New EPI diagnosis

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.
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Olesia711
Founder & Research Director
Posts: 3858
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: New EPI diagnosis

Post by Olesia711 » 13 Mar 2021, 21:01

WOW Nicole, Thank goodness you double checked to see if the vets office tested for Diabetes. So glad you caught this AND checked up on it... PHEW!
Cali sure is so lucky to have you are her human companion!

445 is not bad for uncontrolled bran new diabetes.... not good but now that she is on insulin.... and once you and your vet figure out the right does, things should improve.

the goal for a non-EPI diabetic dog is to keep the blood sugar value fairly stable and if possible in the 100's.
with an EPI + Diabetic dog, the goal post moves.... if you can keep the blood sugar no higher than 250, then you are doing good

Also.... there could be what they call a honeymoon period. you get the diabetes under good control and you think all is well, and then a few months later everything goes to hell..... this might happen... but this too you will get through.

One key point i forgot to mention... with this dual health problem..... going forward feed Cali ONLY twice a day with insulin 12 hours apart (and of course enzymes) if you feed snacks or inbetween meals, the diabetes will not be well managed......... feeding 12 hrs apart and being consistent is extremely important.

The not good poos, most likely was not due to Diabetes but rather the EPI part.... BUT.... new wrinkle here.... with EPI if the SID is out of control, that could cause a wee bit of inflammation... that wee bit of inflammation can trigger higher blood sugar values.... so ... this is another reason to try and keep the SID under good control.

SO.... the food.... UGH...... this is the HARDEST part..... have you tried home feeding? for us, a combo of home feeding with a little bit of is what helped get everything in control for us..... BUT..... with both EPI & Diabetes, you probably are just going to have to try things to see what works best.

SO..... middle of the road dog food that might work with both EPI + Diabetes is possibly Annamet Lean and Grain Free, or Taste of the wild / pacific stream or priarie version or Sport Elite grain free, the other suggestion i have is go on Chewy website ... look at foods that are grain free, not a lot of peas, (or pea free) ... if you have to use a food that has a higher fiber content (like 5%) you most likely will have to increase the amount of enzymes you are using to compensate.

In short..... my guess is that you will be trying lots of different types of foods... KEEP RECORDS on the ingredients and which food appears to work better than another.
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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Madelon
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Location: Nashville, TN
Country: United States
State: Tennessee
Pet name: Doc

Re: New EPI diagnosis

Post by Madelon » 14 Mar 2021, 11:17

Oh gosh - you two have been through SO MUCH! I'm glad you got this diagnosis and she's already starting treatment. Olesia will be your best guide in managing the diabetes and EPI.

Before reading the diabetes diagnosis I was wondering if you could tell us exactly what dry food you are using - you said it was soy, corn free but that doesn't necessarily mean it's grain free and the fiber content is what we recommend and that could be what has been causing the issues with getting SID/EPI managed. So, if your current food does not specifically say grain free and is not 4% fiber or less that might have been a big part of the problem. I would definitely recommend trying one of the foods Olesia suggested.

Hang in there - you got this!
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.

CaliGirl
Member
Posts: 63
Country: United States
State: California
Pet name: Cali
My name: Nicole

Re: New EPI diagnosis

Post by CaliGirl » 14 Mar 2021, 12:31

Olessia- I thought about the fact she was getting 3 meals a day and how that would work, ok going forward I will do 2 meals, but my question is, should I still be doing 150%? She is currently getting a total of 1 cup and a half of food( that was spilt into 3 meals) should I still give her the same amount , split into 2 meals? Or lessen the food, I still need her to gain weight too...
.right?
this was all definitely a curve ball, and I know it will eventually get there, right now I think I am just very overwhelmed. She is a puppy. Giving her these shots are hard enough, she doesn’t understand, she doesn’t stay still. I have tried to do it while she is eating, she has already learned what I’m doing and tries to hide to eat.
I will look into different foods and see what I can find.
As far as the SID I don’t know what to do. I can’t get antibiotics. I don’t know how to figure that part out.

Barb
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Country: United States
State: New Jersey

Re: New EPI diagnosis

Post by Barb » 14 Mar 2021, 14:38

Oh, Nicole, I am sorry that Cali has this new complication! You are to be congratulated for being alert and observant, so that you thought to ask about the glucose.

If anyone has done an amazing job with these two conditions (plus many more!) it is Olesia. I just marvel at all that she went through with Izzy and that girl lived to be almost 15. You are in good hands. I certainly understand your overwhelmed feelings, but taking one day at a time is all we can do. When one of our Bridge German Shepherds,(Kip) developed Degenrative Myelopathy on top of his Seizure Disorder, I didn't think I could cope. But we made up our minds to treasure every day with him and not project into the future. He lived to be 13....and we had no regrets.

You have a lot on your plate, so be gentle with yourself. And if you need to vent, someone is always here to listen.

Hugs.

Barb

CaliGirl
Member
Posts: 63
Country: United States
State: California
Pet name: Cali
My name: Nicole

Re: New EPI diagnosis

Post by CaliGirl » 18 Mar 2021, 10:30

Good morning everyone. Just a little update and of course more questions, Cali has been having more consistent hard poops, yesterday she had one “soft formed” poop the rest were hard. We have been averaging 3 poops a day now. I don’t know if this is because of only getting two meals a day, or the “up” in enzymes? Again she is still getting the same amount of food, 3/4c with a tiny wet food in AM same thing in PM, with 3/4 tsp of enzymes at each feeding. Should she still be getting 150% of food?? Cali is still gaining weight, at 9lbs now. Just don’t know how long your suppose to be feeding at 150%
I am having the HARDEST time giving her shots. She doesn’t sit still, I have to literally hold her down to give them to her and I hate it. It stresses her out and me. I tried to do it while she was eating in the beginning, then she learned quickly I was coming at her and glared over her shoulder while eating. I didn’t want to associate that with eating because I want her to eat and not be afraid of eating. I then tried giving her a bunch of treats, knowing she just had enzymes in her, that worked for a day. Does anyone have any ideas? She is 6 months and this will be for the rest of her life, as much as I feel like she will “eventually” get it, I’m trying to figure something out now as I literally cry every time I have to do this.
I am trying so hard with everything. I try to stay calm, I try to teach her(train her) things between all this. I have been trying everything. We both still work full time and I feel like I am failing at so much.
I’m kind of breaking down, and I hate that I am feeling this way. (This is real talk)
Let me know if anyone has any ideas. Thank you!

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Olesia711
Founder & Research Director
Posts: 3858
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: New EPI diagnosis

Post by Olesia711 » 19 Mar 2021, 20:29

Yes..... regarding giving those damn insulin shots..... in the beginning i HATED that, and i got nervous and i too cried... so then i learned to first "tent" the skin a littl before giving the shot......AND what i did, but this take time... is (i'll try to map out a step by step process)

AFTER HER MEAL....First call her to you, and lso labr it by telling her "SHOT TIME" and reward her when she comes to you with a tiny piece of protein (meat) .
Show her the injection needle, give it a name (and use this name every single time consistently!) give her another itty bitty tiny piece of protein (meat).
And then Get up and walk away.

a minute later, call her again to you, say "SHOT TIME" and reward her
SHow her the injection needle, call it by the name, reward her
Tent her skin (i did usually around the back neck area) tell her "Tenting skin" and reward her.
Again, Get up and walk away

A minute later, (this can all be done in about 5-8 minutes) call her again to you, "SHOT TIME" reward her
SHow her the injection needle, call it by the name, reward her
Tent her skin , tell her "Tenting skin" and reward her.
Inject her, immediately and quickly reward her with multiple tiny pieces of meat, one right after the other. (multiple piece importan- -so she doesn't have time to think of getting upset with you for injecting her)t!)
when done, tell her how good she is, clap you hands make a BIG happy production of it... if she likes to play with a tuggy or something do that too.

Basically it is a process that you are are not pulling a fast one. because you are showing (and labeling) what you are going to do every step of the way, So this entire process is based on TRUST & REWARDS!.... and as you can see it is loaded with rewards- -but immediately after an enzymed meal :). After a while... when i did this, i slowly reduced the rewards and didn't give one until after the injection and she got her promised mulitple meat treat for the 8 years that we dealt with diabetes!

In time what "hopefully will happen" is that when you call her for her shot she'll come running in anticipation of the treat(s).
WHen my vet saw how my Izzy would run to me all excited (i used this same technique to do this when i stabbed her repeatedly for blood to test her blood sugar) my vet laughed and said he never saw a dog get so happy to be injected.... but her loved the technique and said he was going to start teaching the same theory to other diabetic pet owners.... so, i really, REALLY REALLY hope this works for you too.
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.........

CaliGirl
Member
Posts: 63
Country: United States
State: California
Pet name: Cali
My name: Nicole

Re: New EPI diagnosis

Post by CaliGirl » 20 Mar 2021, 00:45

Thank you so much! I will DEFINITELY TRY THIS! I really hope it works too! I really appreciate you letting me know this technique! Thank you olessia! You are the best!

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

Re: New EPI diagnosis

Post by Jean » 20 Mar 2021, 08:18

Olesia is a treasure, well done you on keeping an eye on things, as my vet said , you live with them 24/7 I see them for maybe 1/2 hour so I will always take notice of what you bring to me

Loved him

Jean
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

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Madelon
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Posts: 1317
Location: Nashville, TN
Country: United States
State: Tennessee
Pet name: Doc

Re: New EPI diagnosis

Post by Madelon » 20 Mar 2021, 10:12

Hi Nicole. My heart was breaking for you reading your post about giving the shots. Please know this is your safe place to vent - scream, cry, laugh - we've all been through it in some form or fashion and as I always say whether EPI or something else, it takes a village to care for these precious souls.

I don't think Olesia has mentioned it but on top of being the EPI guru and founder of this organization, she's also phenomenal with dog training as one of her dogs was trained search dog. I hope the technique works for you - these dogs are SO smart!! Please keep us posted on how it goes.
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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Madelon
Staff
Posts: 1317
Location: Nashville, TN
Country: United States
State: Tennessee
Pet name: Doc

Re: New EPI diagnosis

Post by Madelon » 20 Mar 2021, 10:35

I forgot to answer your question about the 150% of food - we recommend using that amount until the dog reaches their goal weight - then slowly try reducing the amount keeping an eye on the weight. Just remember, the amount on the bag of food is just a "guide" - every dog is different as to the amount of food they need to maintain weight. My GSD during the summer months (because he's more active) requires a cup more than what the bag recommends but in the winter I have to cut that back or he tends to have some extra junk in his trunk LOL
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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