Newly Diagnoised

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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PipersMom
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Posts: 164
Country: United States
State: New Jersey
Pet name: Piper
My name: Shawn

Newly Diagnoised

Post by PipersMom » 25 Apr 2021, 06:30

Hello and thank you for allowing me to join the forum. Please let me apologize now if I get too lengthy with my words and if I am out of order on events. I am very worried and concerned and scared.

A little background. Piper, she is a rescue that came home with us Nov 2019. She is now 20 months old and 50lbs. We did the Embark test and Piper is Chow Chow, German Shepherd, Catahoula Leopard Dog, Bluetick Cookhound, Border Collie, and a tad bit of pit. Over 50% is the Chow and Shepherd alone which I know both are prone to EPI. At a few months old Piper was diagnosed with USMI (Urethral sphincter mechanism incompetence) and is on Proin for that. She is also on Gabapentin for a pinch nerve in the base of her spine when needed. She has been table for over a year with both but will be on both meds.

Summer of last year, could have been earlier, she started getting bouts of diarrhea and/or loose stool. The vets first thought maybe from all the rain and eating something from the ground and gave her metronidiazole and it would get better before it would start again. She was then diagnosed with Gastro issue and colitis. Piper was doing well but her stool just never became firm and was often soft if not loose. It was at this time the doctor did an ultrasound and BW. Both came back fine with the exception of eosinophils which was high and took her off chicken and started Pepcid at night. Things got better and she is allergic to all things with anything with wings. No chicken fat, starch, etc. We tried an all Lamb diet and while it worked for a time the loose stool came back. She was placed on the RC HP Food. Her stool started getting this weird consistency with red fibrous material inside. As things were not looking up the vet did bloodwork and tested for cTLI. It was at this time she was diagnosed with EPI.

On April 8, 2021, Piper started on 1 tsp PancreVed Powder mixed with food and dampened with water. I let it still a minimum of 15 mins if not more. She was eating fine but I had to put peanut butter mixed in for her to eat her food. On April 12th she went in for her first B12 shot and had her second on April, 10, 2021. Her stool has been great since the 16th. However after the 2nd B12 injection she started not eating her food. I was able to mask it with peanut butter then cream cheese but as of yesterday I am lucky to get a quarter of her food eaten with a lot of coaxing. I have tried applesauce, pumpkin, beef and veggie broth. All of which she still will not touch the food. We even tried oatmeal and rice. Nothing.

We actually are going to try a fresh food Diet of Beef now. Since she will not touch anything lamb anymore (I have so many different lamb products here and will not touch any) we have fresh food meals coming in from The Farmers Dog. They are one protein only meals. This is the only service that offers two Proteins other then Chicken and Turkey both of which Piper can not eat. However in the meantime I am worried because she is not eating, especially this morning nothing. She had a belly ache all night with gurgling. I also noticed that for the past two weeks she is eating grass. She is not throwing up but she eats it. I do not know if it is just because there is fresh new grass with Spring or if it is her belly.

Tomorrow I give Piper her 3rd B12 and then next week I take her in for BW to test B12 levels. I will say that my vet has been very diligent in figuring out what Piper has. Now that we know we just need to get her food she can eat.



So I guess I have several questions....

~ How can I get Piper to eat the kibbles we have now until the fresh food comes (and I pray she will eat that)?
~ What if she goes a few days without eating much (I don't want her to loose the weight we just put on her)?
~ What is it with the grass eating?
~ Has anyone else tried a Fresh Food Diet?


Please, if anyone has any help, tips or words for me I would appreciate it. If there are sections I need to read or look at please let me know. I am very new to this site and have not read much. I am overwhelmed but I do know that dog with EPI can live a healthy long life. I just need to learn about this condition.


Thank you in advance for any help and information you can give.

PS, sorry for the long post.
Shawn, from NJ. Piper is Chow Chow, German Shepherd, Catahoula Leopard Dog, Bluetick Coonhound, Boxer, Border Collie, and Pit. Born 8/28/19.

EPI Diagnoised
: 4/7/21 (cTLI-1.8, B-12-<150, Folate->24). Started Enzymes 4/8/21. Piper's weight dropped to 45 but was a is a steady 50lbs. Lowest weight 42lbs. As of 4/5/21 B12 was 505. As of 12/14/22 was 830
Daily Meds: PancreVed Powder with each meal, B-12 1000mg every other day, Proin 25 mg BID, Gabapentin 150mg BID, Proviable-Forte Capsule, Priolosec 20mg and Incurin .5mg. If needed: Galiprant, Cerenia, Tylan
Current Food: Homemade food by me with a vet nutritionist recipe that has added vitamins and minerals.

Tuckaboo Pam
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Re: Newly Diagnoised

Post by Tuckaboo Pam » 25 Apr 2021, 10:41

Hi, Shawn & welcome to the forum. You have absolutely nothing to apologize for. The more details you share, the easier it will be to help you.

I will jump right in, and ask you to ask your vet for Tylan, a very specific antibiotic, because it sounds like Piper has out of control SID. Another option ( I actually do both of these), is Slippery Elm, a natural herb full of prebiotics. Just try one thing at a time, and keep notes about the outcome (literally). You may eventually want to add a probiotic, but let's not get too crazy all at once! It is often recommended to give slippery elm a chance before asking for Tylan, but my concern is that Piper isn't eating. Not feeling well could certainly affect her appetite. Her treatment with metronidazole may have compromised her tummy flora, but you can work to make that better, with some of the aforementioned products.

You have several conditions you are dealing with, and the researchers on staff will have more experience & they'll jump in & correct any mistakes I may have made here. My Tucker has been on a regimen for two years now, and he is currently doing well. However, it has often been a matter of trial and error, which makes writing things down so very important.

In the meantime, this might be an interesting read for you, in fact the entire "Managing EPI" section has a lot of useful information.
https://epi4dogs.com/sidsibo-in-brief/

So, keep in touch & check back for more help. Ask every single question you have, too, because someone on the forum will be able to help you in one way or another. And, this may seem overwhelming at first---we have all been there---but this is very doable. And, OH! You should check out Enzyme Diane. Many of us use her wonderful enzymes, and they are way less expensive than the ones from the vet. Loving an EPI dog can be pricey, so it helps to save money wherever you can.
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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PipersMom
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Country: United States
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Pet name: Piper
My name: Shawn

Re: Newly Diagnoised

Post by PipersMom » 25 Apr 2021, 10:57

Thank you Pam and Tucker.

I have made note of both the Tylan and Slippery Elm and will email my vet tomorrow. She is currently on a Probiotic and have 4 days of that left (been on it about 100 days so far). I actually need to get a renewal of it.

I just got home from the food store and bought some baby food and some food topper (Purina Beneful Medleys Tuscan Style Wet Dog Food with Real Beef, Carrots, Tomatoes & Rice). I had boiled some orzo pasta in veggie broth. At the end I added some of her HP kibbles. Once cooled. I used some of the veggie broth to dissolve the enzymes let sit about 40 mins. I added it to some of the pasta along with her kibbles and one small can of the Beneful Beef Medley topper. She did eat about half of that. I want to note the baby food and this medley stuff is only being used to get her to eat something until the new fresh food arrives.

She wants to go out but all she is doing is eating a ton of grass. I do not know how to stop that and if I should even let her, As soon as she starts eating it I bring her in. Now she is laying down and whining. I know she does not feel good and has not since yesterday.

Any ideas about the grass?
Shawn, from NJ. Piper is Chow Chow, German Shepherd, Catahoula Leopard Dog, Bluetick Coonhound, Boxer, Border Collie, and Pit. Born 8/28/19.

EPI Diagnoised
: 4/7/21 (cTLI-1.8, B-12-<150, Folate->24). Started Enzymes 4/8/21. Piper's weight dropped to 45 but was a is a steady 50lbs. Lowest weight 42lbs. As of 4/5/21 B12 was 505. As of 12/14/22 was 830
Daily Meds: PancreVed Powder with each meal, B-12 1000mg every other day, Proin 25 mg BID, Gabapentin 150mg BID, Proviable-Forte Capsule, Priolosec 20mg and Incurin .5mg. If needed: Galiprant, Cerenia, Tylan
Current Food: Homemade food by me with a vet nutritionist recipe that has added vitamins and minerals.

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jilbert57
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Re: Newly Diagnoised

Post by jilbert57 » 25 Apr 2021, 11:42

Hi Shawn,
There are 4 cornerstones of Epi that need to come together before healing can occur;

Enzymes: dosed per cup of food. Dry kibble is 1 level teaspoon enzyme per 1 cup kibble. Mix and add a little room temp. water and incubate 15 to 20 mins. Stir and serve.

Diet.Most dogs do better on a grain free diet of 4% or less fiber. Grains in the diet interfere with the efficacy of the enzymes.(some dogs can get along eating some grain)

Antibiotic for SID/SIBO(overgrowth of bad bacteria in small intestine) Pam suggested Tylan and I agree. Tummy rumblings, belching , farting and upset tummy.

B12 Epi dogs need a B12 in the upper end of the range so around 600. This can be oral supplementation or B12 shots.

Under the Epi banner here to the right is a pink home button. If you click on it it takes you to a page with dropdowns and a lot of information.

If your pup will just not eat the food there are things you can try, like putting the enzymes in gel caps and feeding pre meal, just watch for sloppy poop. Also there is Creon caps you don't incubate, just sprinkle the capsule contents on the food and make sure it is all consumed.

You can try spreading the incubated food on a flat plate and put parmesan cheese or drizzle some tuna oil or a little bacon oil on top.

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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PipersMom
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Posts: 164
Country: United States
State: New Jersey
Pet name: Piper
My name: Shawn

Re: Newly Diagnoised

Post by PipersMom » 25 Apr 2021, 12:01

Thank you Jill! I made some comments below.

I am very thankful I found this forum.

jilbert57 wrote: 25 Apr 2021, 11:42 Hi Shawn,
There are 4 cornerstones of Epi that need to come together before healing can occur;

Enzymes: dosed per cup of food. Dry kibble is 1 level teaspoon enzyme per 1 cup kibble. Mix and add a little room temp. water and incubate 15 to 20 mins. Stir and serve.

I get one cup of food. It is usually a cup of kibbles but today it was a mix of kibbles and orzo mix with the 1 tsp of enzymes I was doing what you stated able but when she stopped eating I had to get creative. I guess I may have been incorrect in doing so

Diet.Most dogs do better on a grain free diet of 4% or less fiber. Grains in the diet interfere with the efficacy of the enzymes.(some dogs can get along eating some grain)

I asked my vet about that and she wants her on grains. I have no clue why. I need to ask again.

Antibiotic for SID/SIBO(overgrowth of bad bacteria in small intestine) Pam suggested Tylan and I agree. Tummy rumblings, belching , farting and upset tummy.

I have this listed in an email I am sending to the vet

B12 Epi dogs need a B12 in the upper end of the range so around 600. This can be oral supplementation or B12 shots.

I am giving her weekly injections right now. She will be having bloodwork on May 4th to see what her level was.

Under the Epi banner here to the right is a pink home button. If you click on it it takes you to a page with dropdowns and a lot of information.

If your pup will just not eat the food there are things you can try, like putting the enzymes in gel caps and feeding pre meal, just watch for sloppy poop. Also there is Creon caps you don't incubate, just sprinkle the capsule contents on the food and make sure it is all consumed.

You can try spreading the incubated food on a flat plate and put parmesan cheese or drizzle some tuna oil or a little bacon oil on top.

I actually read that somewhere here and tried it. I do not know if it made a difference yet but I will make her dinner up as you suggested again and try. I a, going to add the Parmesan cheese to see if that helps.

Jill
Shawn, from NJ. Piper is Chow Chow, German Shepherd, Catahoula Leopard Dog, Bluetick Coonhound, Boxer, Border Collie, and Pit. Born 8/28/19.

EPI Diagnoised
: 4/7/21 (cTLI-1.8, B-12-<150, Folate->24). Started Enzymes 4/8/21. Piper's weight dropped to 45 but was a is a steady 50lbs. Lowest weight 42lbs. As of 4/5/21 B12 was 505. As of 12/14/22 was 830
Daily Meds: PancreVed Powder with each meal, B-12 1000mg every other day, Proin 25 mg BID, Gabapentin 150mg BID, Proviable-Forte Capsule, Priolosec 20mg and Incurin .5mg. If needed: Galiprant, Cerenia, Tylan
Current Food: Homemade food by me with a vet nutritionist recipe that has added vitamins and minerals.

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jilbert57
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Posts: 2088
Country: United States
State: Washington

Re: Newly Diagnoised

Post by jilbert57 » 25 Apr 2021, 12:25

Good on all that Shawn. About the grain free diet. Might be to the Grain free- DCM issue your vet is worried about. I am attaching a couple of links you can read and maybe share with your vet.


https://epi4dogs.com/why-grainfree-foods/

https://epi4dogs.com/taurine-grainfree-diets/
https://epi4dogs.com/dog-food-options/

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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PipersMom
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Posts: 164
Country: United States
State: New Jersey
Pet name: Piper
My name: Shawn

Re: Newly Diagnoised

Post by PipersMom » 25 Apr 2021, 12:44

I printed them out and will show the vet when I see her. I did a search on Chewy. I did see many of these however Piper being allergic to all things chicken, turkey and duck (anything with wings) it is hard. Even if they say no chicken, there is chicken fat, chicken starch or turkey in them. I have found a couple of companies that have just beef or just pork and lamb too. But Piper will not touch lamb. I need to research and make a list of all that I can find that are grain free with nothing else in it.

Thanks again. I know what my Monday will consist of :)
Shawn, from NJ. Piper is Chow Chow, German Shepherd, Catahoula Leopard Dog, Bluetick Coonhound, Boxer, Border Collie, and Pit. Born 8/28/19.

EPI Diagnoised
: 4/7/21 (cTLI-1.8, B-12-<150, Folate->24). Started Enzymes 4/8/21. Piper's weight dropped to 45 but was a is a steady 50lbs. Lowest weight 42lbs. As of 4/5/21 B12 was 505. As of 12/14/22 was 830
Daily Meds: PancreVed Powder with each meal, B-12 1000mg every other day, Proin 25 mg BID, Gabapentin 150mg BID, Proviable-Forte Capsule, Priolosec 20mg and Incurin .5mg. If needed: Galiprant, Cerenia, Tylan
Current Food: Homemade food by me with a vet nutritionist recipe that has added vitamins and minerals.

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Olesia711
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Re: Newly Diagnoised

Post by Olesia711 » 25 Apr 2021, 13:03

Hi Piper's mom..... a food that you can try is Sports Elite SLWD dog.

NOT chicken or chicken fat.... and 3.5 fiber content
https://www.sportdogfood.com/products/s ... ngredients

Many of us here on the forum use Sport ELite dog foods (different versions for different needs) for our EPI dogs :)
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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Olesia711
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Re: Newly Diagnoised

Post by Olesia711 » 25 Apr 2021, 13:06

Hi Shawn,
Thank you so much for writing in and giving us great details... that is very helpful.

Most likely what your sweet gal is dealing with is SID (small intestinal dysbiosis). This would account for the grass eating (she is most likely trying to self medicate... eating grass can often make them puke and that relieves an upset tummy.

WIth an upset tummy from SID.... many dogs don't want to eat cause their tummy hurts.... while other dog just chomp away without an issue.... so... i suspect that yours falls into the first category..... she doesn't want to eat cause it hurts.

As discussed by Pam and Jill... the FIRST thing i would do is contact your vet Monday morning and tell them you want Tylan (NOT METRO!) for your EPI dog because her SID is out of control and making her sick.....

REgarding testing for the B12..... levels to see if they came up... please share with your vet that it is too soon to test ....When using the B12 injection method..... the protocol set forth by TAMU for EPI dogs is as follow:
"give cobalamin supplementation: q 7 days for 6 weeks, then one dose after 30 days, and retesting 30 days after the last dose. "

That is wonderful though that your vet is trying very hard to stay on top of your dogs' progress. EXCELLENT!!!!

Also.... just i case the inappetence does not go away after giving Tylan (which should work fairly quickly) so i am going to say if the in appetence continues 5 to 7 days after you started the Tylan.... please suggest to your vet to have her check her over for possible kidney issues.......... because we have seen this happen too,if it displays like SID, but nothing helps and the inappetence continues... it could be kidneys and have nothing to do with EPI.........not trying to scare you but just trying to make sure i give you all the possibilities!

Hope this helps.

OH... meant to ask... how much enzymes are you giving per how much food????? Sometimes SID is encouraged to get out of control (all EPI dogs have it to one degree or another, our goal is to keep it in check) but sometimes if not enough enzymes are used it encourages SID to go out of whack.
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.........

Jane&Clyde
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Posts: 157
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Pet name: Clyde
My name: Jane

Re: Newly Diagnoised

Post by Jane&Clyde » 25 Apr 2021, 13:23

If your vet insists on a diet with grains, you might want to try Taste of the Wild Ancient Stream. Many dogs on here do well with the version without grains. My Clyde actually does better on the version with grains because he, like many other EPI dogs, doesn't do well with peas. Peas should not be in the first several ingredients if you can help it. Oh, yeah...I checked and didn't see any poultry ingredients.

If your vet will agree to a grain free diet, one formula that many dogs do well on from here is Sport Dog Elite Herding Dog. It uses sweet and white potatoes instead of grains or peas/legumes. Once again, no poultry in it.

Whatever you feed, please make sure it has 4% or less fiber. The lower the better for EPI dogs.

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