New Here - Maverick's Journey

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.
VizslaJess

New Here - Maverick's Journey

Post by VizslaJess » 22 Jul 2021, 13:30

Hello everyone!

I'm Maverick's mom, Jess. I have been up and down every part of this site over the past 2 months(or so I thought...), but just noticed today there's a forum. I think my delayed finding will reduce the number of HELP!! posts you should see from me, lol.

Maverick is a 6 year old Vizsla. He started getting sick in December of 2019 with a bout of severe vomiting. After x-rays and ultrasound Mav went home with a doze of pepcid and direction to continue pepcid for some time. Being a dog who eats everything his indiscriminate diet was blamed. Pepcid helped, the vomiting stopped, but Mav started to lose weight following this episode.

At first my husband and vet thought I was loony, and that Maverick was fine. His weight loss was so slow, and he over his first 5 years was always very lean. He gets bird brain every spring, runs more, and loses some weight.. but this was more than usual. So, despite my assumed lunacy we proceeded with tests which found nothing. After about a year of testing for different things, Maverick lost enough weight that I lost my nutjob status and others agreed something was wrong.

In June of this year our vet had exhausted all ideas and tests. Maverick had gone from 85 lbs to 65lbs. He was a bag of bones. You could count his vertebrae and ribs. His hips were prominent. He lost muscle mass and his thighs were pancake thin. We were referred to internal medicine and scheduled our consult for 7/5 at which point I received a copy of Mav's records and all his labs. I noticed in one of his total body function tests his Precision PSL result was super low, a value of 8 with a normal range of 24 - 140. This led me to searching for pancreas related things, and EPI fit.

From my google diagnostics, I found enzymes if not needed would be relatively harmless, so we immediately purchased some powdered porcine enzymes (pan-tenex) and started on Friday 6/11. By the time we went to our internal med consult I had done the at home poop test from Ezyme Diane (which was positive for EPI), started enzymes, and our boy had gone from 65 lbs to 72 lbs in 3.5 weeks. He was starting to look great! The vet was almost confused by why we thought EPI until we explained that we already started enzyme replacement therapy.

We of course had EPI confirmed with a TLI test (along with cobalamin and folate). Maverick's TLI was 1.9 and confirmed EPI. His cobalamin was 204. We immediately started a B12 supplement following internal med's recommendation, along with fortiflora 1x daily.

We are now 7 weeks into enzyme replacement therapy, and so far it is going well. We have a dog scale at home and Maverick has put on a couple more pounds, he is up to 74 now and looking good. He is still a bit gassy, some days more than others. We are learning a lot about how to care for him. I never thought so much of my life would become consumed by preparing dog food, but he is worth it.

Phew, that's a lot of words. I probably missed a lot. I can't blame anyone for not reading all of this. We have been on a journey, and I am so relieved to find a community of others who have been dealing with a lot of the same fears and frustrations of this disease.

-Jess

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jilbert57
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Posts: 2088
Country: United States
State: Washington

Re: New Here - Maverick's Journey

Post by jilbert57 » 22 Jul 2021, 16:00

Wow Jess! Welcome to you, your hubby and Maverick. Great job on applying some things to get Maverick back on course, the enzymes. The recommended dose is 1 level teaspoon per 1 cup kibble, incubated with a little room temp water 15 to 20 mins. Enzymes needed with all food and snacks.
B12- good job on the shots. The level needs to be maintained at around 550 and up. You might have been on the B12 link and read about oral supplementation, which works well if you don't want to continue shots.

What is your pup eating for food? The recommended diet for Epi is 4% or less fiber and grain free.

Did the vet say anything about SID/SIBO in the gut? This can cause belching, gas ,vomit, upset stomach.

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.

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

Re: New Here - Maverick's Journey

Post by Tuckaboo Pam » 22 Jul 2021, 20:22

Hi Jess! Welcome, from Pam & Tucker in Florida.

For starters, your post was not too long! Feel free to ask as many questions as you like. Somebody usually checks the posts every few hours & will start the replies. You will get a lot of help from the people here.

Tucker had an internet EPI diagnosis, too, which speaks to how important this foundation is, for getting the word out about the condition. I feel that if I hadn't accidentally stumbled onto a story & done a little research, I may have eventually lost my good boy.

I agree with Jill. SID is something virtually all EPI dogs have, in varying degrees, so under Managing EPI, look for SID/SIBO, and probably bring this up to your vet. You can get slippery elm & Proviable OTC, and they work for some dogs. It's good to try them first, and if they don't you will need Tylan, an antibiotic. Metrodinazole is often the antibiotic vets go to, but it is bad for gut flora, so be aware that Tylan is what you want. If you get to that point. When you decide to try something, you can ask for help with dosing & administering.

It's a good idea to keep a journal, in case something changes.

Keep in touch, and thanks for doing such a good job with that beautiful Visla!---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: New Here - Maverick's Journey

Post by Barb » 22 Jul 2021, 21:03

Congratulations, Jess! That was some fine detective work you did. Mav is certainly lucky to have landed with you. You are doing all the right things and it is obviously showing. Maverick is doing amazingly well. It took us much longer to get everything in balance when we were going through this with Kolby. And weight gain already !! That is great.

I'm glad you are supplementing the B12. It is so important.
.
And I heartily endorse keeping a journal, recording everything you give Maverick, the amounts and the resulting poos. It helps you to see what is working and what needs to be adjusted.

Keep up the good work.

And keep following your intuition.

Barb

VizslaJess

Re: New Here - Maverick's Journey

Post by VizslaJess » 23 Jul 2021, 08:38

Thank you so much for all of the replies!

Maverick at this moment is eating Honest Kitchen Turkey 1.5 cups dry (rehydrated it approximately doubles to 3 cups) plus 2 cans of Purina Pro Plan Complete Essentials daily. He's eating about 2200 calories a day. For him a maintenance caloric intake is around 1500/day.

I don't believe I have been giving him enough enzymes. I must have misunderstood 1 tsp per cup as 1 tsp per meal, but luckily he still was showing good gains and improvement. After reading some posts here yesterday I increased his enzymes last night accordingly.

His B12 is in pill form, it's a Cobalequin 1000 mcg with 5-mthf. I am not yet certain how he is doing on it, the vet wants to see us in 3 months to re-check his labs, or sooner if there's any changes or he stops improving.

He is definitely showing signs of SID. I think that is why the internal med Dr has him on Fortiflora. She did not tell me to start off slow as I saw some recommendations on here, and now I wonder if that caused some of his stomach upset over the past couple weeks. His poops have improved significantly, so I believe it is helping. He went from yellow cow patties to brown logs. Not quite as formed as his sister's (not a 2 on the chart yet), but much much better than we've seen in a long time. Who would have thought they'd spend so much time examining poop?

The main issues we are seeing are I believe SID related. Some gas, bloating, and farting. That said it has been improving consistently so I hesitate to change anything or try anything different just yet. He used to groan and fart, and flop around appearing in discomfort after eating, with loud gurgling belly sounds. Now it's much more subtle, with barely any gas some days. The acid reflux has been pretty persistent though. He will burp and spit up some clear fluids once in a while, and seems uncomfortable when that occurs. I'm continuing to give pepcid for now, but definitely open to suggestions.

I am definitely going to start a journal. The other piece that the vet did not state was NO treats without enzymes. She said "A small treat once in a while is fine". He gets 1 small treat at bedtime, but I will either stop that or adjust his food to give him a meal at bedtime as well, so he can keep his bedtime treat routine.

Pam, you are so right that this foundation is incredibly important. It absolutely helped me find what was wrong with my boy when his vet could not.

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jilbert57
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Posts: 2088
Country: United States
State: Washington

Re: New Here - Maverick's Journey

Post by jilbert57 » 23 Jul 2021, 09:40

Hey Jess.

I feed Honest Kitchen to my non Epi dog.
Since it is wet food you are feeding and NOT the recommended dose of enzyme is 3/4 t enzyme per cup of wet food.

So 5 cups wet food per day would be about 4.5 teaspoons enzyme per day

A lot of vets with no knowledge of enzymes will say a dose per day and NOT per meal. But your dog makes no enzymes at all to digest food so to get nutrients out you need to add them to ALL food.

Another thing a long the line of SID is if you can't clear it up it might be the food. The rice in the Purina might be a culprit and last I talked to Kat at Honest kitchen none of the formulas were low enough in fiber.(some dogs do ok on a little grain) including their grain free versions. (Something might have changed)

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.

VizslaJess

Re: New Here - Maverick's Journey

Post by VizslaJess » 23 Jul 2021, 11:05

Hello Jill,

The canned food is a grain free variety, so no rice in this particular variety. It is very low fiber (less than 1.5%).

The Honest Kitchen Turkey with grain actually has less fiber than the grain free (5% in grain inclusive vs 9.6% in grain free). The grain inclusive version is oat based and causes less stomach upset than the grain free did, but that could also partly be the much lower fiber content. I know the recommendation is to be under 4%, so 5% is higher than I'd like to see, but combined with canned food at 1.5% it's overall the average is under 4%. He has been on this current combo for a couple months. Since he's been eating this food since we found enzymes and seeing great improvement I am trying to separate the success from the food and attribute it to the enzymes. It is just very hard to know which pieces are working, could be better, or harming.

We have had numerous dietary changes with our vet while trying to figure out what was going on, so we are definitely open to trying anything that will help him. We are probably hitting VIP status at Chewy.com based on our food bill, lol. Maverick tends to be quite picky which makes it all the more challenging, but our other 2 non EPI Vizslas are not picky and will help out eating whatever foods we tried that Maverick won't touch.

With EPI dogs and dietary changes, do you often see improvements quickly (days) or is it a slower progression that may take weeks to see any real change? I know there's sometimes digestive upset with food changes in general, but with EPI I have to wonder if removing a problematic food and replacing with something better will show improvement quicker.

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

Re: New Here - Maverick's Journey

Post by Tuckaboo Pam » 23 Jul 2021, 11:20

Jess---I am so sorry if I am addressing something we've already covered, but I wanted to make sure you are spreading his food over two or three meals a day. ie, If he eats five cups per day, either feed 2 1/2 twice, or 1 2/3 three times, with the appropriate amount of enzymes at each feeding.---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.

VizslaJess

Re: New Here - Maverick's Journey

Post by VizslaJess » 23 Jul 2021, 11:29

Hello Pam,

We are currently doing 2 meals per day. We were doing 3 up until last week, but started doing 2x daily, because we were finding he often didn't have much interest to eat a 3rd time. That said, I think he was tolerating 3x better than 2x daily, so I'm going to switch back to that. Twice a day is more convenient for us, and he's more likely to eat all of his food, but it still may be too much food at once. Also, I definitely had the enzyme quantities wrong, so hopefully we see improvements from increasing that.

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Jean
Forum Director
Posts: 1707
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: New Here - Maverick's Journey

Post by Jean » 23 Jul 2021, 12:10

Good evening from Liverpool in the UK

You have done soooo well and what works for one dog works for that dog alone, they are ALL different

people mainly in the US use Enzyme Diane which is a discounted enzyme

https://enzymediane.com/

the b12 is essential to digestion in an EPI dog

https://www.petmd.com/dog/wellness/evr_ ... py_for_epi

most US people use

https://www.wonderlabs.com/itemleft.php?itemnum=K9688

again the Intrinsic factor is essential

the weight gain is good , we have been part of this foundation since 2010, and it is indeed special

Tylan is the antibiotic of choice for small intestinal Bacterial Overgrowth, and recommended because of so many positive results over the years

the one thing is to only change one thing at a time and record it, so you know what works and what does not, and leave for maybe 5 days ish

and try the fresh carrot test

chop carrot finely and add to food, record that time, record the time it comes out the other end undigested , and that will tell you how long your dog takes to digesst food, its useful when you are changing foods

the journal is essential

so ask away about anything, and I welcome you to the forum , and I love Vizlas, we have know many in our 35 years of big dogs


Jeanx
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

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