Another 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.
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MarcyO
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Posts: 3
Country: United States
State: Iowa
Pet name: Charlie
My name: Marcy

Another newbie

Post by MarcyO » 25 Apr 2021, 14:07

Hi there. My name is Marcy and my dog Charlie has recently been diagnosed with EPI. Prior to his diagnosis, he was not eating well, but still eating, and had chronic vomiting. After several X-rays and ultrasounds, examining of poop, and treatment with cerenia and a really strong antibiotic, the vomiting stopped, but he stopped eating almost completely. We took him to an internist who did a GI panel and diagnosed him with EPI.

We have a few things going on. First, he has an ulcer. He is on sucralfate and Pepcid for that. Second, to control nausea and vomiting, he is on cerenia daily. But lately he has thrown up at least once every day for 3 days.

He is currently eating science diet a/d to help him get the most calories the most efficiently. We have to feed him with a syringe. He gets about 100cc of food 3x a day. Which I know is not enough. But it’s about all his tummy can handle. Plus I have to time his other medications around feeding. I use 1 tsp enzyme per feeding. He just received his first B12 shot on Friday and seemed to perk up a little bit.

My biggest question is, could the introduction of the antibiotic (enroflaxin that he did not finish a course of, it did more damage than good) be the culprit for his constant nausea and not wanting to eat? Causing an overgrowth of bad bacteria? Would a round of tylan help? I literally have NO ONE here in this area that knows much about this disease save the internist and I don’t know her that well at this point. I assumed she knew a little, because she knew to do a GI panel and knew about diane’s enzymes.

Charlie’s enzyme is PancrePlus
Marcy and Charlie

Tuckaboo Pam
Member
Posts: 1346
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: Another newbie

Post by Tuckaboo Pam » 25 Apr 2021, 15:11

Hey, Marcy, and welcome. We have all been where you are now, and I promise you will get lots of help here, and Charlie will get through this.

Do you have test results you can post? It is very helpful to know what tests were given & exactly what the results were. It's good that you are comfortable with the internist, that is so helpful. I hope she will be open to some suggestions from the forum, once the people on staff respond here.

Off the top of my head, it is often the case that EPI dogs do not do well with poultry, and it looks like your food is made from chicken. My Tucker gets turkey wing broth & the occasional bite of meat, but having just tried him on the chicken formula of Sport Dog food, I am going to switch back to buffalo & sweet potato, due to softening poopoo. So the chicken protein might be something to consider being part of Charlie's problem.

Since I am pretty good at saying WELCOME, but I am not scientifically wired at all, I'll just say look back in a little while for a response from staff, and you will receive lots of good information. Please do post all the tests Charlie had done & how they turned out, because that will give them a headstart. Thanks!---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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jilbert57
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Posts: 2092
Country: United States
State: Washington

Re: Another newbie

Post by jilbert57 » 25 Apr 2021, 16:29

Hi Marci, your post actually posted twice and I wrote on the other one. Will copy and paste my answer:

e: Another newbie
Post Sun Apr 25, 2021 12:09 pm

Hi Marcy.
I know nausea is one of the side effects of sucralfate. Vomiting and lack of appetite are side effects of the Cerenia and also hypersalivation. In my opinion you could have quite a few things mixing up. Also the enroflaxin side effects are gastro upset, lack of appetite.

I am wondering if Omeperazole(prilosec) might be a better choice than Pepcid.

Mickey used the sucralfate but most got sneezed away on me but it did make him nauseous.

I might sit down with the vet to work out the nauseous producing meds.

Jill
My name is Jill and we live on the Hood Canal in Washington State. We currently have one pup. TJ is a 5 year old Jack Russell.

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.
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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MarcyO
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Posts: 3
Country: United States
State: Iowa
Pet name: Charlie
My name: Marcy

Re: Another newbie

Post by MarcyO » 25 Apr 2021, 17:09

Thank you for your responses. I did not receive the full panel but his TLI was 5. His B12 was low-normal. I can ask for it tomorrow. He was given cerenia for the nausea/vomiting. He is on the sucralfate for bloody stools caused by (what they believe to be) an ulcer. His stools were indicative of GI hemmorage, and since then his stools have improved. He was on omeprazole and it didn’t help, but he was also on the nasty antibiotic. I can try it again.

This is so frustrating and heartbreaking. I am starting to feed him little bits at a time as to not overwhelm his stomach. I put his enzyme in his food, before giving it to him. Should I not be doing that? They suggested a “meatball” but he refuses everything. And he does tend to shy away from anything chicken. Naturally, because I just bought 12 cans of a/d. So far, this journey has cost us over 2k and we still keep spending and spending and spending and yet no one seems to know what to treat and are treating each symptom as they come up, without looking at the big picture. And sometimes not even looking at the notes or his chart. No one explained to me that cerenia caused hypersalivation. (Thank you) I’m tired. And I am frustrated. So far, I’ve been dealing with 4 different vets at 3 different clinics. A couple nights ago, I almost took him to be euthanized.

This is one of those situations where I’m not getting the help I need from the people who are supposed to be the ones who are knowledgeable. And the information I AM getting, is mostly contradictory to what you all are saying. I don’t know which came first, the ulcer or the EPI. Did the EPI cause the ulcer? Or did it just bring it to light? Everyone keeps telling me the only answer is in an endoscopy. For another 2k. I love my dog. But we can’t afford to keep up at this pace. I have a child with a chronic kidney condition and that has to come first. I’m frustrated and I’m tired. I feel like we keep running but getting nowhere.

Thanks for letting me vent if you made it this far.

Also, not sure what happened with the double post. Sorry about that.

Marcy
Marcy and Charlie

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jilbert57
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Posts: 2092
Country: United States
State: Washington

Re: Another newbie

Post by jilbert57 » 25 Apr 2021, 18:02

By looking at the test result of 5 his Tli is in between Epi and normal:

2.5 or less = clinical EPI
3.5 thru 5.7 = not clinical EPI but possible pancreatic acinar cell destruction (EPI) developing. Re-test in the near future.

Was your pup food fasted for at least 8 ours before the test?

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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Montgomery
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Posts: 418
Country: Canada
Pet name: Montgomery (I'm a CAT!)
My name: V

Re: Another newbie

Post by Montgomery » 25 Apr 2021, 21:19

Would it be beneficial to put Esbilac into the food he's being syringe-fed? I've done this with KMR with cats who are not eating because it adds extra calories without adding extra volume. I just mix the powder into the canned food and then down everything goes. Sometimes when an animal isn't eating its because they associate that food with feeling rotten, no matter if that's what caused it or not. Changing the smell of the food (I know a/d stinks to begin with) can help. Warming the food or using a topper. Montgomery, my little EPI guy, can't stomach much of anything, but he CAN eat nutritional yeast. It smells very cheesy, and doesn't take more than a dusting on top of his food to get him eating. There's a company called Granville Island and they make dried tuna flakes for cats, but dogs can eat them, too. The veterinarian may let you exchange the remaining cans for the Medi-Cal or IAMS equivalent if you're really stuck.
Good luck with your little one. You've found a good place, here.
Montgomery was born 20 March 2012. He eats extra lean ground chicken, lean ground pork and lean ground beef completed with Alnutrin and freeze-dried chicken liver, with hard-cooked egg. He gets two size zero capsules of Enzyme Diane's enzymes at each of his six meals, and a size four capsule of Tylan three times a day. He's a fierce little Spitfire with a roaring Merlin engine.

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MarcyO
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Posts: 3
Country: United States
State: Iowa
Pet name: Charlie
My name: Marcy

Re: Another newbie

Post by MarcyO » 25 Apr 2021, 22:33

The doctor did mention that though he isn’t considered clinical, with his history, she wanted to get him started on this regimen for at least a couple weeks to see how he is doing. Needless to say, we have seen a very little improvement with the B12, but now he is vomiting after feedings.
Marcy and Charlie

Tuckaboo Pam
Member
Posts: 1346
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: Another newbie

Post by Tuckaboo Pam » 26 Apr 2021, 15:00

Those vet bills can really add up. I am so sorry you are feeling so helpless, and it's clear how much you love Charlie. I probably would have felt the same way, if I hadn't visited a second vet, who owned the practice & was very kind about what he charged me.

As far as giving the enzymes, I know Olesia has said dogs can segue into EPI, so that does make sense. Have you been able to eliminate some of the nausea-causing meds Jill mentioned?

I'm so sorry, I really have to go get the kids up from their nap, but I wanted to reach out & touch base.

Keep looking here for more suggestions. You'll get through this. Charlie is beautiful!---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.

Barb
Staff
Posts: 918
Country: United States
State: New Jersey

Re: Another newbie

Post by Barb » 26 Apr 2021, 15:58

Hi Marcy. I am so sorry you and Charlie are going through all this. It does sound like there are a few things going on. Low B12 always made our Kolby not want to eat. So supplementing the B12 should begin to help. I also noticed that you are giving Charlie 1 teaspoon of enzymes per 100cc. I think that is a little less than a 1/2 cup of food, so the enzymes might by just a bit too much. We usually suggest to start with 1 tsp per cup, so you might want to lower the enzymes to 1/2 teaspoon per 1/2 cup and see if that helps.

I was going to agree with you on giving a round of tylan, but it is very bitter and we don't want to discourage Charlie any more from eating. Tylan is milder than other antibiotics, though.

I hope you can work out with your vet the medicines that are causing Charlie to be nauseous. I don't have any experience with ulcers with any of our pups, but it sounds like that area is improving.

I know how hard this is when you are searching for answers and getting mixed messages. Please feel free to vent here. Let us know how Charlie responds and what information the vet might have.

Hang in there.

Barb

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