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

Re: New EPI diagnosis

Post by CaliGirl » 10 Mar 2021, 00:12

I feel like I am at a loss and at the beginning again where I was so confused and stressed. I don’t think Cali is getting too much food or too much or not enough enzymes. She is eating 1/2 a cup of kibble( hills science diet puppy food free of soy, corn and wheat) with a spoonful of wet ( hill science diet I/D chicken stew) 3 x a day with 1/2 tsp of enzymes at each feeding. In the morning and the evening I give her 1/8 tsp of slippery elm with a little wet food(tiny amount) right before incubation starts along with two tiny beads (the insides of a pill) of Prilosec. The afternoon feeding she gets a capsule of visbiome. The vet wanted me to change her food to Purina E/N which I was hesitant in doing because of the ingredients, I didn’t see anything on there but a whole bunch of processing. When I tried canned merrick grain free food she didn’t respond well, so I went back to the other canned food which she seemed to do well on. Her gas and reflux has stopped. However her poops just keep getting watery. Sometimes they are soft and formed but lately no form. My vet is refusing to give me tylan. This is not something I can get without a prescription. I have appointment with another vet but that is not until the 21st and I feel a little stressed that starting new may not help me for a little while as I will have to start at square one. I don’t know if tylan will be something this new vet will give me right away. I honestly don’t know what to do. I have come right out and asked and they just won’t give it to me. What am I suppose to do? I suspect as well there is SID. But I just don’t know how to control it without antibiotic. When I tried grain free on Cali that’s when her poops seemed to be come less formed and even more poops that she is doing now. I don’t know if this is possible as it seems grain free is the best option for EPI dogs, but could it be that she doesn’t need grain free? Or that it doesn’t sit well with her? I just don’t know how I am to obtain tylan when my vet is refusing. I can’t even see if it would work for Cali. But these poops just can’t be like this forever. She has had literally two hard poops( when I wrote before bragging about it) and that’s it. I was following the exact same regimen above when that occurred. I thought it was because of the visbiome and it was going to last, it didn’t. I just don’t know. But since I have started she has yet to have “good” poops. We are going on 60 days, since enzymes, probiotics, prebiotics, Prilosec, changing food, changing probiotics, you name it. I don’t understand how I could have only had one day of two solid poops. I was just so excited when then happened, and now it is gone. 😞

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jilbert57
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Posts: 2088
Country: United States
State: Washington

Re: New EPI diagnosis

Post by jilbert57 » 10 Mar 2021, 09:02

Hi Nicole, I am sorry things have gotten mucked up.
What strength enzyme are you using? I suspect you have tried upping or lowering the amount of enzyme by 1/8 teaspoon? With the added canned food it might need the tweaking. Are you incubating all food you are feeding?
Are you still supplementing with oral B12?
I would print the information from this site on the use of Tylan to manage SID/SIBO in your pup.

Jill
My name is Jill and we live on the Hood Canal in Washington State. We currently have 2 Jack russells, TJ is 8 and Sadie is 2.

Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.

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

Re: New EPI diagnosis

Post by CaliGirl » 10 Mar 2021, 10:05

Hi Jill. I have not increased the enzymes. I don’t fill the 1/2 cup full, I leave a little room for the wet food, she is only getting a spoon full, so she is getting a measured 1/2 cup of feed for each feeding(both dry and wet) with 1/2 tsp enzymes, her food incubates for 1/2 hour each feeding.
Her enzymes are pancreplus. No strength. I’m on my last bottle and will be buying dianes 6x.
She is not getting b12 supplement, her b12 was tested in feb and was at 623, so she shouldn’t need b12.

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jilbert57
Staff
Posts: 2088
Country: United States
State: Washington

Re: New EPI diagnosis

Post by jilbert57 » 10 Mar 2021, 11:41

Thank you for the information!

Jill
My name is Jill and we live on the Hood Canal in Washington State. We currently have 2 Jack russells, TJ is 8 and Sadie is 2.

Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.

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

Re: New EPI diagnosis

Post by Olesia711 » 10 Mar 2021, 12:46

well, this is frustrating.. i;ve been typing for over an hour trying to explain things to you regarding Cali's situation and accidently deleted the post before i was finished...... GRRRRRRRRRRRRRRRRrrrrrrrrrrrrrrrrrr!

So.... this is going to be brief.

FIrst, i am so so SO sorry you are feeling at your wit's end. Unfortunately, it can take a LOT of time to figure out the right balance of the recommended EPI protocol.... with some it has taken 2 years or a little more to figure out the right balance of things! Our suggestions are based on how to "start" treating EPI but some times things have to be tweaked to best suit each individual EPI dog.

So... even if you follow the recommendations exactly and think the food you are giving is perfect, but the stools are really bad.... it could mean that there is something in that food that is just not agreeing with the dog. This is why we encourage people to keep crazy very detailed notes! And try things one at a time for a few days before trying the next thing on the list- -this is the only way to really figure out what in the world is going on, what helps and what doesnt...... Over the years, pet owners have discovered that even a supposedly perfect EPI food did not work for their dog because of some minor ingredient didn't agree, like Rosemary, or sunflower oil, or a particular fish ingredient, etc..... all kinds of small stuff that would not be on your radar with an EPI dog. It's just crazy!

Anyway, based on your most recent post, you mention watery stools. This can be from a food intolerance... like i mentioned in one of my previous posts. What you are seeing might not even be the results of EPI but rather could be a food intolerance. I completely understand you not liking what the ingredients are in some of the special foods your vet recommended.. ... i personally like to call it "crap in a can".... BUT.... that being said.... if this is a food intolerance.....(and it could be a possibility!) you really need to address that or Cali will forever not do well. I strongly suggest contacting your vet and although i understand his/her logic of recommending Purina EN,,,,, please tell your vet that you want to try Purina HA...not EN. HA is a true Hydrolyzed food and this will help you determine if this is a food intolerance that is troubling Cali, and you can get it in a canned version. I would just ask for a couple of cans to try to see if this is the underlying issue. NOrmally i highly recommend Royal Canine Ultamino, but that is a dry food and i suspect Cali will do better with a canned food.......

Next.. how much Visbiome are you giving? Cali is very tiny so although this is good, what you don't want to do is give too much as that too can cause loose stools....

And last, Tylan.... i hear your frustration. i get so upset when vets refuse. That's when i go in armed with tons of research and ask them to explain to me why not! Have you downloaded and printed the veterinarian EPI research recommendations for using Tylan on EPI dogs struggling with SID/SIBO? If need be, please show THIS article by Joerg Steiner, head of the Texas A&M Gastrointesintal Lab on how to treat SID in EPI dogs: https://www.vin.com/apputil/content/def ... pid=12886& ... there is a process, and when all else fails... try Tylan! "Antibiotic

Oxytetracycline used to be the therapy of choice for small intestinal dysbiosis, but oxytetracycline for oral use has become largely unavailable. Tylosin (25 mg/kg q12h for 6 weeks) is the new antibiotic agent of choice. Tylosin is extremely safe and is not used in humans for the most part - thus, creating resistant bacterial strains is not a big concern. In one study, a group of dogs was treated with 400 mg/kg daily for a period of 2 years and none of them developed any side-effects. The superb efficacy of tylosin has been well-demonstrated in studies from Finland.

the only no longer valid information in this article by Dr. Steiner is that you can use Metronidazole..... as of fall time 2020, they (Texas A&M/Joerg Steiner and Jan Suchodolski) are advising NOT TO use Metronidazole for any chronic gastro intestinal issues......... please also share this current research with your vet. https://epi4dogs.com/wp-content/uploads ... oved-1.pdf

And last but not least...... don't beat yourself up.... you are trying and doing everything you can to help little Cali out... ... even if your vet refuses to let you try Tylan..... try another vet, like you are already scheduled to do..... and don't worry about the appt being so far in the future..... you are doing everything you can to help Cali. Celebrate the accomplishments... and just know that we are hereto help you as best we can when things don't go as expected...........................
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 » 12 Mar 2021, 18:39

So I just found out today that Cali has diabetes. Is there going to be more? You guys, I’m feeling defeated today.

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

Re: New EPI diagnosis

Post by Olesia711 » 12 Mar 2021, 20:04

Hi Nicole,

SO sorry to hear this, and Diabetes can be tough to manage ....but we can help you with this too, ........ been there done that.... it is not easy, but can be manageable..... for example:

At 1+ yrs old my Izzy was diagnosed with EPI
At 1+ yrs old they also diagnosed her with juvenile incontinence that she had to be on drugs for her entire life
At 4 yrs old she was diagnosed with Rocky Mtn Spotted Fever and then developed Central Brain Vestibular Inflammation
At 6 yrs old she developed Uveitus
At 7 yrs old she was diagnosed with IMHA .... a deadly condition.
At 7 yrs old she was also diagnosed with Diabetes and Low Thyroid.

As you can see, my little gal went thru a lot too.... she lived to be 15 years old and greeted each day with so much joy and was always ready to cause some sort of mischief. ANd she fought it all! She made me laugh everyday. She was the happiest dog and i'd go thru caring for her all over again if she could only be here with me once again.... so if you want, i will help you as best i can to manage these two conditions........

And boy o' boy it sure was a challenge at times... i still remember trying over and over again to learn where to best take blood samples from my little dog, trying to find that "sweet spot" that everyone kept referring to. One day, in sheer frustration, i just sunk down on the floor, threw her blood glucose monitor across the room, sat there and cried my eyes out............ but i finally did get the hang of it and we managed Izzy's Diabetes for 8 years. The first 2 years were real tough, and finding the right diet keeping her blood sugar in good control was the worst part... but we finally figured it out with mostly home-made meals. Just sharing all this to let you know that there is a light at the end of the tunnel.

Anyway.....with EPI and Diabetes, although not easy, there are a couple of things that stand out....., the first thing you do is learn how to test the blood sugar yourself/at home.... This will greatly help YOU learn how to manage Cali's diabetes

Next with EPI and Diabetes, you always give Diabetes preference over EPI... like with Diet. Try to do the best you can to help with the best possible food for both conditions, BUT if push comes to shove, Diabetes over rules EPI... and to balance things out on the diabetes end....you will just need to give more enzymes to compensate for something in the diabetic diet that doesn't agree with the EPI recommended diet.

Next... because of the Diabetes..... go with low fat foods, lean meats. I could not longer even give coconut oil. BUT do give... fish oil/krill oil.

For the Diabetes, go to this site and watch the videos even if you never join the site/forum, VERY helpful! http://www.k9diabetes.com/

And, ALWAYS..... share with your vet everything and anything we suggest. You need to work closely with your vet at least until you are very comfortable dealing with Cali's Diabetes.

And last but not least..... breathe......................
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
Member
Posts: 1345
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: New EPI diagnosis

Post by Tuckaboo Pam » 12 Mar 2021, 21:59

Nicole, I don't have any information for you, but oh my gosh. Poor Cali, and poor you. Parvo, EPI, diabetes, and she's only a few months old? What a full plate you have had. My heart goes out to you.---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.

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

Re: New EPI diagnosis

Post by CaliGirl » 13 Mar 2021, 13:40

This definitely has been quite a challenge. Cali starting drinking A TON of water and peeing “spots” or nothing at all. I thought for sure she had a UTI. I brought her to the vet and they said no UTI she is perfectly healthy. I thought it was weird, it didn’t dawn on me until the next day to call back and ask what were glucose levels were, when I did they said they never checked. Why when I told them she was drinking a ton of water that didn’t register I have no idea, but I brought her back and she was at 445!!!!! Insane! We just stated the insulin last night and again this morning. She is only getting to the number 1. I go back in two weeks and they will keep her for the day to test throughout the day and make change to insulin if needed.
Do you have recommendations for food? I feel like I was in the middle of managing food for poops and now this, so I’m at a stand still. What would be good foods at this point to “try out” for both Epi and diabetes management.
Also would the poops not getting to normal have anything to do with the diabetes? Could this have been the issue all along, just curious.
I just felt very down yesterday. But olessia, you are absolutely right. I need to take everything one day at a time in order to get it all right, I thank god everyday this little girl ended up with me, as I don’t know if there is a whole lot of us out there! So I just take the steps I need to and enjoy her! Thank you all for all the positive encouragement, I am human and some days are harder than others. I am grateful that I can tell you that and not be judged! Appreciate you ALL!

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

Re: New EPI diagnosis

Post by Tuckaboo Pam » 13 Mar 2021, 19:52

There is somebody on staff who has experience with diabetes, so you'll get lots of help.
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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