New and going to the vet on Wed

Epi4Dogs Foundation Inc.’s mission is the advancement of science and education relating to EPI (Exocrine Pancreatic Insufficiency), yielding useful insights and positive outcomes in better managing EPI in dogs and cats. Our goals are to support and/or collaborate with veterinary EPI research and researchers, and to promote EPI awareness by educating the general public, pet owners, pet organizations, rescue and shelter organizations, veterinary schools and veterinarians.
Jane&Clyde
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Posts: 157
Country: United States
Pet name: Clyde
My name: Jane

Re: New and going to the vet on Wed

Post by Jane&Clyde » 06 Jan 2021, 17:14

We just got back from the vet. The good news is that they drew blood and the whole digestive panel (TLI, PLI, B12, and folate) is going to be run. The vet also prescribed 5 days of Panacur in case Clyde could have giardia.

The bad news is that if Clyde's folate is high indicating SID, the vet wants to prescribe Metro. I decided to save that battle for after the results come in.

Another concern is that if Clyde's B12 levels are low, he wants to do B12 injections. In my household, it would be very difficult to take Clyde to the vet weekly. I already have Wonderlabs Pet Factor B12 and would prefer to try that first.

But, I guess I'm anticipating problems that might not even happen, and should just wait until I hear the results.

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Olesia711
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Re: New and going to the vet on Wed

Post by Olesia711 » 06 Jan 2021, 19:23

YEA!!! Glad to hear that CLyde had all the tests done- -oh... did the vet also check for Diabetes? Anyway........now you wait.........................

If Clyde does have EPI, i am guessing his SID is probably out of control.... but PLEASE, do not put him on Metronidazole if Clyde has EPI... EPI is a chronic condition and all dogs with EPI have SID (small intestinal dysbiosis) to one degree or another.... if/when it is out of control is when we treat it...out of control is any of the following signs: "SID is not under good control if the dog displays any repeated signs such as yellowish or pale colored stools, loose stools, gelatinous stool coating, flatulence, lack of appetite, stomach noises, vomiting, acid reflux, "

Anyway... EPI dogs do not have enough bacteria in the gut AND they also do not have enough diversity of bacteria in the gut. Metronidazole is used for many things but you don't want to use it for a "chronic" gastrointestinal condition because it kills ALL the bacteria in the gut (beneficial and non-beneficial bacteria) and the problem is when some of the bacterial strains are killed, they are forever removed and can't be reintroduced into the gut .... for an EPI dog (or any dog with a chronic gastrointestinal condition).... this is one of the worst things you can do :(

THe fact that you started Proviable is a good thing... "hopefully" you will start to see improvement with the gut (SID)... but if you don't, then ask the vet to prescribe Tylan/Tylosin Tartrate soluble powder .. NOT metronidazole. Please feel free to share the 2020 Research on Metronidazole with your vet and why we are recommending (strongly) not to use it: https://epi4dogs.com/sid-sibo-microbiome-research/
It's best not to use any antibiotic, but if you have to TYlan is much better because it is a macrolide antibiotic... in short... it doesn't kill bacteria like Metronidazole but rather inhibits bacterial reproduction.... so the gut isn't altered/damaged permanently like it is with Metronidazole.
You can get Tylan from Chewy
https://www.chewy.com/tylan-soluble-powder/dp/173769
... your vet just has to either write a script for you or authorize your Tylan order.
Or your vet can order it himself from a multitude of places... for example:
https://www.medi-vet.com/VetOne-Tylosin ... /19172.htm

Regarding the B12 shots... it has been proven (via Texas A&M Gastrointestinal Lab research) that high-dose B12 pills work as well (or better in many cases) than the B12 shots. So i am personally comfortable suggesting to you to just give Clyde the Pet Factor B12 pills. the dose for the Pet Factor pills are the same as the shots would be (it is according to weight) https://epi4dogs.com/b12-protocol/ However if your vet insists on the shots, then have him sell you a vial of B12 serum and ask him to show you how to give the B12 injections so you can do this all at home. But (full disclosure) many of us prefer the pills and the B12 pills from Wonderlabs (Pet Factor B12) have been proven on multiple occasions to work better than the shots in some cases.

Even though you don't have the test results in yet.... i think it is good thing to have an idea of how you are going to proceed if it is EPI.
Kudos to you!!!!!!!!!!!!! :)
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

Tuckaboo Pam
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Posts: 1345
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: New and going to the vet on Wed

Post by Tuckaboo Pam » 06 Jan 2021, 19:52

Jane, let me get this straight----You went to the shelter, and said, "give me that skinny pit mix there, the one with the heartworms, whip worms, and sores all over his skin"? You must be some kind of special angel. What a lucky dog he is, and Tucker & I wish the best for you both. Glad you're here. ---Pam
Tucker was a shepherd/lab mix--- TLI 1.3, Folate 9.7, Cobalamin 666, Lipase 38. Took Diane's Enzymes 4 teaspoons/day, Wonderlabs B12 one capsule per day, and Tylan 1/16 teaspoon/ morning (to hold SID at bay). Taste of the Wild High Prairie, 1 1/2 cups/day, with a total of 4 cups of Fresh Pet. Stopped eating everything in sight, and went from 60 to 85 pounds! Tucker was my boyfriend, and my husband was OK with that. Tucker succumbed to hemangiosarcoma, but we cherished every day we had with that wonderful, beautiful boy. I will always, always miss my sweet big boy.

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Madelon
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Re: New and going to the vet on Wed

Post by Madelon » 06 Jan 2021, 20:43

So glad you're getting the tests run. In the meantime you might print out our information on Tylan and why not to use Metro and bring it to the follow up visit with your vet so you can explain to your vet why you would prefer not to use Metro. My vet wanted Metro as well but I brought in all the research and insisted on a prescription for Tylan. As far as the B12 - my vet didn't think the B12 needed to be supplemented because it was 406 but even if they had agreed I couldn't take him weekly because he's so dog aggressive so I opted for the WonderLabs pills and just let my vet know what I was doing - he said since Doc has no other medical conditions where too much B12 is an issue it would be fine - his levels quickly went above 1,000.

Please keep us posted on how things are going and whenever I disagree with my vet I always ask "why" or "why not" and when it's not a life threatening type of issue we agree to try it.
Madelon, owned by DOC. DOC dx EPI 5/2015 = TLI < .4, B12 406; Folate >24. DOC taught me so much and together we battled and overcame EPI, food sensitivies, environmental allergies but we lost the cancer battle. DOC was dx with hemangiosarcoma 5/2022 and crossed the rainbow bridge July 24, 2022. He is and always will be the love of my life, my soulmate, my heart dog.

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Jean
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Re: New and going to the vet on Wed

Post by Jean » 07 Jan 2021, 06:39

we will be interested to learn the results
My name is Jean we live in Liverpool in Uk

I am the Forum Director which I am very proud of

My Kara born 21 July 2009 diagnosed with EPI by cTLI test August 2010 TLI = <1...folate 14 Cobalamin 408, shot down to 94, b12 injections every other day

Lowest weight 39 pounds

We used Panzym enzymes, Tylan and Chemeyes b12 capsules

Sadly, on 10th May 2019, we lost her to DM


Jeanx

Jane&Clyde
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Posts: 157
Country: United States
Pet name: Clyde
My name: Jane

Re: New and going to the vet on Wed

Post by Jane&Clyde » 07 Jan 2021, 18:58

We have results! And they make perfect sense based on what I've seen with Clyde.


PLI: 30 (normal)

Folate: 10.8 (normal) Yay! No trying to talk the vet out of Metro.

TLI: 2.7 (not quite EPI, but significantly below normal) Since his body condition is poor and he has symptoms, we're going with the EPI diagnosis.

B12: 227 (below normal) The vet would have preferred to do injections, but he was ok with trying the oral B12 first. I already have Wonderlabs Pet Factor B12 and started it today.


So, the plan is to continue enzymes, continue Proviable, and add B12. I am going to continue the Slippery Elm, too. After a couple of days, it seemed to make a little bit of a difference in poop consistency. His B12 will be rechecked in a couple of months.

The results made perfect sense to me because Clyde seems to have a milder version of EPI than most of the dogs on here. I have quickly been able to get things mostly under control, which doesn't appear to be the case for many of the dogs on here. If Clyde gains some weight after starting the B12, we'll be in a good place. I understand that we might not always be this lucky, that things could change, but for now, I'm just counting my blessings.

Unfortunately, his glucose level wasn't checked. It fell through the cracks. We were dealing with "curbside only" service, so I gave my notes to the vet tech, and she relayed the info to the vet. I did eventually get to talk to the vet himself, but by that time, I had forgotten all about the glucose. I left without getting the heartworm prevention that I had asked the vet tech for, too. LOL I just was so focused on the EPI, that I forgot everything else and had given my notes to the vet tech. I'll continue to monitor his drinking and peeing, and he could have the glucose checked when we recheck his B12.

And, yes, I pretty much went in to the shelter and asked for the skinny pit mix. LOL What I didn't mention in my intro was that the shelter staff thought Clyde might be deaf. However, within a couple of days, I could tell that he could hear. I'm a real sucker for an underdog.

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Olesia711
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Posts: 3857
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: New and going to the vet on Wed

Post by Olesia711 » 07 Jan 2021, 23:17

Well... at least now you know how to treat... although he is what we call SEPI... (subclinical EPI) he is SOOOOOOOOooo close to the actual EPI mark that you might as well say he has EPI. Glad your vet is going ahead and treating as if this is full blown EPI and glad that the vet has agreed to let you do the Pet Factor B12 pills. The only thing i would like to strongly suggest is to have his B12 checked in 2 or 3 months... what you will have to do is stop giving the pills for 1 week prior to his blood being drawn for the B12 blood test. THis way you will have a good bench mark of his B12 (which, by the way , is very low right now) AND it will also tell you how well (or not) the B12 pills are working. Usually they work very very well, but it is best not to assume and test to make sure.

Also.... it is possible that once you bring his B12 levels up that his poo output might improve. So be sure to take good notes on his progress and even take poo pics so you can compare / assess.

REgarding his TLI value... we did some previous EPI research and what is very interesting is that some dogs with CLyde's TLI value will forever hoover in that range and never become fully EPI, while other's will plummet into confirmed EPI territory. it's about a 50-50 chance which way they go. Crazy stuff.

Do get him checked for Diabetes when you next go to the vets... just in case/better to be safe than sorry....unless his excessive peeing/drinking subsides (sometimes it is the enzymes) and please keep us posted!
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

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Jean
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Posts: 1707
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: New and going to the vet on Wed

Post by Jean » 08 Jan 2021, 08:20

2.7 is so near the positive for EPI, so I am glad you are following the protocol

I wish you the best of luck and keep in touch
My name is Jean we live in Liverpool in Uk

I am the Forum Director which I am very proud of

My Kara born 21 July 2009 diagnosed with EPI by cTLI test August 2010 TLI = <1...folate 14 Cobalamin 408, shot down to 94, b12 injections every other day

Lowest weight 39 pounds

We used Panzym enzymes, Tylan and Chemeyes b12 capsules

Sadly, on 10th May 2019, we lost her to DM


Jeanx

Tuckaboo Pam
Member
Posts: 1345
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: New and going to the vet on Wed

Post by Tuckaboo Pam » 08 Jan 2021, 17:26

Jane, PLEASE keep us posted on his progress! I am so interested in your story. Thanks! Pam
Tucker was a shepherd/lab mix--- TLI 1.3, Folate 9.7, Cobalamin 666, Lipase 38. Took Diane's Enzymes 4 teaspoons/day, Wonderlabs B12 one capsule per day, and Tylan 1/16 teaspoon/ morning (to hold SID at bay). Taste of the Wild High Prairie, 1 1/2 cups/day, with a total of 4 cups of Fresh Pet. Stopped eating everything in sight, and went from 60 to 85 pounds! Tucker was my boyfriend, and my husband was OK with that. Tucker succumbed to hemangiosarcoma, but we cherished every day we had with that wonderful, beautiful boy. I will always, always miss my sweet big boy.

Jane&Clyde
Member
Posts: 157
Country: United States
Pet name: Clyde
My name: Jane

Re: New and going to the vet on Wed

Post by Jane&Clyde » 10 Jan 2021, 15:25

I have a couple of questions. I realize every dog is different, but...

For those whose dogs experienced excessive urination when placed on enzymes, how long did this last? Days? Weeks? Months?

For those whose dogs take Wonderlabs Pet Factor for low B12, how long before you began to see a positive change in poops, energy, or anything else?

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