EPI?? maybe yes, maybe no

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.
tlwright21
Member
Posts: 36
Country: United States
State: Texas
Pet name: Jasper
My name: tony

EPI?? maybe yes, maybe no

Post by tlwright21 » 18 May 2021, 13:28

I noticed about 2 months ago that my 8 year old German Shepherd mix appeared to be losing weight. Took him to vet and confirmed he had lost 6 lbs to 46lbs. Told them he had become ravenous. They did a full CBC and reported nothing wrong. 30 days later he had started having diarrhea and some vomiting. took him back to vet and he had lost another 2Ilbs. they did another CBC. still no problem. they prescribed antibiotic and prednisone. I increased food intake to 6 cups/day from 4. 2 weeks later (last week) took him back and he had lost another 2 lbs. He has been having bad gas and gurgling sounds along with foul smelling yellowish loose poop for about 6-8 weeks.

I mentioned EPI to vet last week and he agreed it sounded like that. (he had not considered that) and we did a fasting blood test last week. Blood test was inconclusive for EPI. his B12 levels were very low but the "t" level was barely below normal. The vet recommended enzymes, weekly B12 shots and low fat food. I bought Hill Prescription diet ID low fat. It has made his stools worse.
I'm feeding him 6 cups per day with 1 tsp of enzyme per 2 cup serving. He started the enzymes 4 days ago.

Honestly my vet is probably not to sharp on this matter. I told him about it after I did the research. Yesterday dog had his first very near normal stool in 2 months, but then followed that later on with severe diarrhea. Am I giving enough enzymes?he is still very energetic and is acting normally but don't know for how long at this rate. Help/Comments/ Solutions?

Tuckaboo Pam
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Posts: 1345
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: EPI?? maybe yes, maybe no

Post by Tuckaboo Pam » 18 May 2021, 13:43

Hi Tony, and welcome to the forum.

Boy, it sure sounds like Jasper is doing a lot of the things Tucker did in the beginning. One thing that will help us help you, is if you can get your vet to email you all of the test results & then post them here. There are some really sharp people on staff who have experience reading test results & they'll give you some great ideas.

Also, what kind of enzymes did your vet give you? Most of the time, the ratio is 1 teaspoon : 1 cup of food, and low fat food is not ideal, rather low fiber is, <4%.

My vet had never seen a case of EPI, so she sent me to one who had. He was very kind & helpful, but I actually doubled my knowledge when I joined this forum. You are definitely in the right place! While you wait to get more responses, you might be interested in some of the other pages, like Managing EPI, B12, Antibiotics, SID, and Food.

Check back often, and definitely get those results posted. 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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Jean
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Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: EPI?? maybe yes, maybe no

Post by Jean » 18 May 2021, 14:21

just done a massive post and it has disappeared !
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

Tuckaboo Pam
Member
Posts: 1345
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: EPI?? maybe yes, maybe no

Post by Tuckaboo Pam » 18 May 2021, 14:25

Jean, I hate that! I think there is something you can click on---maybe your name, and still find it? I have done this once & had it work, but I've also lost a few lengthy speeches on here. Sorry, so frustrating.
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.

tlwright21
Member
Posts: 36
Country: United States
State: Texas
Pet name: Jasper
My name: tony

Re: EPI?? maybe yes, maybe no

Post by tlwright21 » 19 May 2021, 09:41

I got his labs
TLI= 4.4
Cobalamin= 247
Folate= 19.9

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Madelon
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Location: Nashville, TN
Country: United States
State: Tennessee
Pet name: Doc

Re: EPI?? maybe yes, maybe no

Post by Madelon » 19 May 2021, 21:17

Hi Tony! Welcome to our EPI family. Thank you for posting the test results as that REALLY helps. So Jasper is in the area that we call SEPI - where he may be heading towards EPI - here is the link to the information from our website https://epi4dogs.com/tli-test-not-quite-epi/. When your dog falls within this range, which Jasper does we recommend to treat as if EPI and then re-test in a few months. Just to give you my personal story - my Doc was tested at 3mos old - his TLI was 16 totally normal - at 10mos old he started displaying symptoms again - retested at 13mos old (10mos after original test) and his TLI was less than .4!!!

With your values the B12 is extremely low and the TLI is within the range that you should treat as if EPI. As for the enzymes the dosing you are using is not what we recommend - we recommend 1 level teaspoon per cup of kibble, mix in a little luke warm water, mix in kibble and sit for 20-30 minutes before feeding.

As for the B12 - you really need to start supplementing - either shots or the WonderLab Pet Factor B12 pills. B12 for EPI dogs needs to be on the high side of normal 600+ and supplementing is for life.

With EPI, we recommend grain free food with 4% fiber or less and avoid/limit peas and legumes. Fees 150% of the food for the weight your dog should be but in smaller, more frequent meals throughout the day.

To help save you some money - you can get enzymes from EnzymeDiane much less expensive than the prescription enzymes from the vet and you can get the WonderLab Pet Factor B12 pills using a discount of Epi4Dogs15 at checkout.

I know it might seem overwhelming but we will be here to guide you through!
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.

Tuckaboo Pam
Member
Posts: 1345
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: EPI?? maybe yes, maybe no

Post by Tuckaboo Pam » 20 May 2021, 13:56

Tony, I second everything Madelon has said. A couple of other ideas are, 1) Keep a journal about all the changes you make, so you can look back & see what has worked. 2)Check out the signatures at the bottom of posts, because some of them have great ideas about brands of food, etc, that have worked with some EPI dogs. I just always found that helpful, and you can always ask for clarification. ---Pam
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.

tlwright21
Member
Posts: 36
Country: United States
State: Texas
Pet name: Jasper
My name: tony

Re: EPI?? maybe yes, maybe no

Post by tlwright21 » 21 May 2021, 11:03

thank you all. the good news is that for the past 2-3 days he has been having nearly normal stools. No more of that horrible foul smelling diarrhea that he was experiencing several times a day.
We started the enzymes on May 15 and there was a noticeable improvement by May 18.
Also the loud gurgling gut noises and passing gas has dissipated. He is still very ravenous and I have upped his food to 6 cups from 4 cups per day. He still needs to regain about 6-8 pounds weight back to 50 or so. Kind of bony in the hind quarters.

I got a second opinion on his treatments, and short of doing a ultrasound on his small intestine to check for lymphoma, the other vet said to stay the course as long as he is having normal stools. He will be getting weekly B12 shots for as long as I guess he needs it. We haven't spoken about how long that will go on. I have him on Hills Prescription Diet ID, low fat. very expensive dog food.

Tuckaboo Pam
Member
Posts: 1345
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

lon's lead, in feedingRe: EPI?? maybe yes, maybe no

Post by Tuckaboo Pam » 21 May 2021, 14:47

Tony, EPI dogs need low fiber, not low fat, and many of us have had success feeding Sport Dog Elite, herding series buffalo & sweet potato.

Remember, you want to feed him 150% of what he should be eating at his ideal weight. When Tucker weighed 60, and he should have weighed 80, if the bag said 4 cups/day for 80 pounds, I fed 6 cups/day, divided into two or three enzymed meals, marinated with room temp liquid for 20 minutes. You may be doing this already.

Hope this helps.---Pam
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
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Posts: 918
Country: United States
State: New Jersey

Re: EPI?? maybe yes, maybe no

Post by Barb » 21 May 2021, 19:54

Hi Tony,

That is a great update on Jasper. It sounds like he is making a great turn around. Also with regard to the B12, many of our pups need B12 supplementation for life, so after the initial 6 weeks of injections, you might want to switch to pills offered by Wonderlabs called Pet-Factor. They have Intrinsic factor which is necessary for absorption of the B12 for dogs with EPI and dogs do very well with them.

Glad to hear Jasper is doing so well.

Barb

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