EPI * Exocrine Pancreatic Insufficiency

managing EPI

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Debbie
Member
Posts: 17

About 2 months ago we rescued a young female german shepherd. She was very malnourished (50lbs) and showed signs of being abused. About a month after having her we took her in to be spayed. During surgery they found that her spleen was severly damaged and she had to have most of it removed. We took her home hoping that the bleeding spleen was the problem and that she would start gaining weight. Since we got her she had normal to loose stool. Recently in the last 2 weeks she has been ravishing her food, eating feces, and severe cases of diarrhea and gas. We started with a stool sample and she came up positive for giardia. Can giardia and EPI exhibit some of the same symptoms? I am praying this is the case.

January 3, 2013 at 8:11 PM Flag Quote & Reply

Jill
Member
Posts: 1859

Mickey had a case of giardia and took two rounds of the Panacur, 5 day each to clear up. Then he had surgery and got pancreatitis. With the giardia Mickey would go out and poop 3 or 4 times at a "setting" with liquid coming out, then vomiting of foamy bile 2 or 3 times a night. I only let this go on 2 days and one night and took him in. they put him on metronidazol which totally wigged him out and I thought he was going to die on the spot one night, then I took him in and said no, so they put him on Panacur which he had no problem with. Good luck to you.

--

 

Mickey 6/21/99 - 8/29/2014 

17.5 lb  jack russell, chronic pancreatitis, hyperuricosuria

eats hard boiled eggs, RC Hepatic, mashed potato

2 #2 Dianes enzymes 6x premeal

 2.5 mg Amlodipine, .15mg soloxine am/pm, 100mg ursodiol started for gall bladder thinning 3/24

arthritis:  6.25mg tramadol 1x/day, 12.5mg gabapentin every 12 hrs,  Assisi soft loop used on back and elbow,started Yucca Intensive 2x/day 4/29/14, 1 540meq potassium citrate nightly

Denamarin once a day, 1/16 t tylan (150mg)  2x/day 

 Senilife started 12/14/13, Trixsyn

Optimmune and Dry eyes,  

Kiya is Mickeys sister, 3/4 aussie, 1/4 blue heeler born 9/2006.  She thinks she is a 44 lb jack russell who tries to heel Mickey!!

 

 

January 3, 2013 at 8:24 PM Flag Quote & Reply

Debbie
Member
Posts: 17

Jill at January 3, 2013 at 8:24 PM

Mickey had a case of giardia and took two rounds of the Panacur, 5 day each to clear up. Then he had surgery and got pancreatitis. With the giardia Mickey would go out and poop 3 or 4 times at a "setting" with liquid coming out, then vomiting of foamy bile 2 or 3 times a night. I only let this go on 2 days and one night and took him in. they put him on metronidazol which totally wigged him out and I thought he was going to die on the spot one night, then I took him in and said no, so they put him on Panacur which he had no problem with. Good luck to you.

Jill, What type of surgery did Mickey have? They have Cinnamon on flagyl right now to treat the giardia.

January 3, 2013 at 8:53 PM Flag Quote & Reply

Terry Bin
Member
Posts: 1559

I believe flagyl is Metro, which is one of the drugs used to treat SIBO (which a lot of epi dogs have) so using the flagyl may deal with two issues at once.  It will deal with SIBO but not the epi.  I don't know about giardia, but eating feces is seen in epi dogs:  they are starving and since they are not digesting their food, their poop smells like food and they go back to eat it.  Sounds like epi to me.  If you can get some porcine enzymes (not plant based as that does not replace but only supplements) and add to her food you may see some improvement.  Since they did surgery for the spleen, any comments on the condition of the pancreas?  I remember one member talking about how when surgery was done on their dog, no pancreas was found.

--

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 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  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 2 cups kibble with 4 oz cooked meat with 4 crushed tablets.

January 3, 2013 at 9:20 PM Flag Quote & Reply

Jill
Member
Posts: 1859

Hi Debbie:

Mickey had surgery for a mass removal on his liver. On his ultrasound checking for bladder stones they were looking around and saw a mass. They sent me to Oregon State University vet school and they did a ct scan. They operated and opened him up, only to find it was wrapped around his gall bladder so they left it in. He came out with a case of pancreatitis.

As far as Mickey and the metronidazole(flagyl) it made him act very paranoid, and not able to balance very well when walking. It discontinued about 8 hours after I last gave him a dose.

--

 

Mickey 6/21/99 - 8/29/2014 

17.5 lb  jack russell, chronic pancreatitis, hyperuricosuria

eats hard boiled eggs, RC Hepatic, mashed potato

2 #2 Dianes enzymes 6x premeal

 2.5 mg Amlodipine, .15mg soloxine am/pm, 100mg ursodiol started for gall bladder thinning 3/24

arthritis:  6.25mg tramadol 1x/day, 12.5mg gabapentin every 12 hrs,  Assisi soft loop used on back and elbow,started Yucca Intensive 2x/day 4/29/14, 1 540meq potassium citrate nightly

Denamarin once a day, 1/16 t tylan (150mg)  2x/day 

 Senilife started 12/14/13, Trixsyn

Optimmune and Dry eyes,  

Kiya is Mickeys sister, 3/4 aussie, 1/4 blue heeler born 9/2006.  She thinks she is a 44 lb jack russell who tries to heel Mickey!!

 

 

January 3, 2013 at 9:57 PM Flag Quote & Reply

Debbie
Member
Posts: 17

Terry Bin at January 3, 2013 at 9:20 PM

I believe flagyl is Metro, which is one of the drugs used to treat SIBO (which a lot of epi dogs have) so using the flagyl may deal with two issues at once.  It will deal with SIBO but not the epi.  I don't know about giardia, but eating feces is seen in epi dogs:  they are starving and since they are not digesting their food, their poop smells like food and they go back to eat it.  Sounds like epi to me.  If you can get some porcine enzymes (not plant based as that does not replace but only supplements) and add to her food you may see some improvement.  Since they did surgery for the spleen, any comments on the condition of the pancreas?  I remember one member talking about how when surgery was done on their dog, no pancreas was found.

Terry,

They didn't give me any comments about the pancreas. I began the flagyl on Monday and am waiting to see if I see results. So far her diarrhea has slowed and it isn't like cow pies anymore. My next step would be to get the EPI test. I have been searching for a reasonable priced vet to do the test as money is some what of an issue for us right now. Is it ok to try porcine enzymes even though she hasnt been properly diagnosed yet? Where can I find them at. This is all so new to me and I am in foreign territory. Thank you for all of your help. Even though it has been two short months we already love Cinnamon so much.

January 3, 2013 at 10:42 PM Flag Quote & Reply

Debbie
Member
Posts: 17

Jill at January 3, 2013 at 9:57 PM

Hi Debbie:

Mickey had surgery for a mass removal on his liver. On his ultrasound checking for bladder stones they were looking around and saw a mass. They sent me to Oregon State University vet school and they did a ct scan. They operated and opened him up, only to find it was wrapped around his gall bladder so they left it in. He came out with a case of pancreatitis.

As far as Mickey and the metronidazole(flagyl) it made him act very paranoid, and not able to balance very well when walking. It discontinued about 8 hours after I last gave him a dose.

Jill,

Luckily I haven't seen any of those symptoms in Cinnamon since she began the flagyl.

January 3, 2013 at 10:43 PM Flag Quote & Reply

epi4dogs
Site Owner
Posts: 12987

Prior to testing for EPI, my nvet treated my gal Izzy for Giardia and placed her on Flagyl too... for two weeks.... the loose stools disappeared... but only temporary... then they returned within a week with a vengence... then my vet decided to test for EPI and actually put my gal on enzymes that same day that he drew the blood... even before we had the test results.  The enzymes won't hurt anything and will not skew any testing but on the flip side, you don't want to put Cinnamon on enzymes long-term if it is not what she needs and the cause of what is going on is something other than EPI....'


For us, we had to wait almost two weeks for the results..and the TLI test confirmed that she did indeed have EPI..... but within those two weeks my gal was started on grain free food, enzymes and Flagyl (again) .... and her stools STILL didn't improve...  until my vet changed the antibiotics to Tylan... then the nextday we had firm poos.       

--

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 changes to our daily EPI routine. We had to alter the fiber, type of fiber and the fat content her diet. She was getting Annamaet Lean kibble plus a lean meat and did well on it....... but we have since switched again because of her diabetes to an all home-made diet which she does even better on and has even been able to reduce the Vetsulin (por-based insulin) dose from 9 units to 6 units... because of the diet change to all home-made i no longer worry about hypoglycemia- -she is much more even keeled with a diet of sweet potato+ a lean meat+coconut oil/fish oil+vitamins and bone meal. We tried Novolin N a human synthetic RNA insulin.... but Izzy did not do well on it. aside from all of Izzy's health issues.... she continues to wake up every day full of joy and a great sense of humor!


January 3, 2013 at 11:34 PM Flag Quote & Reply

Debbie
Member
Posts: 17

epi4dogs at January 3, 2013 at 11:34 PM

Prior to testing for EPI, my nvet treated my gal Izzy for Giardia and placed her on Flagyl too... for two weeks.... the loose stools disappeared... but only temporary... then they returned within a week with a vengence... then my vet decided to test for EPI and actually put my gal on enzymes that same day that he drew the blood... even before we had the test results.  The enzymes won't hurt anything and will not skew any testing but on the flip side, you don't want to put Cinnamon on enzymes long-term if it is not what she needs and the cause of what is going on is something other than EPI....'


For us, we had to wait almost two weeks for the results..and the TLI test confirmed that she did indeed have EPI..... but within those two weeks my gal was started on grain free food, enzymes and Flagyl (again) .... and her stools STILL didn't improve...  until my vet changed the antibiotics to Tylan... then the nextday we had firm poos.       

Are next step is to do the EPI test. My question and I apologize if it is to personal is about how much do you spend in a year on treatment. We unfortunately are a family with two young children and live paycheck to paycheck as it is. I looked on Diane enzyme and feel that the enzymes will be do able. But are their alot of other unforeseen charges all the time. Like I've seen comments about needing B-12 shots often. I am heart broken over this situation and am just trying to do our best with what we have to work with. Would it be a good idea to order one of the samples from Diane enzyme website and if so what is a good one to start with?
January 3, 2013 at 11:53 PM Flag Quote & Reply

Sailin Suzie & Brenda
Member
Posts: 1017

Hi Debbie,   There are many people in your shoes at this time, so please dont feel embarrassed if you are hard pressed for money.  It is the sign of our Nation right now.  As for enzymes, yes I would see no problem with getting enzymes and giving it a try.  I suggest you make a phone call to Diane.  She is very helpful and will tell you exactly what to get to try enzyme treatment.  And she is not a "salesman" and would never take advantage of you, so put your complete trust in her.  Most of us here, including myself, trust her completely.  I have bought from Diane for many years now.   As for B12 shots.  Not a big deal either.  I get a bottle of B-12 (not B complex as it wont work for you) and some syringes at a vet supply store and give Suzie a shot a week myself.  They are easy to do just under the skruff of the neck.  And the dosage amount is listed in the information tabs on this website.   You can also order Tylan antibiotics on line for a very reasonable price.  If you research the tabs at the top, you will find out where to get these things.   EPI is very managable and not that expensive once you get your dog stable.   I also agree that testing should be done, but if you cant afford it at the moment, treating for EPI will not harm your dog.  You will know very quickly if it is NOT  EPI, as she wont improve.    And everyone here will help you as best we can.  There is a wealth of knowledge in the members here.  Anything you need to know, just ask.

--

Brenda & Sailin Suzie.   Worlds Greatest Boat Dog

January 4, 2013 at 12:18 AM Flag Quote & Reply

Wimmysmom
Member
Posts: 207

Hey..

I just was reading the post headers and I saw EPI vs Giardia... My dog had such severe giardia..that it caused the problems we now are dealing with. We had to go many, many, many rounds of Flagyl (metro), Panacur..etc. That poor dog nearly died several times but we finally came up with a clean sample (no giardia)...after a month!!! That is really a long time for most cases. Not typical either.

 If you can prevent the dog from eating poop it would be best. The giardia will keep returning if you do not keep the area they poop in as clean as possible, then you also have to wipe their feet and our vet went so far as to have us wash her every day. Yours may not be so severe..I hope it isn't. Once we finally got rid of the giardia, my dog still had diarrhea. That is when I turned to this forum and was led on to find the right help for my dog. We ended up having to do a full thickness biopsy and a TLI test etc. to find out what was wrong with her but in the meantime we gave her enzymes hoping it would help. It wont hurt your dog. It didn't hurt ours..it may have even helped a bit..but it didn't cure the diarrhea. We ended up taking her to a specialist in colorado springs who helped us figure out her diet. She told me that most dogs with dietary issues such as ours can be helped by giving them 99% lean ground turkey mixed with baked potatoes. We just brown the meat and then chop up cooked potatoes and mix it in. Giving your dog that diet should help while you are figuring out the rest. Our dog had allergies to chicken, beef, fish, pork..etc..plus she has Inflammatory Bowel Disease and Lymphectasia. We are now EPI too.

 Whimsey has to take B-12 shots weekly, eat that bland diet of turkey and potato..but we are able to give her 80% lean turkey and we mix in white rice and a dehydrated dog food called Preference. It is a very bland and exceptionally low fat diet..but that is all she can tolerate. We also give her Tylan and 10mg prednisone daily.

We had to find all of this out the very long and hard way. I am hoping things go better for you and your dog won't be so complex..but I just wanted to let you know that having giardia can cause other problems and treating for EPI wont hurt..but if things still don't seem right it is always good to get tested..I understand the money part trust me..and I know that we aren't supposed to recommend a certain diet..but that bland diet that our dog is on stopped her diarrhea immediately.

There are many great people here..they will help. :)

Heather and Whim

--

Whimsey is an 2 1/2  year old German Shortrhair Pointer. She was diagnosed IBD/ Lymphangectasia/allergies ,via full thickness biopsy, in December 2010. She currently eats: ground turkey, rice, potato, The Honest Kitchen "Performance"  10mg Prednisone, 1/4tsp Tylan. She also gets a B-12 shot monthly. . Also mom to Rolo a 11yo. Chocolate Lab. Oh...Tim and Jane too..my 2 legged children.:)

January 5, 2013 at 4:30 PM Flag Quote & Reply

Wimmysmom
Member
Posts: 207

PS.. we are the same way..We have 2 kids..my son eats like a football player and he's only 11..and we live paycheck to paycheck too. With the enzymes..I can't comment much. We just started them up again and this was due mostly to the fact that our dog won't gain any weight. We got rid of the diarrea about 1 1/2 years ago. So she is not 100% EPI like the other dogs here..I went to Amazon and found some very affordable enzymes. I would however, order one of enzyme diane's sample packs..she gives you just enough to see if it helps..but then you aren't out a ton of money. The Tylan and prednisone and B-12 we get from KV vet online and it is pretty affordable. It may or may not be what you need...and checking with a vet will be helpful..but our vet knew less about this than I did. :( Like the other gals said..once you get it figured out, it is pretty affordable..it is just getting to that point.

Keep your chin up..your dog will thank you! :)

Heather

--

Whimsey is an 2 1/2  year old German Shortrhair Pointer. She was diagnosed IBD/ Lymphangectasia/allergies ,via full thickness biopsy, in December 2010. She currently eats: ground turkey, rice, potato, The Honest Kitchen "Performance"  10mg Prednisone, 1/4tsp Tylan. She also gets a B-12 shot monthly. . Also mom to Rolo a 11yo. Chocolate Lab. Oh...Tim and Jane too..my 2 legged children.:)

January 5, 2013 at 4:44 PM Flag Quote & Reply

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