EPI * Exocrine Pancreatic Insufficiency

um good question well there are various answers to this.

1 it still has undigested food in it - so you could try an enzymes tweak 1/8 th of a teapoon.

2 Sibo is still lurking...but again not enough enzymes can cause this so can low b12 etc

3 Barbs dog cedar still does this and the worst bit is so do her other dogs she has tried pinapple spinach etc to try and deter this but it carries on .....

Jessica..

You are doing nothing wrong....this is the ups and downs of EPI..Each pup is different and as Kodi is our 2nd EPI pup..you would think I would have everything figured out!!  NOT !   She still keeps us guessing and figuring out what to tweak  next!!!  Hang in there...I hope you are keeping a journal.. it helps me keep my sanity!

Hi All,

I have a few questions. If I would like to switch from the B12 injections to a daily B12 with intrinsic factor, what brands are recommended?

What brands of probiotics are recommended? Is the only concern making sure it's given 3-4 hours away from the Tylan?

Buttercup seems to be having some more bladder issues where she is peeing in her crate. When she started having all her troubles last fall, she was peeing in her crate before she started the pooping in the crate due to EPI. I doubt there is a connection, but has anyone ever heard of any sort of connection with EPI dogs having urinary/bladder issues as well?

Thanks as always,

Jessica

Hello- firstly re the B12 the pills must contain the intrinsic factor and we recommend the tablets from wonderlabs there is a direct link to these on my signature.

As for the probiotics if you look on the SIBO tab and scroll down to the bottom of the page there is a list on there we recommend that you start with a small dose and build up and yes you are right about the dosing .

Tylan are you still using this if so have you tried to taper the dose down if so i would introduce the probiotic and then try and reduce the tylan dose to one a day then after a few weeks half the dose per day and then try and go to very other day hopefully the probiotic will have had chance by then to restore the correct gut flora and hopefully eventually you can take the tylan away.

Peeing issues i had problems with this early on we tested for diabetes and UTI but nothing was found with Maddie is seems to have either been her body took longer to adjust to the enzymes or low B12 but we do have a few dogs on here with UTI.

Hi Jessica. Moxi is currently dealing with UTI. She's on day 9 of a 14 day round of Baytril. She's not soaking her crate, but she still dribbles a good bit. She also will wet her bedding if she's sleeping soundly.

Was really hoping she'd be asymptomatic for the UTI by now. Since she's had so many issues since she was a small pup I don't really know how much to blame on housetraining problems and how much is actually medical issue.

I know I'm not answering your question just echoing it I guess. I wonder some days if we'll ever reach any kind of "normal."

Hi All,

I have more questions again. I am not sure if it is best to keep posting on this thread since they are all questions about Buttercup's situation or if I should be starting new ones.

Buttercup is going to the vet tomorrow for her urinary issues. She hasn't had any bloodwork since I have started treating her EPI. What should I have tested besides her B12 levels? I know she should be fasting for this.

If she is given oral antibiotics to treat her bladder/UTI/whatever this is, how do I administer those if she can't have any snacks, like cheese or pill pockets? Are pills supposed to be given with meals since she will have recently consumed enzymes or does that not make a difference?

Once I buy the intrinsic factor B12, do I give her one or two pills daily?

Also, are there a high percentage of dogs with EPI who end up diabetic?

Along with her peeing issues, Buttercup's teeth are in terrible shape, so we will now need to deal with that. I tell you what, she is quite the genetic mess for a 4 year old hound dog. :-( I love her, but this sure has been a frustrating and overwhelming journey.

Thanks so much for the help.

Jessica & Buttercup

*I found the EPI/Diabetes page, so no need for anyone to answer that question in addition to all of my others.

For now it's best to keep posting on the same thread so anybody wanting to answer your questions can look back at all the information you've given and the suggestions others have offered.

It is best to give the antibiotic when you've giving food.  Mainly because some antibiotics can cause stomach upset if not given with food.

Moxi has a UTI now.  The antibiotic she's on is Baytril which comes as a chewable.  She'll eat it fine by itself so I just drop it on top of her food.  If Buttercup won't eat hers since you'll give it with food (and therefore with enzymes) you can use cheese if you need to.  Many of us use something like cream cheese pouches to give Tylan when we need to for SIBO since it's rather bitter.

As for the B12, it depends on how low her levels are.  Moxi's were pretty low and the vet didn't think she needed shots, so I'm giving her 2 a day, especially since she has SIBO too which will diminish B12.

Not sure about the percentage of EPI dogs that develop diabetes, but I don't think it's that prevalent.  I know it's all a bit overwhelming, but hang in there.  Most of it will become routine after a bit.  

Should I have anything tested tomorrow besides her B12 levels and her urine of course?

I agree with Paula...you've got it covered.  I think the B12 test is always done with the folate test.  The folate value can give you an indication of possible SIBO (although it's not completely reliable), but she's already on tylan for SIBO, so you don't really need that number for any reason.  The only other possible thing I can think of would be if you really suspect diabetes, but I would discuss this with your vet first if you are concerned, before you spend the money. 

Good luck at the vet!

I wanted to give an update on our vet visit and Buttercup's progress. I also have more questions (surprise!).

Buttercup weighs in at 55 pounds! She might belong on the Chunky Monkey page now. ;-) She is down to three cups a day, but when she was a "normal" dog, she had two cups a day. Are we good to go down to that now?

She has an ear infection and a UTI, so we are now on medication for both of those issues.

The vet called and said the B12 range is 280-836 and Buttercup is at 940. I guess it is good she is holding her B12 and switching to oral is worth a try.

I got some FortiFlora, which is a powdered probiotic. I would normally just mix that in with food, but I can't do that since she is still on Tylan. How do I give that to her if it needs to be 4 hours away from the Tylan? Should I mix it with cream cheese or something?