EPI * Exocrine Pancreatic Insufficiency

managing EPI

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PitBullMom33
Member
Posts: 49

My name is Allison. I have a 10 yr old pit bull named Jazmyn who started rapidly losing weight a few weeks back. I too her to the vet and she said she was having pancreas issues and was anemic they gave me lixotinic and metronidazole 250mg and pancre plus tablets.What tests should I ask her to run and what can I do now to help my baby girl.My heart aches so bad its like I am watching her slowly die in front of me I refuse to give up on her shes been by my side since I got her from an abusive home at 3 months old she sleeps right beside me every nite and follows me everywhere shes my best friend and I have to help her. What tests should I ask for ? Is there anything I can do for her now till I can get into the vet for the tests? I switched her food to Taste of the Wild and cut off all treats. I am desperate for any help all the signs she shows is just like this site talked about the pics of the dogs look just like her shes 37 pds and prob shld be 60 65. PLEASE I AM BEGGING FOR ANY HELP!!! PLEASE HELP ME SAVE MY BABY GIRL JAZMYN!!!!!!!!!!

December 21, 2012 at 2:35 AM Flag Quote & Reply

Jean and Kara
Member
Posts: 5639

firstly you do not need to beg for help

 

we are here

 

what made your vet think pancreatic issues??

 

anyway she must think EPI is a possibility as she has prescribed enzymes as pancre plus

 

ask her to run cTLI test along with cobalamin and folate levels this will give you what you need to know the test is a 12 hour fasting test and as the holidays are next week you are running out of time I would think

 

however in the short term you can order from wonderlabs Trinfac unless your vet will do  generic b12 shot now

 

http://www.wonderlabs.com/itemleft.php?itemnum=6881

 

the b12 must have the intrinsic factor inbuilt

 

have a look at the food bag and work out what you need for the weight she should be and add 50% more over the day split into a few meals all with enzymes on

 

might be worth looking at enzyme diane website

 

http://www.enzymediane.com/

 

most folk here use her for enzymes

 

it will do no harm to start as if it is EPI and she will be able to send you a small amount to try

 

I would encourage you to just give her a ring she will also be able to help you no end as she has so much experience in EPI and is a champion here and will understand your fears

 

What are her poops like?? does she have a gurgly tummy???

 

let us know

 

have a read of my "thought on EPI " post it says it all I wrote it about 8 months ago

 

jeanx

--

 

 

Kara

 

From Liverpool England


born 21st July 2009


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, causing shedding of bowel lining

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

39 kilos as of 10th June 2014

 

"UNCONDITIONAL LOVE WAS INVENTED BY DOGS"

 

 


December 21, 2012 at 5:01 AM Flag Quote & Reply

maddie ann
Member
Posts: 3184

Hello Alison

Yes i to am wondering how your vet determined that she had pancreas issues without running any tests so i would speak to your  vet and ask them on what basis this has been DX the problem is that unless the CTLI has been done we dont know wether your dog has EPI or Pancretitis enzymes are given for both but the diet is completely different so TOTW is good for EPI but not for Pancretitis.

The other problem we have is that alot of other conditions can mimic EPI ie IBD /SIBO/Diabetes etc the list goes on .

I do feel your anguish but you must ensure that you are treating the correct condition.

Alot of our dogs including mine lost 1/3 of there body weight .....i would certainly go a head and order the b12 or ask your vet for a b12 shot this is good for any dog and is often the missing link for EPI dogs.....go for feeding 15O % of her food over smaller meals..

But can you tell us what ratio of food to enzymes you are using so at least we can ensure that you are dealing with this aspect correctly while you wait for a proper DX.

 

--

 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.

December 21, 2012 at 5:26 AM Flag Quote & Reply

Paula
Member
Posts: 2633
Hi Allison- I see you have the tablets. You need to crush them and then treat them like the powder (mix with warm water and kibble and soak for at least 20 minutes). The starting point is 1 tablet for each cup of food, plus one for the bowl. So 2 cups of kibble needs 3 tablets. Some have found they needed quite a bit more. Please do let us know what the vet said... How Jazmyn was diagnosed.
--

Paula and Maya (bday 12/21/06) (diagnosed 10/26/10 TLI 1.5, B12 659 (ref:249-733), weight 52 lbs. After 30 days, retested B12/folate - B12 plummeted to 200, which greatly affected her personality. After following B12 protocol, currently giving semi-weekly B12 shots at home, plus daily WonderLabs Trinfac. Weight in July 2013: 75 lbs - the picture of health


December 21, 2012 at 8:45 AM Flag Quote & Reply

PitBullMom33
Member
Posts: 49

She was given a CBC blood test and I was told it was her pancreas. I have called to speak to her about the other tests but due to her staff havent been able too. I am going to take her to another vet who prob can do the tests needed. I know that she is very gassy and her poop is cow pilish and she eats like she hasnt ate in months. I am sorry for the begging in my last post I am just heartbroken and was just desperate for answers. Thank you everyone for your input I am going to call her gain today but if I cant speak with her will call another vet that I am sure can do the tests. How long do you usually have to wait to hear about the results. I realize the holidays are coming up and I hope if they cant do it before Christmas then maybe wed morning. So I should mash her pill up and put in her food with water even tho she told me to give it to her 30 mins before she eats. I am hoping its something that has the potenital to be cured and I will do whatever it takes to keep her here as long as I can. I appreciate all the advice and please keep it coming. I will keep ya updated about what I find out and everything.

December 21, 2012 at 9:52 AM Flag Quote & Reply

PitBullMom33
Member
Posts: 49

the website you listed above for B!2 is it the tablets will that help her or is just the shots. I am willing to try anything until I can get a full honest answer from a trusted vet. The vet told me the other nite to put her on grain free food and give her these pancre plus it dont have an end date but the other 2 medicines do.

 

December 21, 2012 at 10:03 AM Flag Quote & Reply

Paula
Member
Posts: 2633
Allison FYI - the blood tests require a12+ hour fast. I used to make sure they'd do the blood draw first thing in the morning so Maya didn't have to go too long without food. Ask them for a B12 (not B-complex!) injection right after the blood draw. it wont hurt and if her cobalamin is low, you'll have a head start. The metro (with food, every 12 hours, right?) should help if Jazmyn has SIBO (which from your description of her poops it sounds like it). If you haven't, yet, take a look at the EPI in Snapshots tab at the top of the page.
--

Paula and Maya (bday 12/21/06) (diagnosed 10/26/10 TLI 1.5, B12 659 (ref:249-733), weight 52 lbs. After 30 days, retested B12/folate - B12 plummeted to 200, which greatly affected her personality. After following B12 protocol, currently giving semi-weekly B12 shots at home, plus daily WonderLabs Trinfac. Weight in July 2013: 75 lbs - the picture of health


December 21, 2012 at 10:07 AM Flag Quote & Reply

PitBullMom33
Member
Posts: 49

Will a CBC show the B12 levels or have to do a different blood test? I know that in my gut I feel that she has this epi and the things she prescribed her but she said it could also be her age well I refuse to give up on her just cause she is 10. how do I do her food crush the pill up and water or what she weighs 37 pds shes like 30 ods under weight. Thanks for all your help I cant tell ya how much it means.

December 21, 2012 at 10:13 AM Flag Quote & Reply

Paula
Member
Posts: 2633

No CBC doesn't tell much re EPI. She needs the cTLI along with cobalamin/folate tests. Crush the tablets, add warm water (body temp) and the kibble. let it soak for about 20-30 minutes so Jazmyn doesn't get mouth sores.The B12 shots are the sure way (proven research), but the Wonder Labs Trinfac tablets have worked for many (just not proven with research). The tabs are $15 for 120. You can get them from wonderlabs.com.

--

Paula and Maya (bday 12/21/06) (diagnosed 10/26/10 TLI 1.5, B12 659 (ref:249-733), weight 52 lbs. After 30 days, retested B12/folate - B12 plummeted to 200, which greatly affected her personality. After following B12 protocol, currently giving semi-weekly B12 shots at home, plus daily WonderLabs Trinfac. Weight in July 2013: 75 lbs - the picture of health


December 21, 2012 at 10:26 AM Flag Quote & Reply

PitBullMom33
Member
Posts: 49

Thank you Paula I got ahold of my vets receptionist a different receptionist and she said she would give the vet a message she said it may be this afternoon before she got back to me. I am going to ask if she does these test. For a 37 pd dog how much food should I give her whatever the bag says plus so much more how much water do I add and could I order the B12 and the enzymes wld that hurt her to give her those anyways. Any way to give her the metro she chews the pancre care right up but the metro she spits out. I am learning about dog pancreas and everything its like a bad dream because my husband is type 1 diabetic and is currently on dialysis at the age of 32 so I have a sick husband 90 pct of the time and now my best friend Jazmyn is sick. I thank you for answering all the questions I have and I am sure I will have lots more so if I ask the same ones over just tell me to reread thru the posts. Thanks again.

December 21, 2012 at 10:35 AM Flag Quote & Reply

Paula
Member
Posts: 2633

Take a quick look at EPI in Snapshots - it's the nutshell summary. The metro is in a capsule right? Can you just put it down her throat? Or try puttig a little cream cheese on it. It's good she likes the enzymes, some don't. It will make your life easier. If this is EPI, once you get it under control and managed properly you won't even know she's sick. Can you feed her four times a day (or more)? That's best, small meals at a time. Start with 1 cup per feeding, spaced at least 2 hours apart. The enzymes and B12 will not hurt her. enzymes for short term are okay, even in normal dogs or dogs with pancreatitis. B12 is always fine. It's water soluble, so Jazymn will pee out what she doesn't need.  That's tough about your hubby, hope the dialysis does it's job for him and he gets well.

--

Paula and Maya (bday 12/21/06) (diagnosed 10/26/10 TLI 1.5, B12 659 (ref:249-733), weight 52 lbs. After 30 days, retested B12/folate - B12 plummeted to 200, which greatly affected her personality. After following B12 protocol, currently giving semi-weekly B12 shots at home, plus daily WonderLabs Trinfac. Weight in July 2013: 75 lbs - the picture of health


December 21, 2012 at 10:41 AM Flag Quote & Reply

PitBullMom33
Member
Posts: 49

No its a tablet. and a 7 day supply plus she was anemic and they gave me liquid stuff for her on that. Ok I will get that ordered this weekend which b12 do I need to order and which enzyme? Her mate Titan has not left her side he knows shes sick they have been beside each other since i brought her home 10 yrs ago hes my 11 yr old pitbull. I appreciate it I hope the dialysis works too and that a transplant will be in the near future. I thank you so much for your help this is all new to me and I pray it is something that can be helped and she can have a few more years with me. to bad dogs dont live 30 or 40 years.

December 21, 2012 at 10:45 AM Flag Quote & Reply

Paula
Member
Posts: 2633

Oh - and please don't tell your vet that you "learned on the internet"... Instead, ask her to look at epi4dogs.com herself.  They will have to send the blood out for the tests, either to a local lab (which will be faster) or to Texas A&M (TAMU), which could take several days. There is a protocol your vet should follow to gather the sample, so make sure she looks at the guidelines or talks to the TAMU GI lab.

--

Paula and Maya (bday 12/21/06) (diagnosed 10/26/10 TLI 1.5, B12 659 (ref:249-733), weight 52 lbs. After 30 days, retested B12/folate - B12 plummeted to 200, which greatly affected her personality. After following B12 protocol, currently giving semi-weekly B12 shots at home, plus daily WonderLabs Trinfac. Weight in July 2013: 75 lbs - the picture of health


December 21, 2012 at 10:46 AM Flag Quote & Reply

PitBullMom33
Member
Posts: 49

I was going to tell her I have a friend who had a dog who had epi and she thought maybe Jazmyn should be tested for it and have her B12 levels tested.Yeah I can imagine telling her I looked up on the internet she wld prob look at me like I was crazy. I just wanna know if it is epi that way I can take the necessary steps and work with her also on getting Jazmyn better. So I should tell her about the site ? Maybe when she gives the blood test if she can do it may have to go a bigger vet office who knows.

December 21, 2012 at 10:53 AM Flag Quote & Reply

Paula
Member
Posts: 2633

Where in TN are you? I order my enzymes from enzymediane.com. 1/3 the cost of what you can get from the vet and just as good (just generic). Let your vet give Jazmyn the injection for now. If you want to do it yourself after that, we'll tell you where to order it (I got my injectable B12 from my vet, plus syringes for $60, will last over a year). The epi4dogs.com site is very reputable among vets. So, I would probably tell her just as a source of the latest info (my vet was on it frequently when Maya was first diagnosed). She says she would recommend it to anyone with an EPI dog.

--

Paula and Maya (bday 12/21/06) (diagnosed 10/26/10 TLI 1.5, B12 659 (ref:249-733), weight 52 lbs. After 30 days, retested B12/folate - B12 plummeted to 200, which greatly affected her personality. After following B12 protocol, currently giving semi-weekly B12 shots at home, plus daily WonderLabs Trinfac. Weight in July 2013: 75 lbs - the picture of health


December 21, 2012 at 10:59 AM Flag Quote & Reply

PitBullMom33
Member
Posts: 49

I am in Cookeville about an hr from Nashville. ok should I order the enzymes and let her worry about the b12 after she checks her levels. Ok I hope she can do these test and if so I will tell her about the site. I have told a friend about it hes got A german shepard thats almost 2 same signs as my dog.I am glad this is here I have learned alot and I am glad to finally feel like I am not alone. I broke down in the vets office when she said pancreas problems she said she has seen alot of dogs do well on the pancre care and a change of food

December 21, 2012 at 11:08 AM Flag Quote & Reply

Terry Bin
Member
Posts: 1575

Hi Allison,  Welcome to the forum.  We totally understand your fears and concerns about your furbaby!  We have all walked down this road.  For some it is a rougher road than others.  Getting a diagnosis is often the hardest part...some vets are resistent for some reason.  EPI is sometimes seen as a GSD disease so if your dog isn't a GSD a vet doesn't think/want to test for it.  Our attitude here is "your dog, your dollar".  We normally suggest having the test done Monday, Tuesday or Wednesday so the blood doesn't sit over the w/e in a lab or in transit...with Christmas it makes it trickier so you may be right to wait until Monday...but you can do a lot until then.

You should feed 150% of what is normal for her...spread over smaller meals....4 meals is best if you can do it with your schedule, but at least 3.  Since you are feeding more food it is easier on their tummy if the meals are smaller.  All meals with the enzymes.  We use PancreaPlus tablets and we started with the ratio Paula gave but, just like powdered enzymes, you sometimes need to tweak the amount of enzymes.  Right now our pups are getting a little bit more than that but they have been treated for a number of years and sometimes that happens. 

Keep in mind the poop you see is not from the last meal...the transit time for each dog varies but ranges from 12 to 72 hours usually.  So once you are adding in enzymes it may take a few meals before you see any improvement.  One way to know her transit time is to add some raw shredded carrot to a meal and time how long before you see it in the poop (it is not digested).  The other thing that helps is to keep a lot (there is one in the download section) of everthing you do and how the poop looks....when you start tweaking things/making changes it can be helpful to figure out what worked and what didn't. 

Most vet offices send the cTLI/cobalamin/folate blood test to TAMU (Texas A&M) for the processing.

Hang in there...we know how really scary this is.

--

Terry

Mom of three 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 was 76.6; 85lbs on 9/22/12; 86.7 lbs. on 9/24/14.

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.  Weight 7/16/14 was 84.5 lbs.  B12 was 211 in June 2010 so started six weeks of shots and was only 293 on 8/10/10.  She receives B12 shots weekly at home.  B12 in September 2014 was over 1,000.

Both are fed twice a day and we use Merrick BG brand: 1 1/2  cups kibble in the morning with app. 4 oz cooked meat (usually chicken) with 4 crushed tablets and in the evening 1 1/2 cups to 2 cups kibble with 4 oz cooked meat with 4 crushed tablets. 

Moku was born 4/15/14 does not have epi.  His grandfather is Taiko's and Pharaoh's father (through his mother).  On 10/09/14 his weight was 71.6 lbs and he still has a lot of growing to do!


December 21, 2012 at 11:12 AM Flag Quote & Reply

Paula
Member
Posts: 2633

It sure does sound like she suspects EPI (diet change and enzymes). But without running a TLI you can't be really sure - although the weight loss sure sounds indicative. Given your husband's pancreas problems I understand you breaking down. You are definitely not alone. We have all been in your shoes. If money isn't an issue, go ahead and order the Trinfac tablets. You'll want them for maintenance probably, anyway, once you finish the shots protocol. Now that you have caught your breath, and while you are waiting the interminable time for your vet to call you back, I'd suggest you read the info on the website. Start with the Overview Tab (Detailed Effective Managment of EPI), then you can read about B12 and SIBO. Yes, your friend with the GSD should ask about testing for EPI, but there are things that mimic it (sometimes SIBO alone will create the symptoms - and is treated by a 45-day course of antibiotics). (I asked about where in TN, because I'm in western  NC, close to the TN border)

--

Paula and Maya (bday 12/21/06) (diagnosed 10/26/10 TLI 1.5, B12 659 (ref:249-733), weight 52 lbs. After 30 days, retested B12/folate - B12 plummeted to 200, which greatly affected her personality. After following B12 protocol, currently giving semi-weekly B12 shots at home, plus daily WonderLabs Trinfac. Weight in July 2013: 75 lbs - the picture of health


December 21, 2012 at 11:15 AM Flag Quote & Reply

PitBullMom33
Member
Posts: 49

The picture I downloaded was of Jazmyn this summer before she was sick. I appreciate all your help and I will read the site my husband has been too. my husband told her he knew how she felt shes anemic too. Well money is kinda tight because I had to quit my job to care for my husband who up till may was blind he has diabetic retionopthy in both eyes he had surgery on one and can see out of it but the other prob cant be saved, We are livng on his disability I am trying to find a job but its hard in this town like everywhere. I am hoping to do billing from home I went to school for it but we will see . I am happy I found this site and after some nap time with my furbabies I havent slept much the past few days I am a worry wart always have been but everyone answering my questions is easing my mind. Thanks once again.

December 21, 2012 at 11:25 AM Flag Quote & Reply

Terry Bin
Member
Posts: 1575

I don't know how many days/weeks worth of enzyme tablets you have but if epi or a condition that can benefit from enzymes you may want to look at www.enzymediane.com as she sells generic powdered enzymes at a very good savings.  Many, many people here on the forum use it.  We have stuck with the tablets as it was what the vet had when we started and both dogs have done well on it...so haven't wanted to rock the boat, as they say.  I did a cost calculation and the tablets are just a bit more a year than EnzymeDiane's powder.  But given your situtation I know any bit will help.

--

Terry

Mom of three 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 was 76.6; 85lbs on 9/22/12; 86.7 lbs. on 9/24/14.

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.  Weight 7/16/14 was 84.5 lbs.  B12 was 211 in June 2010 so started six weeks of shots and was only 293 on 8/10/10.  She receives B12 shots weekly at home.  B12 in September 2014 was over 1,000.

Both are fed twice a day and we use Merrick BG brand: 1 1/2  cups kibble in the morning with app. 4 oz cooked meat (usually chicken) with 4 crushed tablets and in the evening 1 1/2 cups to 2 cups kibble with 4 oz cooked meat with 4 crushed tablets. 

Moku was born 4/15/14 does not have epi.  His grandfather is Taiko's and Pharaoh's father (through his mother).  On 10/09/14 his weight was 71.6 lbs and he still has a lot of growing to do!


December 21, 2012 at 11:59 AM Flag Quote & Reply

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