EPI * Exocrine Pancreatic Insufficiency

Hondo before treatment  

In August 2004, I lost my best buddy, a GSD named Duke. Within 8 months I lost him, a cat, and 2 other dogs. I took it hard, especially Duke. After about 6 weeks or so of moping for Duke, my friends were worried about me. One friend dropped off a GSD pup she wanted me to “baby sit” for the day. Hint-hint. A neighbor took me to her friend who shows and breeds, thinking maybe I’d take one. My best friend, Connie, called one day. Her and her husband wanted to buy me one from the breeder in RI where she got hers and have it shipped to MI. By October I started talking with breeders and scheduled an appointment to see one on a Saturday. I got my husband to come with me. She brought out this little bundle of fur, so calm and gentle. Don picked it up and it got crazy. She held it again and it just settled down. I held it and he went crazy again. The breeder couldn’t believe in the change. She made a comment about Dr. Jekyll and Mr. Hyde. We laughed. Then we spent some time there playing with him and a litter mate and left. Think he knew he was ours? We were about 1/2 way home when Don pulled into a store, said we were getting a crate and called her back and said we were coming back for him. I still wasn’t sure I was ready but Don said something had to help me out of this slump. So back we went. I cried all the way home, felt guilty. But it was the best thing he could have done.

Hondo after treatment

This pup was no calm pup. We named him Hondo. He was so full of mischief, kept me on my toes non - stop. Hondo ran me ragged. He ate the carpet, rugs, and got into everything. In the first year, 2 times I had to go for X- rays. Once it was a broken nose. He was just a non stop wild child. Grandkids called him a psycho dog. But Hondo was just so very loveable and enjoyed kids and other dogs too! He was very timid, though, around adults and outside of his home territory. At 5 months of age, I took him to obedience. He stayed behind or between my legs. Wanted to run with the other pups, but was too timid. Instructor suggested bringing him in for puppy classes, also. This made a world of difference in just a couple of weeks. Then I spent lots of time socializing him. I took him just about everywhere with me. Today, you wouldn’t know he was the same dog. He still gets excited over being able to play with other dogs and still loves kids.

In a span of a few months after I got him, he had roundworm, hookworm, tapeworm and Coccidiosis. No one could understand it. He was on heartworm meds and had been wormed. He was always having normal poops, then diarrhea, then mush. This went on for months. He had lots of fecal tests done. He also had been on metronidazole, Tylan, bland diets, and Science Diet ID.

Around October 2006, we picked up another pup (a sister for him). And then he got the diarrhea back really bad, the cow paddies, the mushy poop kind. We tried all the bland diets, metronidazole, and did fecal tests again. Nothing seemed to work for long. A few days good, then back at it. He was free fed. I was constantly filling up his food dish. The more he ate, the more he pooped. I think one morning we counted poops 4-5 times before 10:00 a.m. And these were not small piles, but big, stinky piles! I thought it was because we got Molly, his sister. The vet assured me it wasn’t. In January 2007 he tested positive for tapeworms again. And he started losing weight. He was never a big dog, always skinny, weighing between 76-77 lbs. Now he was around 71–73 pounds. End of January 2007 blood was drawn for a TLI test. Since I had been searching for causes, I knew what this was and was hoping it wasn’t. Beginning of February 2007, I had my answer. He had EPI. His TLI tests came back at 0.4, high folate and low cobalamin. He was then started on Viokase (enzymes). Not much was explained to me, I was doing lots of research on my own. By mid February I called the vet as he was having diarrhea again and asked about B-12 or antibiotics. His tests indicated he had the SIBO and low B-12. I was told no need to supplement with B vitamins or run a course of antibiotics, but instead to just increase pancreazyme. In May 2007, I mentioned all the “gas”. This time I was told to try decreasing the viokase. (He was on either/or enzymes). This went on all summer. He’d be fine, but then every couple weeks Hondo would have diarrhea, cow paddies, etc., and he was still losing weight. I was switching between regular food and bland diet constantly. In September 2007 he was down to 68 lbs. I was taking him to vet every couple weeks for weigh ins. I would weigh him, tell them he was on the bland diet again, and we’d leave. They never wrote it in his chart. Guess they thought I was a bored housewife who had nothing better to do but drive 20 miles to see he wasn‘t gaining.

Once during the summer he had a bleeding sore on his tongue. It went away. In September 2007 he got it back so I took him to the vet. It wasn’t just the tongue. It was on the palate and all. They thought it could be an immuno-disease or the enzymes. They then suggested I soak the enzyme with the food in water. Why didn’t they tell me that before? How much other damage had I done? Needless to say, we now soak. We were still having problems with soft stools every few weeks. Still letting the vet know and still searching online and B-12 and SIBO keep coming up. Vet still says to go back to bland diets.

In October 2007 I signed up to join K-9 epiglobal yahoo group http://pets.groups.yahoo.com/group/k9-EPIGLOBAL/ Right after I called the vet asking for antibiotics again to try. She gave me 10 days metronidazole. I got accepted into the K-9 epiglobal group later that day. Immediately I felt hopeful again. What I had thought all along, they concurred. I was going to give up and they gave me hope. I mean, why go on with the struggle when you are only going backwards? How does Hondo feel? Was I only keeping him alive for my sake? Was he one of the dogs that wouldn’t/couldn’t be helped? One thing that was verified, I had found a website for SIBO and it said minimum 30 days for antibiotics, some dogs long term. K-9 epiglobal verified it. Since he had tested positive for it in February and was never treated for it, 10 days 8 months later wasn’t going to help. So I did something I never did. Found a place online that sold Tylan without a prescription and ordered it. Hondo finished the 30 days with the Tylan. While on the Tylan, he did great. K-9 epiglobal group “held my hand” throughout this. They let me vent. They gave me advice. I had never belonged to a group before, so glad I joined.

Beginning of October 2007, I decided to go to the generic enzymes as it is 1/2 the cost and the expense was getting hard. The vet did not agree to it. But I decided to do it anyways. Hondo was now down to 67.5 lbs.

On October 30^th  I scheduled Hondo’s yearly exam a couple weeks early, armed myself with papers on SIBO, B-12, etc., and decided I had to put my foot down. I was told she didn’t have time to argue with the internet. Why did I feel he needed the B-12 shots and Tylan. Finally we got it together, he had tested low B-12 and high folate for the SIBO, was never treated so we were just going backwards. She wouldn’t agree to do anything but would call TAMU for advice. I received a call later that day that we were going to start the B-12 shots, bring him in the next day and 30 days of Tylan if needed. Since he was just getting off of his 30 day behind her back treatment, I agreed. We started the shots and within 3 days of going off the Tylan, he had the dire rears back. So I got the 30 days Tylan from the vet. Immediately after the first B-12 injection, he started gaining some weight back. Within 2 weeks he was up to 70.6. But he still had gas. By the end of November 2007 he was back up to 72 lbs. Still not perfect poops, sometimes hard and other times mushy. So then she started saying it was the generic enzymes. Even though this had been going on for a year?

Then my husband suggested again of putting him down. I am not a quitter. I am a fighter. EPI global has been a lifesaver. Someone wrote to the “newbies” (new members on the epi global group) about changing vets about 3-4 times before finding one that would work for and with her. I felt that hint was directed straight at me, i.e. we had been going back and forth for so long and now my husband was giving up. So in the beginning of 2008, I made an appointment with a different vet for a second opinion. This vet gave him a thorough physical and said she felt his intestines were thickening and along with an X-ray suggested he may have IBD now. We had just switched foods, again, to a novel protein, carbohydrates, fish and sweet potato. She put him on a dose of prednisone for a month and metronidazole for 3 weeks. Midway through, we had a bad relapse. Throwing up, dire rears big time, down to 66 lbs. In February 2008 Hondo’s hind end was weak. I didn’t think he was going to make it. Switched to duck and potato and started to improve, then again, after a few weeks, started to get soft. That is when after a lot of searching and thinking, we decided to switch him to raw. The end of March is when we made the switch he took to it great. Stools immediately were in much smaller amts, only going 2 -3 times a day. It is a lot of work, since he has EPI, everything has to be ground in a grinder. Bones, meat, and veggies, it all has to be ground up. But if it will help him, we will do it. He is my guy, my sidekick, my buddy. My Mr. Hondo. Throughout all of this, he has been a trooper. You would never know he was sick.

Here is where we are at today. Still not perfect, formed hard stools, but not diarrhea, some formed, some not so formed. The gas has stopped as of a few weeks ago. Weight as of Thursday, May 15, 2008, is 74.8, yes! As he was weighed, the tears started falling. The receptionist had to hand me a Kleenex. I never thought he’d get that far, that fast, after our last “blowout”. Fur looks shiny, has lots of energy. We may never have perfect poops, but I will take what I can get now. We are doing B-12 shots monthly at home and Hondo is still on Tylan and has been since Oct. 2007. We have tried to go off the antibiotic, Tylan, a few times but within 3 days he has diarrhea again. If he keeps up like this, may try to go to a lower dose then off, but vet wants to wait until he has 30 days of good poop, so until that happens….Him and Molly are best buddies and if they can’t get me to play, they beat each other up. Molly gets all of Hondo’s leftovers and she doesn’t seem to mind a bit. Although, she does like the raw, which she gets every now and then.

I have been in contact with Hondo’s breeder and she doesn’t know much about EPI, but she knew enough to say she knows she can’t breed those two again. This is her first EPI dog. She also emailed me in February 2008 saying if Hondo doesn’t make it, we can go pick up another pup. I thanked her and told her I don’t want another one, I want Hondo. This is the biggest fight I have ever done, but we are going to do it. I still like my old vet and would recommend her for someone else. But my new vet is willing to work with me, not afraid to do research, will call TAMU if she has questions. Read what I brought in for her. She even made copies of some. Hondo hasn’t had to go back in awhile except for weigh-ins, but if I have a question I can call and she calls me back. She will talk to me for quite awhile if need be. That was the hardest call I ever had to make, to my old vet, to ask for my records. I had been with her for years, but in the end, I had to put my personal feelings aside and do what I thought best for Hondo. I know it won’t ever be easy for us. There have been lots of sleepless nights, many, many tears, lots of guilt feelings. It is such a frustrating disease. No two dogs are the same, nor can they be treated the same. I will always wonder, if he was treated for SIBO & B-12 right away, would we be where we are, or would he be stable. Could I have caught it sooner? Is it something I fed him? Was it bringing home Molly? Even though we will always be one of the “difficult” cases, we will persevere! July 19, 2008 we will celebrate his 4th birthday, something last year I didn’t think would happen. We are getting there.

This research is so important for these fur babies. We need to find the cause and to also educate vets more about this disease. Since not many vets see it, many do not know how to treat it. We need to get the word out! When fecal tests turn out negative, the first test done should be for EPI, SIBO, B-12, etc. Then do research on how to properly treat it. Ask questions. It would help a lot of doggies and save their owners a lot of heart ache.

Hondo’s mom, Karen (P.S. As of May 2009, Hondo is tipping the scales at a glorious 99.1 lbs!!!)

...for all those that visit this website... you have probably noticed that we have happily reported Hondo's steady weight increase since we first published his story...just want to let all those that read about Hondo.... that yes, there IS hope!