most accurate. Also, are they doing cultures with the urinalysis? If not, insist on it. Then you will know what antibiotic will be most effective for the type of UTI. Sometimes to save you a bit of money, the vet will just prescribe a broad spectrim anti without culture....and on occasion it may not happen to work well for that particular bacteria. And sometimes the length of time on the anti just isnt long enough, even if it is the right one....this has happened to my dogs twice. A longer course (3weeks) did the trick. Keep us posted, it is hard when our fur kids arent well. We worry about them so much. Lisa | |
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Member Posts: 368 | Wanda, Forgot to say... Are you sure the belly tenderness is really coming from the belly, or could it be actually from the bladder/kidney....seeing as Maezi appears to have had the UTI for a bit now? My opinion is not to make any food, enzyme or other changes until you get the UTI cleared, as it is possible that is what is causing the problem. If she is still not feeling well after a negative urine culture comes back, THEN I would go looking for answers elsewhere. Lisa | |
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Member Posts: 2780 |
Hello Wanda - Sorry to hear Maezi is not doing well.... I do not have any experience with UTI's so don't have anything to offer but a hug. Kinda thinking along the same lines as Lisa.... maybe the antibiotics she needs for the UTI are upsetting her stomach and once done with them her appetite will improve? | |
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-- ~Becky~
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Member Posts: 1328 |
I would go along with Lisa: make sure a culture is done and that the right antibiotic has been given and possibly given for a longer time. Then once you know for sure she's ok there then look at making other changes in food or enzymes or B12. Hope she is feeling bettre soon! | |
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-- Terry Mom of two EPI Shiloh Shepherds: Pharaoh born Nov. 2007 and dx with epi December 2009. Pharaoh weighed 62.4 lbs. (15 lb. weight loss) when diagnosed in 12/2009. Weight 10/31/11 his weight was 76.6. 85lbs on 9/22/12. Received six weeks of B12 shots Jan-Feb 2010 but his B12 on 8/10/2010 was only 232. So started weekly shots at home, which we continue to give. His older half sister is Taiko born Sept. 2006 and was dx with epi June 2010. Since she has severe bilateral hip dysplasia she had always been on the thin side. Taiko's weight was 70.7 lbs. in June 2010 (time of diagnosis; about a 10 lb. weight loss. Weight on 10/31/11 was 80.4 and on 9/22/12 was 82.4 lbs. B12 was 211 in June 2010 so started six weeks of shots and was only 293 on 8/10/10. She receive B12 shots weekly at home. Both are fed twice a day and we use either Costco grain free brand or Merrick BG brand:2 1/2 cups kibble in the morning and 4 oz cooked meat (usually steak) with 4 crushed tablets and in the evening 2 cups kibble with 4 oz cooked meat with 4 crushed tablets.
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Member Posts: 2135 |
Wanda, I am sorry Maezi is having these problems. I agree with Lisa about getting the culture too, so you know which antibiotic to use. I hope this gives you a diagnosis and it is an easy fix. It is upsetting when our pups have setbacks. Sending you lots of hugs. Barb | |
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Member Posts: 368 |
Good point Becky.....definately could be the antibiotic that could be causing the digestive issues or poor appetite. When Maya was on her longer course of anti's, she stopped eating well the last few days she was on it. When I asked the vet, she told me that some of the anti's make the food taste strange or can cause a metallic taste that the dog associates with the food and they may refuse to eat. Within a day or two of stopping the med, Maya was back to her normal appetite. Some can also cause upset tummys and loose stool (had that issue too). Hopefully once done with the meds, you will have the old Maezi back.
Lisa
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Site Owner Posts: 10230 |
Hi Wanda... so sorry to hear that Maezi is not feeling well.... B12 UTI .... and now ... although a slim possibility.... there might be another "maybe" to why she started feeling well and now started feeling poorly again..... like mentioned above,my first thought is that it is a UTI issue... and possibly the B12 could also be contributing for some of the lethargic feelings... but i am wondering if her "all of a sudden feeling poorly now" could be SIBO which could have come about from the added veggies.... and the only reason why i ameven mentioning this is because something similar happened to us (although we were not dealing with a UTI issue at the time).... but rather i added some veggies to Izzy's meal...and or 3-4 days later SIBO creeped in :(...... not sure if Maezi would be that sensitive.... cuz every EPI dog has different levels of tolerance, but for us... we have to be very careful with veggies and keep it to a minimum or else we have issues almost immediately. ....just thought i would mention this ... just in case. If you have time, you might want to check out the UTI section here http://www.epi4dogs.com/urinarytractinfections.htm it explains what types of anti's for what types of UTI's and it has a section on why some UTI's re-occur and how to treat it effectively.... and there also are some posts included from folks here who have dealt with UTI issues.... hope this helps a little and please keep us posted! | |
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-- Olesia, owned by Izzy-45lb SWD, Diagnosed at 1.5 years old - TLI results 1.3, Stable almost 7 yrs! Once stable, was able to reduce enzymes to only 1/2 tsp of Enzymes with each meal, but after almost 4 years of stabilization... had to increase the amount of enzymes to 3/4 teaspoon with each meal. Feed various grain-free kibble+real meat, 6x pancreatin enzymes from EnzymeDiane. I give 1 tsp of coconut oil one day and 1 tsp salmon oil next day, and also give canned sardines packed without salt or canned herring for extra omega oils. In Feb 2013, Izzy developed a very serious condition called IMHA which she (thankfully) beat and is now in remission. We also discovered that now, at 8 years old, she not only has EPI, but also Diabetes and Low Thyroid. Izzy was able to receive excellent care because of the kindness of so many here on epi4dogs and is currently doing extra-ordinarily well. If anyone could spend a day with Izzy, they would never guess that she has any health problems!
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Member Posts: 449 |
Urinalysis was pee in a cup - no culture- dropped off this morning Our reg vet wasnt in & I missed vets callback at closing time so I couldnt even call back -- but left message saying that "urine looks pretty clean in terms of no bacteria but still crystals--assumes that it is the crystals that are causing some problems for her" and that we need to look into a urinary tract diet as the primary thing as she is forming crystals and he will call back tomorrow to discuss and send email with further info". Email said " no signs of UTI but moderate oxalate crystals are present which may be the pre-disposing cause for Maezi & we should try Urinary S/O to help reduce the formation of crystals and probably worth a bladder xray to check for bladder stones" I only tried the vegees for 3 days as I too wanted to wait before I changed too many things before we found out how much was connected to the UTI issue. She has a few more days left of the 2wk Baytril. Still on daily Florentero. Will get another B12 shot when she goes back in as a could help. Diligence - one really must be with these dogs to try to catch things quickly - we dont know how long this issue may have been going on as we were dealing with so many other things
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--Maezi is a female Australian cattle dog (blue Heeler) from BC Canada born may 11-2010 Dx with EPI july 27,2011 & Oxalate crystals june 2012.The story of her journey and struggles with EPI are featured on the EPI stories section above
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Member Posts: 2124 |
Wanda Hope you get the proper answer soon. Might be worth you doing a search on the advanced bar for crystals because it sound like a prescription diet .......just wonder if anybody has managed to control it through any othe food . Are you going to ask for the Bacteria to be checked . I know what you feel like you get one thing under control and something else happens in my case my other dog i still dont understand the saying that dogs are supposed to lower blood pressure. Ann | |
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-- ANN (UK)
Maddie DOB 01-10-2007 she is now 5 DX 04/11 .B12 140 now 644 TLI <1.00 Folate 14.2. B12 RETESTED 0N 21-05-2013 Value 902 after 15 months of daily piils Yipheeee Weight was 22.3kg now 33.2kg (04-05-12) she is a small GSDbut she gained .(24lbs) Feed a mixture of foods she does better on fibre 3% and below she has b12 tablets daily (imported from the USAhttp://www.wonderlabs.com/itemleft.php?itemnum=6881) now changing to the uk version from http://www.chemeyes.co.uk/ Also omega3 and Vitamin E daily. Use Panzym 1/4 a tsp per 200 grams of food .Got SIBO under control after antibiotics ( stormormgyl) used synbotic by protexin. a pre-probotic
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Member Posts: 2120 |
i still dont understand the saying that dogs are supposed to lower blood pressure. ******************* Me niether ... it is relaxing to pet them then all disaster breaks loose and we are on the rollercoaster again. It didn't seem like that years ago so maybe we have bred trouble into them over the years? What goes round comes around and we have definately messed about with dogs from day one.... inter-breeding in some cases ... feeding them the modern kibble full of grain (now even beet pulp goes in as a filler) not surprising their digestion had gone down the pan.... along with some of the behaviour tendencies. My last two GSDs have been rejects compared to the ones I had 40 years ago. Val (getting off her soap box) | |
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-- Razzy, GSD. EPI for 4 1/2 years... sadly lost to cancer 30th July 2011 aged 9 1/2 years.
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Member Posts: 368 | Hi Wanda, If it were me, I'd have a sterile urine drawn (not a pee in a cup, that can be contaminated by bacteria on the skin or fur) about 5 days after Maezi finishes the Baytril. Do a UA AND culture to ensure the UTI is gone. If there are still crystals, do an Xray to look for bladder stones, as you said. Some urinary tract infections will lead to a changes in urine pH which will in turn lead to crystal formation. So it is a question of did the UTI cause the crystals or did the crystals cause the UTI. If the UTI was the cause of the crystals, once that is gone you may not have anymore issues with crystals. Just a thought. My cat is on Urinary SO food for crystals in his urine....which in males can cause blockages in the urethra. (we had a couple instances where he was unable to pee). Honestly, the dry food is expensive and it is crap. It is corn based with lots of byproducts. The canned is better quality, but even more expensive. I do use both, but supplement it with meat because of the poor quality. I would be even more concerned with the food with an EPI dog, as it is not grain free. I wonder how Maezi would do on it. I would get some more input from your regular vet with this whole situation. Lisa | |
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Site Owner Posts: 10230 |
Wanda....found a good piece on manging Oxalate Crystals... on the Vet Partner.com http://www.veterinarypartner.com/Content.plx?P=A&A=662 Also... in order to control it at home, my girlfriend bought those human pee strips at the drugstore and monitored her dogs crystals (monitoring the pH) via getting him to pee on the strip and then she adjusted the diet accordingly...
Because urinary pH varies throughout the day, test your dog’s urine at the same time each day to determine her “normal”pH. The best time to do this is first thing in the morning, before she eats. Urine should be tested before it hits the ground. You can collect some in a paper cup or simply hold a pH test strip in the stream."
You can check out "The Whole Dog Journal"piece on these stones: http://www.whole-dog-journal.com/issues/13_6/features/Kidney-Stones-Bladder-Stones_16231-1.html | |
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-- Olesia, owned by Izzy-45lb SWD, Diagnosed at 1.5 years old - TLI results 1.3, Stable almost 7 yrs! Once stable, was able to reduce enzymes to only 1/2 tsp of Enzymes with each meal, but after almost 4 years of stabilization... had to increase the amount of enzymes to 3/4 teaspoon with each meal. Feed various grain-free kibble+real meat, 6x pancreatin enzymes from EnzymeDiane. I give 1 tsp of coconut oil one day and 1 tsp salmon oil next day, and also give canned sardines packed without salt or canned herring for extra omega oils. In Feb 2013, Izzy developed a very serious condition called IMHA which she (thankfully) beat and is now in remission. We also discovered that now, at 8 years old, she not only has EPI, but also Diabetes and Low Thyroid. Izzy was able to receive excellent care because of the kindness of so many here on epi4dogs and is currently doing extra-ordinarily well. If anyone could spend a day with Izzy, they would never guess that she has any health problems!
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Member Posts: 449 |
Ok first you Guys are amazing
your info & advice gives me lots to ask my vet.
I read thru alot of info on the links as well.
Lisa yes I am going to talk w our reg vet tomorrow when she's in - I emailed this vet back & mentioned maezi's EPI & my concern with the food as it has rice & 40% fat - not good for her - asked if should wait & talk to DrC instead - he said yes I was right given the complexities of maezi's case it would be better to stick with one doc who knows the background & he would forward email etc to her & that she will be in tomorrow .
So I wait to hear from her as to what to do next.
She has last baytril tonight @9 - her appetite is bit better when I started adding fresh boiled chicken to it -- her poos are good -- no throw up in 2 days --
her food " first mate - grain free chicken & blueberries" says it is good for dogs urinary health.
Thanks Wanda and maezi
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--Maezi is a female Australian cattle dog (blue Heeler) from BC Canada born may 11-2010 Dx with EPI july 27,2011 & Oxalate crystals june 2012.The story of her journey and struggles with EPI are featured on the EPI stories section above
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Member Posts: 368 | I am glad you will be able to get in touch tomorrow with the vet that knows Maezi the best. And knows how you are managing her EPI. I would think that even if the crystals need to be managed by diet, there would be some way to keep her on her current EPI protocol and make adjustments by adding other foods, meds or supplements. As Olesia mentioned, it seems to be mainly a matter of regulating the urine PH. Let us know what the regular vet recommends and I hope Maezi feels better soon. Lisa | |
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Member Posts: 449 |
Yes thanks Lisa - my reg vet dr Noreen carrigan wasn't able to call back during office hrs but she emailed me after hours to let me know that with maezi's special circumstances & conditions she will be consulting "nutrtion expert vets" to determine what diet would best suit her needs . And also what xrays/ tests will need to be done .
She has lost 2 kgs 
Val & Ann - omg yes lower your blood pressure - I have often said she's going to give me a heart condition but when she lays with me & looks at me - all I see in my heart is "unconditional love" - she is truly amazing. Spoiled omg yes she has as Craig can understand 'totally destroyed" 2 of her bday toys - she sits & watches me stitch them up just waiting to get them back :). Michelle - admire the determined confidence you have with jackie :).
Waiting patiently (not)
Wanda and maezi
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--Maezi is a female Australian cattle dog (blue Heeler) from BC Canada born may 11-2010 Dx with EPI july 27,2011 & Oxalate crystals june 2012.The story of her journey and struggles with EPI are featured on the EPI stories section above
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Member Posts: 528 |
Wanda, So sorry that Maezi is having these problems. I'm thinking of you and sending lots of love and prayers. I hreally hope you find out what is wrong soon. | |
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-- Pamela and Rosina; 9 yr old LH Chihuahua Mix; dx'd 10/26/10; Currently 2.5 lbs overweight at 22.5 lbs. Free fed in AM and PM on 3/8 cup Wellness Core Chicken, Turkey Liver, and Chicken Liver Dry and 2 tbsp Wellness Core Chicken, Turkey Liver, and Chicken Liver canned, 1 tsp pumpkin (sometimes add 2 tbsp greenbeans when she needs more food because of increased appetite from the Temaril) and 1/2 tsp Diane's 8X granulated enzymes; 1 tbsp Wellness 95% Chicken or Turkey and 1/16 tsp 8X enzymes incubated and mixed with 1/16 tsp Tylan in the AM. Taking Temaril occasionally for allergies and Metacam 1X most days for leg pain.
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Member Posts: 2124 |
Wanda Sounds like your vet is good taking advise from a nutrition expert to cover both of the conditions i am sure once you get the diet correct those 2 kgs will come back on it will be intresting to hear what food etc they recommend sure sounds better then those prescription diets. As for the toys can i send you some in the post to sew for me !!!!!! Ann | |
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-- ANN (UK)
Maddie DOB 01-10-2007 she is now 5 DX 04/11 .B12 140 now 644 TLI <1.00 Folate 14.2. B12 RETESTED 0N 21-05-2013 Value 902 after 15 months of daily piils Yipheeee Weight was 22.3kg now 33.2kg (04-05-12) she is a small GSDbut she gained .(24lbs) Feed a mixture of foods she does better on fibre 3% and below she has b12 tablets daily (imported from the USAhttp://www.wonderlabs.com/itemleft.php?itemnum=6881) now changing to the uk version from http://www.chemeyes.co.uk/ Also omega3 and Vitamin E daily. Use Panzym 1/4 a tsp per 200 grams of food .Got SIBO under control after antibiotics ( stormormgyl) used synbotic by protexin. a pre-probotic
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Member Posts: 2120 |
My dog toys are past sewing... like Olesia they are 'play rags' and its so embarrasing when people come and get offered a fluffy rag that was buried this moring and dug up again. Val
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-- Razzy, GSD. EPI for 4 1/2 years... sadly lost to cancer 30th July 2011 aged 9 1/2 years.
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Member Posts: 449 |
Still waiting for word from Vet as to what to do for Maezi's diet that will be good for EPI and oxalate crystals and allergies and possible IBD issue. In the meantime our first order of wonderlabs B12 w intrinsic factor arrived--- @50lbs thinking one daily to start.... Is it better to give them with food or not ? Play rags
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--Maezi is a female Australian cattle dog (blue Heeler) from BC Canada born may 11-2010 Dx with EPI july 27,2011 & Oxalate crystals june 2012.The story of her journey and struggles with EPI are featured on the EPI stories section above
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lol yes thats more what they become ! You must login to post.
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