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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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kaseydawn
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Country: United States
State: Indiana

new!

Post by kaseydawn » 28 Aug 2018, 12:33

hello all! I'm a vet tech from Indiana. I recently had my dog diagnosed with epi 2 weeks ago. her name is reba, 3 yrs old, and she a westie/heeler mix. yup she was a clients oops. anyway, I was wondering if anyone had any tips for getting these guys stable? her cobalamin was normal, folate was high (14), TLI was low (<1), Microalbuminuria was normal. I gave her a b12 injection 2 weeks ago so her next one is due tomorrow. started on tylan powder 1/8 tsp and prozyme powder 1/4 tsp/cup of food ( per bottle recommendation). I didn't read were you needed to let it set so I'm going to start that tonight. started on royal canin low fat gastro-intestinal diet. my concern is that she has lost almost another pound in this 2 weeks. she acts like she's starved to death ( basically is) trying to steal off plates and out of trash can. her energy is better now and she's wanted to play more, but the stools have shown no improvement or hint there of. how long did you give adjustments to work before trying something else? I have a probiotic did that seem to help a lot of yours improve? she's now 17# and before she was a fit 20-21# any tips would be great! thanks so much.
diagnosed august 2018 with EPI. currently on 1/8 tsp tylan twice daily, 1/4 tsp prozyme twice daily, pancreatin x 6 1/2 tsp twice daily, Diamond naturals small breed adult and a vitamine b12 injection every 2 weeks :D

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kaseydawn
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Country: United States
State: Indiana

Re: new!

Post by kaseydawn » 28 Aug 2018, 13:36

ive notice a couple pictures of food with water. it makes since in my head to add a little water to help activate the enzyme. does it help?
diagnosed august 2018 with EPI. currently on 1/8 tsp tylan twice daily, 1/4 tsp prozyme twice daily, pancreatin x 6 1/2 tsp twice daily, Diamond naturals small breed adult and a vitamine b12 injection every 2 weeks :D

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Bpcooper14
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Location: Lynchburg, VA
Country: United States
State: Virginia

Re: new!

Post by Bpcooper14 » 28 Aug 2018, 14:02

Welcome! What part of Indiana? I'm originally from Ohio and lived in Angola, IN for about 6 years. There are people here that are way more educated who will chime in soon. I'm a newbie here myself and was overwhelmed with the amount of information this group has to give.
I don't know much about the Prozyme powder but have used enzymes from enzymediane.com like many of the others on here. A quick comparison between the 2 might shed some light on dosing. Typically I use (per recommendations and trial and error) 1 tsp per 1 cup of food. I have been fortunate and not had to administer B12 shots but have been supplementing with wonderlabs petfactor B12 pills.
Yucky stool may indicate there is more than just the EPI. SID is common so that may need to be looked into with Tylan being a common antibiotic of use (again, i've been lucky this hasn't been a problem for me so far).
Good Luck and don't hesitate to reach out to the group. There are some here who have been dealing (and their fur babies have been thriving) for YEARS. I'll sit back and watch the experts responses. :lol:
Hi all, I'm Bill. Ace was diagnosed with EPI on 5/31/18. In January, 2018 he was at the vet for routine check-up and weighed in at 34 lbs. In May after fighting with weeks of poor poo, he weighed 24.6 lbs. On Saturday July 28th, Ace was diagnosed as diabetic.
2 meals per day. He receives 6 units Vetsulin injections twice daily with each meal.
1 cup Victor Multi pro with 1/2 cup ground chicken breast, 1/4 cup sweet potato, 1/4 fat free cottage cheese. 1/2 tsp Pantenex enzymes, incubated 20-30 minutes.

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kaseydawn
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State: Indiana

Re: new!

Post by kaseydawn » 28 Aug 2018, 14:45

thank you for responding! southern Indiana, around Seymour. never been to angola but heard of it. ive read were several people use the enzyme diane. I have her also on the tylan powder. I wondered about the oral b12 but read they absorb the injectable better, so I may look into it once she's stable. feels like its going to be forever! :?
diagnosed august 2018 with EPI. currently on 1/8 tsp tylan twice daily, 1/4 tsp prozyme twice daily, pancreatin x 6 1/2 tsp twice daily, Diamond naturals small breed adult and a vitamine b12 injection every 2 weeks :D

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Bpcooper14
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Location: Lynchburg, VA
Country: United States
State: Virginia

Re: new!

Post by Bpcooper14 » 28 Aug 2018, 14:49

I have an idea where it is. I've been down around the Hanover area before for cross-country and track meets. Once you get things figured out, it'll become second nature and just a part of the routine. It's just all the unknowns and juggling at first trying to find what works. Someone mentioned to me early on you need a lot of patience. Sometimes results take a little bit to show themselves.
Hi all, I'm Bill. Ace was diagnosed with EPI on 5/31/18. In January, 2018 he was at the vet for routine check-up and weighed in at 34 lbs. In May after fighting with weeks of poor poo, he weighed 24.6 lbs. On Saturday July 28th, Ace was diagnosed as diabetic.
2 meals per day. He receives 6 units Vetsulin injections twice daily with each meal.
1 cup Victor Multi pro with 1/2 cup ground chicken breast, 1/4 cup sweet potato, 1/4 fat free cottage cheese. 1/2 tsp Pantenex enzymes, incubated 20-30 minutes.

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Miss Maddie Moo
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Re: new!

Post by Miss Maddie Moo » 28 Aug 2018, 14:55

Hello.
What i need to check is the prozyme when i google it i come up with a supplement and not a replacement enzyme which i think will be plant based ...i may be wrong i have been before..if i am correct this will be the main problem we need the correct enzyme for things to be correct.( so porcine based not veg and at the correct dose!)
Also with EPI we suggest that fat isnt restricted.. in addition a grain free diet has found to give us the best results.
Great with the B12 we need to have the levels in excess of 600 for life.
Keep asking questions we were all new at EPI once !
Maddie DX April 2011 along with low B12 she was feed with a low fibre food below 3% , fat was not restricted ( she wasnt good on pea based foods ) She initially had a course of B12 shots weekly over a period of 6 months and then we used the B12 pills from Chemeyes in the UK . We used Panzym and slowly had to increase the dose as she aged when she was first DX she was 23kg but she gained weight quickly and got back to 33 kg .
Maddie gained her angel wings in Jan 2018 at the age of 10 to a condition unrelated to EPI.
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kaseydawn
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Country: United States
State: Indiana

Re: new!

Post by kaseydawn » 28 Aug 2018, 17:21

thank you miss maddy moo! yes the enzyme is plant based which I didn't realize when we ordered it, but haven't had much time to research as much as id like with a 4 month old baby, work and home stuff. so im glad I came across the site today! the Vets I work for haven't had much experience in EPI, maybe 1-2 cases, and I personally know no one who's delt with it. so the research in books we have is older. im going to continue to do some research over the next week and definitely try some of these other enzymes and foods if she continues to not respond. it breaks my heart to see my girl so skinny. i'm just glad she doesn't feel as bad as she looks.
diagnosed august 2018 with EPI. currently on 1/8 tsp tylan twice daily, 1/4 tsp prozyme twice daily, pancreatin x 6 1/2 tsp twice daily, Diamond naturals small breed adult and a vitamine b12 injection every 2 weeks :D

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Olesia711
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Location: North Carolina
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State: North Carolina
Pet name: Izzy

Re: new!

Post by Olesia711 » 28 Aug 2018, 18:35

Hi Kasey,

Welcome!
As Ann (MaddieMoo) suggested, the Prozymes that you are using is plant base. That is not the right stuff. To best treat EPI, you really need animal based pancreatic enzymes, pig enzymes are recommended.

Because the porcine enzymes are so expensive, many of us use generic enzymes from EnzymeDiane... and just order the 6x. https://enzymediane.com/shop/ The 6x is the same potency as Pancrezyme Viokase, etc, the standard brand name porcine enzymes but at 1/3 the cost. I have been using EnzymeDiane's enzymes for 12 years now... thankfully.... otherwise i could not have afforded the enzymes.

No prescription is needed, and EnzymeDiane is recommended by many vets and has been written about by vet researchers as a good alternative to the brand name meds.

Next...you are correct.... most info on EPI is now outdated. Please share with your vet this website and Dr. Patrick Barko did an EPI presentation to vets last fall time in Nashville... the EPI presentation is here on this website, your vet might be interested in it https://epi4dogs.com/epi-seminar/

... my presentation is right below Dr. Barko's.. mine is geared towards the EPI pet parent :)

Anyway..... managing EPI is all about finding the right balance of the 4 aspects of EPI.

1. Enzymes, the right kind, the right dose, prepared properly
2. Diet, most EPI dogs do better on a low fiber diet, usually 4% fiber content or even less works better (no need to limit the fat content unless there is another health concern dictating you to do so). Just try to avoid (in the beginning) food that has "peas" in it over represented.... like 3 different versions of peas in the ingredients. Most (but not all) EPI dogs have trouble with peas. We noticed this years ago... but since then research came out to support our anecdotal observations
3. B12, over 80% of all EPI dogs need B12 supplementation. What was your pup's B12 level when tested? They need to be at least in the upper mid range (anywhere in the upper 500's - 600's). Use this B12 guideline for B12 dosing: https://epi4dogs.com/b12-protocol/ ... but please know that there are B12 pills with intrinsic factor that many of our EPI people use that are extremely effective https://www.wonderlabs.com/itemleft.php?itemnum=K9688 . Old research dictated B12 shots, but new research has shown that high dose B12 pills are just as effective and sometimes better. https://epi4dogs.com/b12-in-brief-2/ and research: https://epi4dogs.com/b12-researchpublications/
4. SID, we now know that all dogs with EPI have SID. The trick is to keep it under good management. If your pup is having loose stools that just won't firm up, then 1st try a prebiotic (we suggest SLippery Elm powder NOT capsules.. with powder you can control the dose https://epi4dogs.com/slippery-elm/ ) if you do not see any improvement at all within a couple of days on SLippery ELm, then ask your vet for Tylan antibiotic... should be given twice a day for 45 days. Tylan info: https://epi4dogs.com/antibiotics/

* In your particular case.... i suspect your dog is not improving at all (yet) simply because you do not have the proper enzymes. As soon as you start putting the right enzymes on all food... you ought to see improvement. If not THEN you need to get the SID under control. (above guidelines). THen if still not optimal, look at changing the diet. Also, it the B12 is not optimal, supplement accordingly *

The thing about EPI is that because there are 4 moving parts, it is enough to drive you bonkers, hence why we recommend keeping an EPI log and recording daily observations.... AND.... after the initial implementation of the right protocol... if things are not improving as expected.... THEN you start making changes one-at-a-time... observe for 3-5 days (a week is best) to see if the change you made is helping or hindering.... this is how we find out what works bets out of the recommended protocol for our individual EPI dog :)

And last but not least..... we are here 24/7 to help as best we can with any questions :)
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
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State: Tennessee
Pet name: Doc

Re: new!

Post by Madelon » 28 Aug 2018, 20:58

Hi there - welcome to you and your cute little pup!! You've been given great advice so I don't want to confuse you by adding anything more. Just know that it takes a village with these pups and we are all here to help guide you along the way. The one thing I will strongly urge is to keep the detailed log - it has helped me so much over the years - not only figuring out EPI but also allergies. I now keep a log for my non-EPI dog :)
MADELON and Doc. DX EPI and SIBO: 5/22/2015
Test Results: (1st) 7/2014 = TLI 16.5, B12 894, Folate > 24; (2nd) 5/2015 = TLI < .4, B12 406; Folate >24; (3rd) 10/2015 TLI < .4; B12 >1000; Folate 14.4. Prior to DX: May 2014 (2mos) - DX coccidia/bladder infection; July 2014 (3mos) 1st EPI test = TLI 16.5, B12 894, Folate >24 - Dx SIBO not EPI; Feb 2015 thru May 2015 - weight loss only; May 2015 vomitted several times, diarrhea and eating poop. Regimen: 4 cups Sport Dog Food Elite Herding - Diane 6x 1tsp per cup; 1 WonderLab PetFactor B12 2x day; 1/2tsp Slippery Elm 2xday; Multivitamin; 1 Zyrtec 10mg 2x day; Salmon Oil

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Judy
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Country: Canada

Re: new!

Post by Judy » 29 Aug 2018, 07:03

You have received awesome advice so I won't add anything more. As I was reading your first post, I was thinking.....that's the wrong enzymes but Olesia cleared that up and set you on the right course.

EPI does seem overwhelming at first (we've all been there) but, in time, and with the help of this amazing group, you will soon find that it's just a new normal for you and your pup. As Madelon said, keeping a journal is paramount in keeping things straight as it can get confusing at times when we make changes.

Good luck and keep us updated. Hopefully once you begin the proper enzymes, you will see great improvement.
Piper was 13 months old when she began having symptoms and diagnosed at 16 months of age. She had lost 21 lbs from Oct 2013 to Jan 2014 but gained it back very quickly once she began enzymes, B12 and Tylan. She would go on to develop Hypothyroidism, Cushings Disease, SLO, SARDS as well as chronic infections. Through it all, she was just the happiest dog and never met a stranger, everyone was her friend.

Piper crossed the Rainbow Bridge on April 20th, 2018 at just 5 years of age from other auto immune diseases. She will be forever missed, forever loved and her spirit will live on in our hearts and our home.

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