Question especially for people from Europe.

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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Miranda76

Question especially for people from Europe.

Post by Miranda76 » 24 Feb 2021, 05:59

Thank you for adding me! I was very happy when I discovered your website.

I am from Holland, live in France and have three dogs. We adopted this little princess last summer. The last few months her stools have been going up and down. The last few weeks this has worsened (lots and lots of diarrhoea) and she has lost a lot of weight despite her enormous appetite. I have found out a lot of information about EPI through your website. It is clear that Jémie's pancreas is not doing its job properly and she also has a dysbiosis in the intestine (leaky gut). Next week I have an appointment with our vet and we will have her blood tested extensively, TLI/Folium acid/B12/Pancreatitis It is not clear yet if she has EPI or an inflamed pancreas. Besides our regular vet I consult a lot with my orthomolecular veterinaire in the Netherlands. I feed all my dogs BARF but Jémie temporarily goes back on kibble (Essentials Food Balance). This is to let her stomach and intestines settle down.

I am very curious about which enzymes the people from Europe add (how high the USP units in lipase) and any B12? I am familiar with the products from the UK but it has not become easier to order there since they are no longer part of Europe.

Thank you again, also on behalf of Jemie!
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Olesia711
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My name: olesia

Re: Question especially for people from Europe.

Post by Olesia711 » 24 Feb 2021, 08:18

Hi Miranda,

First thank you SO much for opening your heart and your home to Jemie! We will do our best to help you.

If Jemie does have EPI, keeping her on BARF might be better then letting her have kibble...... for many of these dogs, if they are fed raw, it often (although not always) works on better for most of them.

There is a wide variety of enzymes that folks from Europe use. If you want, check out this page on our website https://epi4dogs.com/epi-quick-guides-outside-usa/ and specifically look at the list of 7 of the enzymes that folks in the UK use... that should be available to you. However, if there ever is an issue accessing any of these enzymes...... in Europe the "back-up" enzyme for EPI dogs is CREON which is a human drug to treat EPI, is accessible world-wide and DOES work work on dogs... we just have to alter the technique of how to give CREON because CREON was created to activate in a human's digestive pH level of 4 and dogs have an approximate digestive pH of about 1. So we just open the capsule, sprinkle the contents on food (a little wet food) and serve immediately (do not mix and do not incubate). Or if this technique doesn't work try giving the capsule whole about 3 to 5 minutes before a meal. If the dog's stools are STILL loose, then we recommend trying 1+1/2 capsule and if that helps but is still not acceptable, then give 2 capsules. Often dogs on CREON eventually end up taking CREON 25 as time passes.......

Regarding USP units of Lipase.... it depends on what type of porcine enzymes you are using. with powdered enzymes you need a minimum of 34,000 USP units ... however in the USA, and for most powders, the typical USP Lipase units is 74,000 for powder enzymes.
With enteric coated enzymes (like CREON) you can start with 10,000 or 12,000 USP units up to 25,000 USP units of Lipase.... THere is a chart here on the ENZYME tab that helps explain things... actually check out all the pages on the ENZYME tab, as there is a lot of good info there.. but here are 2.
https://epi4dogs.com/enzyme-conversion/
https://epi4dogs.com/enzyme-list/

There is a company in the NEtherlands that has a doggie enzyme that is similar to CREON, called 'WeNyzymes" here is their link.
https://wepharm.pt/pt/produto/11/
Their product is decent and they have excellent customer service:

Regarding B12
Whether you do B12 shots (simple serum) do NOT use Complex B12 shots with vitamins, as they are not potent enough and they sting.... SO simple Cyanocobalamin and Hydroxycobalamin works.

Here is the B12 chart:
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You can also read about B12 dosing on this page: https://epi4dogs.com/b12-protocol/

One thing about B12 with a chronic illness (like EPI).... the dog will need to take B12 for the rest of it's life.... HOWEVER, that being said, once you bring up the B12 level to the upper mid-range, then you and your vet have to kind of try to figure out what maintenance dose (going forward) the dog will need to maintain that upper level B12. SOme dogs will continue to need it weekly, others bi-weekly and still other just monthly or every couple of months. It all depends on the individual dog. What is recommended is after the 6 weeks, the wait 30 days, give another shot, then wait another 30 days and do the Cobalamin B12 blood test to help you and your vet ascertain going forward how often B12 shots (since this is what you are using) will be needed to maintain upper mid range B12 levels. THat is of course, that the B12 retest shows that the B12 levels have been brought up accordingly.
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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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Re: Question especially for people from Europe.

Post by Madelon » 26 Feb 2021, 19:43

Hi Miranda - oh my goodness your sweet Jemie is adorable - thank you so much for giving her a chance to live her best life!

Olesia as always has given the best advice so I won't muddy the waters but wanted to add that you can order enzymes and B12 from Chemeyes in the UK - Suj is the owner and a former EPI owner and her customer service is AMAZING! Here is a link to her website https://www.chemeyes.co.uk/

Also, be sure to keep a detailed log of everything you give and the resulting poops - it will help you figure out what works and what doesn't. Here is a link to a downloadable one from our website https://epi4dogs.com/epi-log/

Hang in there - you got this and we've got you!
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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Location: South Liverpool
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Pet name: Kara, lost 10th May 2019
My name: Jean

Re: Question especially for people from Europe.

Post by Jean » 01 Mar 2021, 07:22

hI and welcome from the UK

Chemeyes is the one for you as Madelon says

as far as the weight goes you feed 50% over and above what it says for the weight the dog SHOULD be and as many meals as you can fit in

My Kara was fed 5-6 times a day and a late meal of scrambled egg and mashed potato every night they were all enzymed as she had EPI she was pitifully thin but she thrived and did well

take care

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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