EPI * Exocrine Pancreatic Insufficiency

managing EPI

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karls_dad
Member
Posts: 39

Hi well just joined and hoping to gain some help and advice, My lad Karl is looking like he has developed EPI, blood tests results today hopefully, he has always had a very loose stomach but of late this has got out of control, he has lost 10kg in weight and is now looking rather lean, worrying times!

I,m hoping that from members upon here i can gain as much information on exactly how i can manage his condition, in advance i thankyou all from my heart, Karl is only six years old and such a wonderful boy, not a bad bone in his body, so loving and one of the best dogs anyone could possibly be blessed to own,

So my future friends on here, please contact me , offer any advice, i will greatly appreciate it, once again many thanks, Les

October 30, 2012 at 5:04 AM Flag Quote & Reply

epi4dogs
Site Owner
Posts: 12012

Hi Karl's dad.... i see that you are from the UK... we have many members here from the UK and i am sure they will chime in shortly.  I am from the USA and lost power.... so if i get cut off, it's because the generator timed out. 


Welcome to our family!!!

FIrst thing is that you will need enzymes.... PLEASE check the Download page... one of our members wrote a UK piece for EPI owners on what resources there are and where to get them in the UK.... http://www.epi4dogs.com/downloads.htm titled

UK Brochure for Managing EPI in the UK

1. you will need porcine enzymes with every meal.. Differnt types of enzymes need to be prepared differently.... let us know which one you get and we will walk you thru preparing the food.  NO treats inbetween meals... for now, everything that is feed needs to be treated with enzymes.

2.  in the beginning you are best off starting with a dog food that has no more then 4% fiber content.... Ann provides some choices to consider  in the UK Brochure.

WHen first starting out..... if you can feed 150% of what your dog would normally receive... BUT.... (if possible) feed in smaller portions but more often. EPI dogs respond to this better.

There are also secondary conditions that often accompany EPI..... if these are in play and not taken care of... no matter how much enzymes you give you dog.... it will not optimally respond to treatment.... everything needs to be addressed together in the beginning..... and then.... afterwards.. if still not seeing optimal results.... you will need to start tweaking things one at a time (which we will help you navigate ;))

3. Many EPI dogs will have low or insufficent B12... this happens in about 82% of all EPI dogs and should be taken care of with generic B12 injections until the B12 levels are brought up to upper-mid range. NOrmal mid range is not good enough.  "If: you cannot get the injections for your dog (please see the B12 page for the proper protocol) then you can order "Trinfac" B12 pills from WOnderlabs.... normally B12 over the counter pills will not work because EPI dogs cannot process ingested the B12 because they no longer produce their own intrinsic factor to move the B12 from the digestion system into the blood stream.... BUT "Trinfac" capsules are one of two B12 brands that actually include Intrinsic Factor in the pill... so these work with EPI dogs.

4. All EPI dogs when first diagnosed have SIBO (small intestinal bacterial infection).  ..... in short what it is is that there is an imbalance in the gut flora.... to much of  bad bacteria.  Sometimes this corrects itself once you start giving the dog the enzymes with every meal... BUT... unfortunately, this does not always happen... IF.... after you started the dog on enzymes and in the first week... you notice that your dog has lots of gas, is making stomach noises or the poo has a yellow tinge to it and/or is not firming up..... then it means the enzymes did not correct the imbalance in the gut flora and your dog needs to be placed on an antibiotic regimen to straighten this out.  The drug of choice now is Tylan for 30-45 days....


Hope this helps a little to get you started.  Please feel free to ask anything and we will help you as best we can by sharing with you our experiences... ALso... please share everything we suggest to you with your vet.. feel free to print anything and everything from this website.





--

Olesia, owned by Izzy-35lb SWD, Diagnosed at 1.5 years old - TLI results 1.3, Stable almost 8 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, Low Thyroid and High Cholesterol.  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!  Because of Izzy's concurrent conditions of Diabetes and High Cholesterol we had to make chnages to our daily EPI routine. We had to alter the fiber, type of fiber and the fat content  her diet. She now gets 1/2 Annamaet Lean kibble and 1/2 TOTW kibble with either lean pork loin meat, or chicken breast or tuna twice a day. She also receives  9 or 10 units of Vetsulin (depending on her blood glucose reading) a pork based insulin. We tried Novolin N a human synthetic RNA insulin.... but Izzy did not do well on it. And now we have to monitor her exercise.   It's been one heck of a journey... but aside from all that Izzy has gone thru with her health issues.... she continues to wake up every day full of joy and a great sense of humor!


October 30, 2012 at 5:36 AM Flag Quote & Reply

maddie ann
Member
Posts: 2987

Hello Les and welcome to you and Karl i love that name i grew up with a Silver sable called Karl he was gentle giant. Okay so i see you are awaiting your test results so i dont want to over phase you with to much inforamtion but this condition if managed correctly can give your dog along and happy life  what i would suggest you do today is look at this PDf for managing EPi in the Uk and do some research on food look at the foods listed and perhaps order some even if it is not EPI grain free food is good.

So read the PDf and ask loads of questions thats what we are here  for the main points are .

1 Enzymes with all food

2 The right food less than 4% fibre ( we feed 150% ) over 3-4 meals per da y intially..

3 B12 82 %  of our dogs are Dx with this being low.

4Antibotics for Sibo.

My dog lost the same in weight and once i had got my balance right she gained this back in 6 months some do it quicker  some slower. 

When you get your results please post them on here and also what enzyme the vet has given you and we will try and check the dose.

http://www.epi4dogs.com/PDF%20Files/MANAGING%20EPI%20IN%20UK.pdf

Ann

--

 ANN (UK)

 “Saving one dog will not change the world, but surely for that one dog, the world will change forever.”

Maddie DOB 01-10-2007 she is now  6 DX 04/11 .B12 140 now 644 TLI <1.00 Folate 14.2.

After 15 months on the B12 tablets with the intrisic factor she was retested and her b12 is now 902.

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/

organic virgin  coconut oil dailly. 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 also given daily.

October 30, 2012 at 5:41 AM Flag Quote & Reply

Val
Member
Posts: 2314

Hi Les

Worrying times...yes... we have all been there but take heart if it comes up EPI it is easy to manage with the advice from these great people.

I am from UK too and you will hear from others this side of the pond... we all keep in touch and can ring each other if need be so you are in good hands.

Once you get the test results if you can put them in the forum they will help us see where you are and offer help.

Hang in there, mate we are all with you.


Val

--

Razzy, GSD.

EPI for 4 1/2 years... sadly lost to cancer 30th July 2011 aged 9 1/2 years.

October 30, 2012 at 5:45 AM Flag Quote & Reply

Jean and Kara
Member
Posts: 5277

hello Les

 

I am from Liverpool and good friends with both Ann and Val and other UK folk

 

it will be easier to deal with with the results so ASAP if you can post them and give us a run down on your feeding regime as it is NOW including make of food etc

 

you wilol see from my profile we have some issues which maker life a bit more difficult

 

but my Friend Donna has a now 14 yr old Shep dx at 2 ish and is still doing good so it is vaery manageble

 

hey and you are a friend NOW not in the future and if you need any personal help please ask and I will send you my number

 

jeanxxxxx

--

 

 

Kara

 

From Liverpool England

adopted at five months old 26th December 2009

 

EPI dx August 2010

tli<1.00 folate 8.3 cobalimin 611

Antibiotics  2 Oxytet antibiotics 3 times a day also if we cannot fit the Oxytet in she has Tylan 1/8th teaspoon before her meals as a maintenanance dose

Food- Ashenbank Lamb Casserole  twice daily equalling 3 cups per day possibly more

Zantac (ranitadine) 75 mg 30 minutes before each meal as too much acid was being produced

enzymes-Panzym 1 gram per meal twice daily ( 1/4 teaspoon )  plus one Lypex

B12 injection once every three weeks

one Chemeyes B12 with intrinsic factor of 40 daily

one Antepsin before bedtime

alergies to beef pork chicken and white fish confirmed by blood test

33.6 kilos in weight as of 5th May 2013

 

"UNCONDITIONAL LOVE WAS INVENTED BY DOGS"

 

 


October 30, 2012 at 7:41 AM Flag Quote & Reply

Tracey, Sofie's mom
Member
Posts: 1449

Hi Les:) I see the UK gang has you well in hand so all I'll say is welcome, sorry you and your pup have to be here, but you've come to the right place for help and support.

--

Tracey, Sofie's mom

Sofie, Shiloh shepherd, born March 2010; diagnosed April 2011. Currently eats 3.5 cups of Go Turkey Recipe per day plus a bit of cooked beef, pork, tripe or liver, etc. with 1 tsp. of 8x enzymes per cup. I am going to switch her back to TOTW lamb version when this bag is done - I think both her and my non-EPIer have issues with the turkey. 1 Wonderlabs B12 pill per day, 1 tsp Slippery Elm with her lunch, 1 tbsp coconut oil 2x a day and currently back on Tylan 2x a day. Her lowest weight was 66 lbs, she is now a lovely 85 lbs.

October 30, 2012 at 10:04 AM Flag Quote & Reply

Dar
Member
Posts: 2324

Welcome Les and your beautiful boy Karl. Our first EPI girl Sadie was diagnosed at 4 years old and and lived a happy and healthy life to 14 years old. :) . Epi  is managable... The UK folks will take great care of you...Take a deep breath..help is on the way!!

--

  Dar and Kodi, From Washington state

 ' I aspire to be the person that my dog thinks I am !!! '

Kodi (GSD female) , born August 19, 2010 , was diagnosed July 15, 2011 at 11 months .Lowest weight, 47 lbs, weight as of  4/27/2013  62.9 lbs. Our goal for her at this time is now 65 lbs. !!!   And she made it!! .  TLI .07 , Folate 9.4 , Cobalmin 536 .

Kodi is on Pioneer grain and potato free Pork, 2  cups kibble with added canned or home cooked pork 2 times a day with  3/4 teaspoons of enzymes (X 8 ) from Diane. (Also some home cooked meals)1 Trinfac-B capsule once a day. Also  1/8 t. of ground coriander, 1/16 t. of ground fennel seed and cinnamon per meal (for stomach acid and burps). Having acupunture with a holistic vet for food and enviromental  allergies, doing accupressure points and taking 1000 mg.Super Quercetin daily for allergies.

October 30, 2012 at 11:27 AM Flag Quote & Reply

karls_dad
Member
Posts: 39

Wow thanks to you all, i,m completely phased out by all these numbers names and dosages of different things, i went in to the vets earlier today to ask if they had any results in but they were still waiting, they have promised to phone today with the outcome! It really did,nt help that when i got there in the car park were an elderly couple with a very old poorly shepherd, sadly her legs/spine had gone, and she most probably on her way to rainbow bridge, did that upset me, i sat in the car and cried!

The vets want £70 for 14kg of hills prescrption ID, food, online i can see it for £41 with free delivery, does anyone use this? or should i look for something else, i may add that finance is an issue at the moment, i,m not blessed with much spare cash due to a spine iinjury, i have yet to look at the link for uk suppliers etc from above, but once again many many thanks Les & Karl

October 30, 2012 at 11:29 AM Flag Quote & Reply

maddie ann
Member
Posts: 2987

Hi les

if you look at the Uk pdf this should hopefully give you all the information required but also what do you feed at the moment this may also work.

For your information my dog maddie is A typical just a normal ( special ) dog with Epi and now i am in yr 2 of the treatment it cost s me about £300.00 excluding food .....i just pop into the vets when i am passing and weigh her.

Ann

--

 ANN (UK)

 “Saving one dog will not change the world, but surely for that one dog, the world will change forever.”

Maddie DOB 01-10-2007 she is now  6 DX 04/11 .B12 140 now 644 TLI <1.00 Folate 14.2.

After 15 months on the B12 tablets with the intrisic factor she was retested and her b12 is now 902.

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/

organic virgin  coconut oil dailly. 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 also given daily.

October 30, 2012 at 11:55 AM Flag Quote & Reply

Jean and Kara
Member
Posts: 5277

oh es please dont pay for HILLS however £40.00 is not too bad you would in my opinion be better with grain free

 

if you want a chat ring me I will give advice on foods etc

 

0151 726 1468

 

jeanx

--

 

 

Kara

 

From Liverpool England

adopted at five months old 26th December 2009

 

EPI dx August 2010

tli<1.00 folate 8.3 cobalimin 611

Antibiotics  2 Oxytet antibiotics 3 times a day also if we cannot fit the Oxytet in she has Tylan 1/8th teaspoon before her meals as a maintenanance dose

Food- Ashenbank Lamb Casserole  twice daily equalling 3 cups per day possibly more

Zantac (ranitadine) 75 mg 30 minutes before each meal as too much acid was being produced

enzymes-Panzym 1 gram per meal twice daily ( 1/4 teaspoon )  plus one Lypex

B12 injection once every three weeks

one Chemeyes B12 with intrinsic factor of 40 daily

one Antepsin before bedtime

alergies to beef pork chicken and white fish confirmed by blood test

33.6 kilos in weight as of 5th May 2013

 

"UNCONDITIONAL LOVE WAS INVENTED BY DOGS"

 

 


October 30, 2012 at 12:02 PM Flag Quote & Reply

karls_dad
Member
Posts: 39

Once again thanks to all, at the moment i,m feeding him three times a day, one small mug of wag biscuit, about half a tin of canned food, and some boiled chicken cut up into small pieces so he eats everything, i was feeding him a large meal once a day but thought little and often a better proposition, still no news from the vet, i shall try and get as much info from them as possible.

I,m still completely head puzzled with all the info at the moment, just struggling to take it all in, but i,m sure with all your kind support i will get there, thanks again Les

October 30, 2012 at 12:27 PM Flag Quote & Reply

karls_dad
Member
Posts: 39

Just one more thing i would love to upload some pics of my lovely sheps to the site but can,t see how, anyone with some infor please?

October 30, 2012 at 12:33 PM Flag Quote & Reply

Jean and Kara
Member
Posts: 5277

its real hard at the beginning sometimes its better to talk

 

jx

--

 

 

Kara

 

From Liverpool England

adopted at five months old 26th December 2009

 

EPI dx August 2010

tli<1.00 folate 8.3 cobalimin 611

Antibiotics  2 Oxytet antibiotics 3 times a day also if we cannot fit the Oxytet in she has Tylan 1/8th teaspoon before her meals as a maintenanance dose

Food- Ashenbank Lamb Casserole  twice daily equalling 3 cups per day possibly more

Zantac (ranitadine) 75 mg 30 minutes before each meal as too much acid was being produced

enzymes-Panzym 1 gram per meal twice daily ( 1/4 teaspoon )  plus one Lypex

B12 injection once every three weeks

one Chemeyes B12 with intrinsic factor of 40 daily

one Antepsin before bedtime

alergies to beef pork chicken and white fish confirmed by blood test

33.6 kilos in weight as of 5th May 2013

 

"UNCONDITIONAL LOVE WAS INVENTED BY DOGS"

 

 


October 30, 2012 at 12:38 PM Flag Quote & Reply

maddie ann
Member
Posts: 2987

http://www.epi4dogs.com/PDF%20Files/Steps%20to%20take%20to%20insert%20a%20photo%20in%20your%20post.pdf

Hi Les yes please photos.........just take a deep breath and read the information and then we will walk you through it.

Ann

--

 ANN (UK)

 “Saving one dog will not change the world, but surely for that one dog, the world will change forever.”

Maddie DOB 01-10-2007 she is now  6 DX 04/11 .B12 140 now 644 TLI <1.00 Folate 14.2.

After 15 months on the B12 tablets with the intrisic factor she was retested and her b12 is now 902.

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/

organic virgin  coconut oil dailly. 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 also given daily.

October 30, 2012 at 12:48 PM Flag Quote & Reply

karls_dad
Member
Posts: 39

Oh forgot to say i,m on that horrible facebook look for Les Charles, usually found on the UK GSR, page lots of pics of my woo,s on there just send me an invite thingy i think

October 30, 2012 at 12:56 PM Flag Quote & Reply

maddie ann
Member
Posts: 2987

http://www.facebook.com/pages/epi4dogscom/424586920926094

Les- we have an Fb page and today there is a story on there about one of the Uk dogs Wallace it also has lots of info on there.

http://www.facebook.com/pages/epi4dogscom/424586920926094

 

Ann

--

 ANN (UK)

 “Saving one dog will not change the world, but surely for that one dog, the world will change forever.”

Maddie DOB 01-10-2007 she is now  6 DX 04/11 .B12 140 now 644 TLI <1.00 Folate 14.2.

After 15 months on the B12 tablets with the intrisic factor she was retested and her b12 is now 902.

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/

organic virgin  coconut oil dailly. 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 also given daily.

October 30, 2012 at 1:15 PM Flag Quote & Reply

Jean and Kara
Member
Posts: 5277

Gee sent me the whole Wallace the Warrior and pics of all three before gorgeous..........................................

 

I think you will see we are all close here

 

jeanx

--

 

 

Kara

 

From Liverpool England

adopted at five months old 26th December 2009

 

EPI dx August 2010

tli<1.00 folate 8.3 cobalimin 611

Antibiotics  2 Oxytet antibiotics 3 times a day also if we cannot fit the Oxytet in she has Tylan 1/8th teaspoon before her meals as a maintenanance dose

Food- Ashenbank Lamb Casserole  twice daily equalling 3 cups per day possibly more

Zantac (ranitadine) 75 mg 30 minutes before each meal as too much acid was being produced

enzymes-Panzym 1 gram per meal twice daily ( 1/4 teaspoon )  plus one Lypex

B12 injection once every three weeks

one Chemeyes B12 with intrinsic factor of 40 daily

one Antepsin before bedtime

alergies to beef pork chicken and white fish confirmed by blood test

33.6 kilos in weight as of 5th May 2013

 

"UNCONDITIONAL LOVE WAS INVENTED BY DOGS"

 

 


October 30, 2012 at 1:59 PM Flag Quote & Reply

Val
Member
Posts: 2314

Hi Les

If I were you I would settle on one type of food until you get things sorted. The thing with enzymes is they are different with different foods and it would be easier to get the enzyme to food fixed with just one food...

Like kibble needs a bit more enzyme...  

Raw needs a bit less enzyme...  

Homecooked often needs a bit less than the other two..

And canned needs a bit less than homecooked.

It mainly has to do with ease of digestion and water content... the more water the less enzyme.

I had Razzy on cooked chicken before EPI hit and had to leave it out to get sorted.

Could you just use the kibble for a while?


Val

--

Razzy, GSD.

EPI for 4 1/2 years... sadly lost to cancer 30th July 2011 aged 9 1/2 years.

October 30, 2012 at 2:14 PM Flag Quote & Reply

karls_dad
Member
Posts: 39

He is reluctant to eat just a kibble, i give him a little canned food, as he likes the gravy, also some boiled chicken, not alot, just some to encourage him to eat it all.

Now Karl loves fish so i,m temped to order a sack of the salmon and potato, it says 40% salmon so he may eat that on its own, maybe?

I had to call the vets as they had not rung as promised, it seems that they some results apart from if i have this correct the tpi? I have no idea what that is but assure me they will have result in morning,

Can anyone recomend a supplier for the salmon and potato, i have looked at so many companies now i have lost the plot where and what to buy!

Once again many thanks to all for your help,

October 30, 2012 at 4:10 PM Flag Quote & Reply

maddie ann
Member
Posts: 2987

http://www.simpsonspremium.com/sensitive-dog-food/puppy-sensitive-salmon

This one is good it has really low fibre and good amounts of fat so the weight should go one quicker .

We moisten the kibble with hot water and break it down so the smell tends to tempt them.

Ann

--

 ANN (UK)

 “Saving one dog will not change the world, but surely for that one dog, the world will change forever.”

Maddie DOB 01-10-2007 she is now  6 DX 04/11 .B12 140 now 644 TLI <1.00 Folate 14.2.

After 15 months on the B12 tablets with the intrisic factor she was retested and her b12 is now 902.

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/

organic virgin  coconut oil dailly. 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 also given daily.

October 30, 2012 at 4:33 PM Flag Quote & Reply

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