Newbie

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.
Emma
Member
Posts: 31
Country: United States
State: Minnesota
Pet name: Emma
My name: Beth

Newbie

Post by Emma » 06 Mar 2021, 12:33

My dog Emma was just diagnosed this week so just trying to wrap my head around everything so going to start with one thing at a time. B12 level is 347, my vet said it was good but from what I see here it is not. I want to get the supplement I have seen here but don’t know the dosage. She is 35 lbs down from 42 so we caught it early. Her TLI was 0.4. What dosage of B12 do we give? Thank you

Magchick
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Posts: 22
Country: United States
State: North Carolina

Re: Newbie

Post by Magchick » 06 Mar 2021, 14:41

I'm sure some more experienced admins will respond soon but in the meantime the typical recommendation is 1 pill from wonderlabs with two meals. The excess is eliminated in the urine. Hope this helps and don't forget about the EPI4dogs discount on Wonderlabs

Emma
Member
Posts: 31
Country: United States
State: Minnesota
Pet name: Emma
My name: Beth

Re: Newbie

Post by Emma » 06 Mar 2021, 15:45

Thank you. Heard from my vet today and she said to just get OTC B12 500 mg. I noticed that Wonderlabs is 1000 mg. Do you recommend the Wonderlabs verses human grade? Before Emma was diagnosed they thought she had a food allergy and put on a PPP Hydrolyzed vegetarian 3 cups a day. Now that she has been diagnosed they kept her on the same food as not to try and switch over right away. She is currently on PancrePlus two tsp every 12 hours but we recalculate for the three feedings. Seems like a lot of enzymes per day. She is also on 1/8tsp Tylan twice a day. Her poos have gone from 6 a day down to 2 but now the consistency has gotten worse from soft serve to 7 on chart. Her numbers when she was diagnosed were TLI 0.4, Cobalamin 347, Folate 16.3, Spec PL 30. Any advice would be so helpful! Thank you all.

Emma
Member
Posts: 31
Country: United States
State: Minnesota
Pet name: Emma
My name: Beth

Re: Newbie

Post by Emma » 06 Mar 2021, 15:51

Oh sorry, how do I get the discount for Wonderlabs? And one more thing. Once was are done with the enzymes the vet gave us I plan on getting It through Diane. What strength would I order 6X? And how do we get the discount for that?

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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: Newbie

Post by Olesia711 » 06 Mar 2021, 17:38

Hi Beth,

Thanks for letting us know Emma's test values.

B12 is given according to weight. According to her weight, she needs to be on 1 Wonderlabs B12 capsule a day. The 20% coupon is "Epi4Dogs15"
https://www.wonderlabs.com/itemleft.php?itemnum=K9688. Thankfully B12 is forgiving..... if you give too much, they just pee out any excess. However, the instructions on the Wonderlabs bottle is not accurate- - we are working with them to change this. You really need to give 1000mcg B12 pills - -as it is the same dosage as the injectible B12 that is given. Also... OTC B12 (cyanocobalamin B12) does not have intrinsic factor in it... and this has been proven over and over via individual EPI dogs that methylcobalamin B12 with intrinsic factor before and after tests to work much more efficiently than oral cyanocobalamin B12 without intrinsic factor. This is why we strongly recommend the Wonderlabs product.

I noticed you are not giving enough enzymes. The ratio (to start with ) is 1 level tsp per 1 cup of kibble. If wet food then give 1/2 tsp to 3/4 tsp of enzymes per 1 cup of wet food. Be sure to moisten the food so that dry enzymes do not sit on any dry food. And incubate the food with the enzymes for about 20 minutes. This helps avoid mouth sores and although science says it is not necessary, it appear to help many EPI dogs better digest their food.

So... the loose stools now..... this is most likely SID and it can be from a variety of reasons:
When first starting on the enzymes, everything works out great but then sometimes/often about 2 weeks afterwards, all of a sudden the loose stools are back or they start up. SO we start working to get SID under better control... here are some of the reasons why this might be happening:
1. Sometimes, SID gets worse because it is an accumulation of not enough enzymes are being used (this could be part of Emma's problem) .
2. Sometimes SID gets worse because the B12 is not sufficient.... (you are getting ready to address this)
3. Sometimes SID gets worse because there is a food sensitivity.... AND.... very often... you have to try multiple Hydrolyzed Foods until you find one that works best with your dog.... We suggest (although no guarantees) to start with Royal Canin "Ultamino" hydrolyzed food... this appears to work better than most with many (but not all) of our EPI dogs.
4. SOmetimes SID gets worse because you are supposed to feed 150% of what your dog normally would require... HOWEVER stuffing all that food into 2 meals just doesn't work... so it usually work better when the dog is fed 3 or 4 times a say instead of 2... just until most of the weight is gained back and then you can segue back to just 2 meals a day.

ANd sometimes.. the loose stools are a combination of these possibilities ....
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.........

Emma
Member
Posts: 31
Country: United States
State: Minnesota
Pet name: Emma
My name: Beth

Re: Newbie

Post by Emma » 06 Mar 2021, 18:40

Thank you very much! I should probably clarify that the vet is having us add 2 tsp of enzymes per cup of kibble for at least the first week. This means she now gets 4tsp of enzymes a day. Yes we are mixing with warm water then allowing it to stand for 20 minutes. She only wants us to feed Emma 3 cups a day whereas I would like to give her four until she starts to gain. I guess my question is, is 2 tsp of enzymes per every cup of kibble too much? She will not be staying on her current food and will be transitioning to something that is not Hydrolyzed. She was just diagnosed this past Wednesday so I my head and all of the measurements are all over the place. But I am going to be forever grateful for this website!

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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: Newbie

Post by Olesia711 » 06 Mar 2021, 20:18

Ahh... thanks for clarifying that... yes.. it is possible that you are giving too much enzymes. Technically the range of needed enzymes can be anywhere from less than a tsp up to 2/+ tsps per cup..... BUT.... that being said..... we have had situations where some dogs actually do get loose stools from too much enzymes.... it all depends on the individual dog gut.

There was also one more reason why some dogs SID gets worse (which is present in every EPI dog whether or not you see any symptoms or not) and that is if they are not getting enough Tylan or the TYlan is not given twice daily like it is supposed to be given. BUt i did not mentioned this because you are already giving Tylan, and the right amount and twice a day :)

What i also should have mentioned is when you are trying to figure out what might need to be adjusted... try only 1 thing at a time... observe the reaction for a few days BEFORE you try the next thing on the list.

SO... since you are just ordering the B12, and you will be changing the food in the near future.... what you can try as your "first thing to try for a few days" is to lower the amount of enzymes given to 1 level tsp per 1 cup of food... see if that make a difference... give it a few days.

Also.... another thing you can try is adding a little Slipper ELm powder / this is a special type of fiber..... ....what is currently recommended is to first try a prebiotic. this is why many of us use SLippery ELm powder /also can be purchased from WOnderlabs.... or you can order the NOW brand of SLippery Elm from Amazon.... i personally again, like the WOnderlabs product but they are both good. ANyway... if the slippery Elm helps firm up the poo, just not enough.... THEN what is recommended is a pre+probiotic.... and then if this doesn't work, then we recommend using Tylan. But since you have already started using Tylan, is why i did not mention this earlier . However slippery elm is another thing you can try. The only thing is that with SLippery ELm, be careful not to use too much as too much can also trigger loose stools
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.........

Emma
Member
Posts: 31
Country: United States
State: Minnesota
Pet name: Emma
My name: Beth

Re: Newbie

Post by Emma » 07 Mar 2021, 07:45

I appreciate the advice and will try lowering the enzymes today to see if that helps. As for the slippery elm, we had her on Fortiflora prior to her diagnosis. The vet discontinued it when they thought she had a food allergy. Since we have at least a half a box left, do you recommending starting that back up just to get rid of it and not waste it. Yes all of these different diagnosis have been quite expensive but when you adopt a dog you take on that responsibility. She was also put on the Tylan 30 days prior to her EPI diagnosis so she has already been on it for quite sometime and assume you are recommending that she stay on for the time being. I am attaching a picture of our gal. She was a rescue from a SD reservation. We did a DNA on her which came back as Australian Shepard, Pitt Bull (huh), poodle and herding breed. She has the personality of a border collie. Yes she sits funny, always has.
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Tuckaboo Pam
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Posts: 1345
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: Newbie

Post by Tuckaboo Pam » 07 Mar 2021, 08:14

Hi Beth, and welcome! So, Emma came from a reservation in South Dakota? Bless you for adopting her, and may I just say she is gorgeous. I have a silly-sitting hound, who lopes rather than runs. She is one of five rescues in our house.

One of the things I have learned to do, is look at the bottom of posts & see what people are feeding, etc., with success. This has been helpful to me. I didn't read everything you wrote, but I'm guessing you have learned about enzymediane.com, to help save tons of money. She is wonderful, and her product is great.

If you ever decide to try kibble instead of wet food, you may want to give Sport Dog Elite for herding dogs, buffalo & sweet potato. Many of us have had success feeding this; I switched for financial reasons.

Tylan---if & when you take Emma off it, reach out to Olesia for specific weaning instructions; you can't do it cold turkey. I now give Tucker slippery elm & proviable, after taking him off most of his Tylan.

Lastly, for now, I recommend using the tab "Managing EPI", to get dosage information if you are in a rush to know something. Otherwise, ask here, any questions you have. The staff are wonderful and patient, especially to folks who have a newly diagnosed doggy.

Take Care---Pam & Tucker
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
Staff
Posts: 1317
Location: Nashville, TN
Country: United States
State: Tennessee
Pet name: Doc

Re: Newbie

Post by Madelon » 07 Mar 2021, 10:24

Hi and welcome to our EPI family. Your girl is absolutely ADORABLE! Thank you for rescuing her - my non-EPI girl, Roxy, is we believe part lab part border collie and who knows what else LOL.

Olesia has given the best information as always but I wanted to chime in with a few thoughts.

First, if you're wanting to save some money and get EnzymeDiane's enzymes, you could start with the 6x - it will be the closest to the current enzymes you are using. You'll start with 1 level teaspoon per cup of kibble. The difference between the 8x and 6x is that the 8x is a bit stronger so you use a little less but I usually recommend people start with the 6x because if you have to tweak it in the beginning it's easier to work with whole numbers (8x starts at 3/4tsp per cup of kibble). Either way you can't go wrong and your wallet will thank you :)

Second, I highly recommend figuring out your dog's transition time. Cut up some carrot and put it in the food - make a note of the date and time you give the carrot. They won't digest the carrot so then you'll look for it in the poop. A dog's transition time can be anywhere from 12-72hrs and this will help you know if you make a change how that change affected the poop. Often we think the poop we are seeing is from the last meal served but it typically isn't.

Third, I highly recommend keeping a detailed journal of everything you give and the resulting poop - this EPI log will become your bible and help you figure out what works and what doesn't.

Lastly, with regard to the Tylan after 45 days we recommend slowly weaning off. So when you're ready to stop the Tylan don't stop it cold turkey, slowly wean off.

EPI seems overwhelming in the beginning but it will quickly become your new normal and we'll be here to help guide you along the way.
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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