EPI * Exocrine Pancreatic Insufficiency

managing EPI

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epi4dogs
Site Owner
Posts: 12062

Keeping Gigi in our prayers....... when you can, please keep us posted.

--

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!


January 2, 2013 at 2:27 PM Flag Quote & Reply

Gigi's Mom
Member
Posts: 26

No I live in central Pennsylvania. I did speak with a new Vet office yesterday and questioned if the Vet is familiar with EPI and she is! So Gigi and I have appointment to get a second opinion. I did explain about the fluid so....fingers crossed. I can't take much more of the rollercoaster...if there is something in her belly I need to deal with it and if there isn't then I need to stop dwelling on her dying!

Thank you all again! :)

January 3, 2013 at 11:50 AM Flag Quote & Reply

shirl
Member
Posts: 2151

Glad you found another vet to try...when is your appointment?

--

Mom to Pixie, 8 year old sheltie,inherited from my mother-in-law 3/11.  Dx of EPI 9/09.  TLI in 10/09 was 0.4 ug/L.  As of 12/2/11, Folate fasting levels was 13.6 ug/L, and Cobalamin fasting was 615.   Current weight 20.9 lbs (7/13), solid member of the Chunky Monkey Club!  Ideal weight around 17, I think, but she's not obese at this weight, so maybe 17 is a little low.  Feeding grain free - Merrick 96% Pork canned and Nature's Variety Instinct Limited Ingredient Lamb kibble.  Giving slightly less than 1/2 tsp Pancreatin 8X per 1/2 cup of food.  Tylan 1x/day maintenance dose.  Also takes 1/2 tablet pepcid for stomach upset 2x/day.   Getting bi-weekly B-12 shots.  Our little pack also includes my husband, our 13 year old sheltie, Lucy, and our 10 year old sheltie, Einstein. 

January 3, 2013 at 7:45 PM Flag Quote & Reply

Gigi's Mom
Member
Posts: 26

Latest Gigi update...the second opinion vet noticed that Gigi's albumin level was low from bloodwork that was done in December that my first vet didn't happen to share with me. This new vet was also leaning towards lymphoma as well as her lymph nodes are still large but she had an ear infection. She wanted to put her on prednisone. I said no...low albumin levels indicate SIBO so I said we are going to treat for SIBO and treat her ear infection. This was two weeks ago...yesterday was our follow up appointment. The ear infection is not kicked so she put her on other meds. She did more blood work to check her albumin level and that is back in the normal range but now she was diagnosed as a diabetic. I am so at the end of my rope. I just cannot afford to manage this now. Are there cheaper alternatives for managing diabetes as I am looking at around $500 to start and $40 to $60 per month. I just can't pay for this. Thanks.

January 24, 2013 at 12:41 PM Flag Quote & Reply

Gigi's Mom
Member
Posts: 26

I am also wondering is it possible that her blood glucose levels are high because she was on antibiotics and has a massive ear infection? The reason I ask this is her blood sugar was around 100 in December and now was 350! The vet is sure this just came on so I am thinking is it possible that her sugar is elevated due to the antibiotics? That is the only thing that has changed? Now she did have sugar in her urine but the timing of this leads me to believe that perhaps it is the antibiotics that is raising her blood glucose level and she is not a true diabetic? Thoughts? She did indicate that prednisone will increase bg levels so why not antibiotics? It may be wishful thinking on my part.

January 24, 2013 at 12:49 PM Flag Quote & Reply

Jean and Kara
Member
Posts: 5290

which antibiotics are we talking about????

 

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"

 

 


January 24, 2013 at 1:29 PM Flag Quote & Reply

Gigi's Mom
Member
Posts: 26

She was on Metronidazole and Tylan for SIBO for the last two weeks. I was reading online that Metronidazole can raise blood glucose levels. The Vet thinks her "diabetes" just started so the timeframe seems a little more than a coincidence...she is on Metronidazole and her blood glucose is unsually high. Now of course since she still has the ear infection but now she is on different antibiotics the Metronidazole treatment was finished yesterday so....I called the Vet and asked once we get this ear infection taken care of and get her off of the antibiotics can we do a blood sugar test and then go from there. She said yes. So that is going to be my plan of attack.

Again I may be grasping as straws but.....I can't put Gigi or myself through much more.

January 24, 2013 at 2:28 PM Flag Quote & Reply

nicola king
Member
Posts: 94

its very unlikely that antibiotics raise sugar levels.  Blood sugar levela are affected by time in relation to last meal.  But its true that epi and diabetes can go together as both are pancreas related.   Low albumen is what is likeley to have caused teh fluid in her abdomen- its called ascites.  Low albumen is caused by many things.  It can be that te body is not making enough (often a liver problem or in teh case of epi  the body cant because of malnitrition) or that the body is loosing too much. (also a factor in Epi when protein is lost actose the damaged mucosa (lining) if the gut and can be a sign of kidney disease.  Good luck with Gigi and I hope the solution turns out to be less costly than you feared.


--

diagnosed 16th Jan 2013.  Symtoms and clinical signs: PU/PD weight loss, hypoalbuminaemia, Raised ALK/ALP low USG.

10/1/13 TLI 3.8, Fo 7.8 B12 677 weight 24.5kg.  Fed Pets at home sensitive salmon. 240g plus 67 g cottage cheese am and pm with 3tsp pancreatic enzymes for cats and dogs.

23/1/13: weight 27.5kg, USG near normal. Stop cottage cheese. Trying Chemeyes 1tsp.

7/2/13 weight 28.5kg most blood tests returned to normal.  USG still low. Now on Panzyme 1tsp. starting coconut and salmon oil caps

16/3/13 weight 28.1kg now on raw pancreas. TLI 2.1, B12: 310, Fo:9 starting B12 injections.

30/4/13 B12 1363 weight 30 kg (and on a diet)

12/7/13 B12 1300+ (Chemeye dropped to alternate days) weight 31.5 KG (stricter diet!) temp change to panzyme as raw pancreas unavailable Mar 2014 doing really well weight stable . Panzyme .kibble.alt day chemeye b12 caps alt day salmon and coconut oil. Twice daily ranitidine. Teeth extracted -totally rotten


January 24, 2013 at 4:49 PM Flag Quote & Reply

epi4dogs
Site Owner
Posts: 12062

If i remember correctly...(and sometimes i don't)  but it might be in one of Tara's posts.... her dog is EPI +Diabetic..... anyway... i think Tylan (antibiotic) has been known to skew the BG numbers.... so that "might" be contributing to the timely elevated numbers..... but i would ask someone (like your vet) who knows for sure the relation between Tylan/Metronidazole and Blood Glucose levels....maybe this only happens if the dog is already a diabetic...


I am so sorry you are struggling with Gigi right now.... if there is anything we can maybe help with, please let us know. IN the meantime... please keep us posted...

--

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!


January 24, 2013 at 8:02 PM Flag Quote & Reply

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