New EPI Diagnosis

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.
Jane&Clyde
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Re: New EPI Diagnosis

Post by Jane&Clyde » 27 Jul 2021, 02:15

Personally, I think you should leave things as they are for 2-3 more days. You just increased the enzymes and added the slippery elm. Did you know that it takes anywhere from 8 hrs to 72 hours for food to travel through the digestive tract of a dog? Basically the poop that you see now could be the result of what was fed 3 days ago. So you really should wait so you can be certain of what the effects of the changes are. I know it's frustrating because you want Bailey to be better quickly, but making too many changes too quickly is a recipe for disaster with the sensitive digestive system of an EPI dog.

By the way, being at a number 4 poop 3 times a day is a really good starting point.

As for the slippery elm, after waiting a few days I would try increasing the dose to 1/2 tsp twice a day.

Tuckaboo Pam
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Re: New EPI Diagnosis

Post by Tuckaboo Pam » 27 Jul 2021, 07:59

From "Managing EPI" page on this site.

1/8 tsp for dogs under 10lbs,
¼ tsp for dogs 10lbs to 30lbs,
½ tsp for dogs 30lbs to 80lbs,
3/4 tsp for dogs 80lbs to 100lbs,
1 tsp for dog 100/+lbs.

And, since you are showing good signs, I agree with Jane. Stick to what you are doing for a couple more days. And then, if you want, add a little more, but don't go over the dosage chart because too much can give a bad result. I believe at some point adding a good probiotic, slowly, may help with Bailey's gut health, too. I gave Tucker Proviable for a few months, but I just had to cut back on all the money I was spending. I weaned him off it, and now he takes slippery elm & just a smidgen of Tylan, to hold SID at bay.

You are doing great! If you want to read the entire slippery elm article https://epi4dogs.com/slippery-elm/

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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aj6153
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Re: New EPI Diagnosis

Post by aj6153 » 27 Jul 2021, 09:49

Thank you so much Pam & Jane. I’ll leave things as is for several days and see how things go. It is frustrating because you just want to do something that makes a difference right away. I hate seeing him not thriving.

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Olesia711
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Re: New EPI Diagnosis

Post by Olesia711 » 27 Jul 2021, 13:57

Hi Alice,

This is Olesia, and i am so sorry i posted and then became MIA for a few days..... we just got a new puppy, and are still caring for our 14 yr old invalid dog.... so i have been in babysitting, training and peace keeping mode and the typical time i used to allot for time on the computer has totally disappeared!!!!!!!!!! I forgot how much work a puppy can be!

So.... when trying to find the right balance of treatment for an EPI dog (like when the poo is too much, too frequent or too sloppy).... you try things one at a time. In your case, i listed 5 things that i would consider trying .....how & why.

1. SO.... i read thru the posts on this thread.... and i too agree with everyone, always make only 1 change at a time and give it 72 hrs.... as explained.... the poo you see can be from a meal anywhere from 12 hrs to a meal given 72 hrs previously. However, after 72 hrs, if you are not seeing ANY improvement at all from the SLippery ELm, i would cross that off the list for now, and go ahead and try the Diggin product.... see if that improves or makes things worst. Also.... any time you are introducing a new product to an EPI dog with fiber in it ... start with a little less than the recommended dosage.

The reason for this is very convoluted (hopefully this will explain things to Pam too)
WIth an EPI dog, Fiber can inhibit the efficacy of the enzymes from anywhere between 0% to 50%. Unfortunately from one EPI dog to the next dog, we have no idea how much each dog may or may not be affected by this (some EPI dogs CAN handle grain with no issues, but the majority can't. So keeping this in mind, and now there is yet another factor to consider with fiber and EPI dogs....

All EPI dogs have SID (small intestinal dysbiosis/formerly called SIBO) whether or not you see physical evidence of it or not and it doesn't matter if the Folate score was normal when the Cobalamin blood test was run. SID is present in every single EPI dog.

The best way to fix SID in and EPI dog is with dietary fiber (prebiotics)... and herein lies the conundrum... to give or not give fiber to an EPI dog!!!!
Unfortunately you have no control over how much fiber AND what kind of fiber (soluble/insoluble-fermentable/nonfermentable) is in commercial mfg foods. Too much of the wrong kind of fiber will really mess up an EPI dog, and yet a little of the right kind of fiber can help, but even then too much of the right kind of fiber can also cause the same symptoms as the wrong type of fiber. SOOOOOOOOo this is why we suggest low fiber food cause almost everyone feeds commercial food and yet this is also why we recommend adding your own certain fiber products to address SID, but not enough to cause an issue with the enzymes. By doing it this way YOU can control how much and what kind of fiber your EPI dog gets :) To read more about this, please go to
https://epi4dogs.com/fiber-in-the-diet/
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2. Another thing to try, is give a pinch more of the Tylan powder, increase it by 1/8 tsp.... and again.... see if that makes a difference or not. if no improvement.... then that is not the problem.

3. I also noticed you said "He recently switched over to Purina EN from Royal Canine Gastro Low Fat." this too could be part of the issue... did he do better on the RC gastro low fat? If so.... go back to it.

4. Also.... with the amount of food you are feeding him, in my estimation, he is not getting enough enzymes...... this too could be the underlying problem..... i would be giving him 1+3/4 to 2 tsp of enzymes..... with the 1+3/4 dry + 1/2 canned food.

5. And last but not least with a Cushings + EPI dog ... if the stools are sloppy, if he is on Tylan and if his stools are yellow to where the Tylan is not helping at all....if you haven't recently, double check that he is getting the right dose of the Cushings meds he is on. Cause this too could be the Cushings..... BUT.... in all honestly, this would be the last thing i would check, i would first focus on possible EPI imbalance causes.

There are other possibilities too, but this is a good list to start with......................
Please keep us posted!
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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aj6153
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Re: New EPI Diagnosis

Post by aj6153 » 27 Jul 2021, 17:35

Hi Olesia,

I love puppies! They are a lot of work though. My Bo is a 6 year old Lab and as many people with Labs know they stay in “puppy stage” for a looong time. He is my goof ball who always makes me laugh.

Thank you for all of your recommendations. The fiber is very confusing….too much, too little what a balancing act! I may up his enzymes to 2tsp. Now that we’re completely switched over to the EN I’d say he’s about the same. His poop has an orange tone to it. I’m not sure if that’s good or not. I’ll try implementing your suggestions one at a time and see where we end up. He recently had his bloodwork for Cushing done and his levels are good there( this poor boy has had more blood taken and tests run recently! He still just wants to go with me even if it’s to the vet as long as we’re together he doesn't care)

I’ll keep you posted. Good luck with the puppy training!

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Olesia711
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Re: New EPI Diagnosis

Post by Olesia711 » 28 Jul 2021, 12:21

All Orange is not great..all orange usually means something like liver, gallbladder or bile acids are out of whack.
An orange tinge is better.... often something you can fix. First consider that the food you are feeding might be contributing to a lighter color...especially if you are feeding real sweet potatoes or giving canned pumpkin..
but a slight orange tinge... often just means uncontrolled SID so something needs adjusting. If you can take a poo pic and post here. I know it's disgusting, but you'd be amazed at how much seeing an actual picture can help

SInce it is a slight orange tinge... go ahead and give more enzymes for a few days... and let us know if this helps or hinders the situation.
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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aj6153
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Pet name: Bailey
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Re: New EPI Diagnosis

Post by aj6153 » 28 Jul 2021, 17:39

Hi Olesia,

I’ll get a pic and post it next time he goes. I upped his enzymes to 2 Tsp per meal. I’ll let you know how it goes. Thank you again. I am so stressed about finding the right balance. My vet mentioned if he doesn’t improve among other possible things like IBS, lymphoma could be a possibility. Now I have that in the back of my mind. Praying that’s not the case 🙏

Tuckaboo Pam
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Re: New EPI Diagnosis

Post by Tuckaboo Pam » 28 Jul 2021, 18:58

Hi Alice---

So, Bailey was just diagnosed a couple of weeks ago, right? Was he given the fasting blood test? Did we ever ask you to post his test results? I read back through, and I think maybe a couple of steps have been skipped, and they could be important. I'll admit I skimmed, so apologies if this is redundant.

If that hasn't happened, can you please post them? This really helps. Plus, since it's been only a couple of weeks it may be a little early to start thinking worst case scenario. Is your vet familiar with EPI? My vet wasn't, and diagnosis took awhile, but once we had that it still took awhile to get Tucker stabilized. So, I'm just saying take a breath, because there are a lot of different things going on. I just started with enzymes and tylan, before even adding intrinsic factor B12, so I guess my situation didn't have as many factors in it as yours.

I wonder if the fiber product could make his poop orange? Pumpkin gives Tuck's an orange hue, and his kibble is almost black.

Take Care---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.

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Olesia711
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Re: New EPI Diagnosis

Post by Olesia711 » 28 Jul 2021, 19:02

Please don't stress, so many of these dogs are at death's door just prior to being diagnosed and then once they are properly diagnosed and start getting the right balance of the recommended EPI protocol... they bounce back and often times they bounce back even healthier than before.

Finding the right balance just takes a lot of tweaking that takes time. The hardest part of EPI is not the dog but rather us having patience!

In any case.... we will work with you step by step.... and be sure to keep notes / take pictures AND make sure you share with your vet everything we suggest to you . The best care a dog can get is when everyone is on the same page and works together :)
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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aj6153
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Re: New EPI Diagnosis

Post by aj6153 » 28 Jul 2021, 20:34

Hi,

Pam - yes, he was just diagnosed a week ago but we have been dealing with pancreatitis and gastritis since May 18th. He had two ultra sounds, one in May and one in July since he wasn’t improving. Our vet suggested running the TLI test(it was a fasting test)after the second ultrasound which came back positive for EPI. I’ll ask my vet’s office to send over the results from Bailey’s test so I can post them. To be honest, I’m not sure how versed in dealing with EPI my vet is.

Olesia- I appreciate the help from the bottom of my heart. It is hard to have patience… I’m learning. I m keeping my vet posted on what we try. We definitely all want to be on the same page.

I took some photos of Bailey’s poop earlier🙄(I’m learning more about poop than I ever thought I would!)
The photos are in order last to first( top photo is the last poop and bottom is the first- if that makes sense) He was walking around the yard pooping in several locations
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