Suspected EPI in my 11 mo GSD

[greekolive]

Hi everyone, I’m new here to the group. Felix is my 11 month old GSD, he has been in perfect health and such a big and husky boy, until 2 months ago when he started having diarrhea that has only gotten worse. He was neutered 2 weeks after diarrhea began, and I just assumed his diarrhea was worsened by the meds he was on. But when the meds were done, he still had diarrhea. We took him to vet and he had gone from 75 lbs down to 63! They put him on Metronidazole, probiotics and Hill’s Science for GI. This had zero effect. He seemed to be losing more weight, bones are showing thru. We took him back and they added Imodium and wanted to extend his antibiotics. (I didn’t agree with them at first but ended up saying yes). He had lost another 2 pounds. They did a second fecal test and bloodwork. Results were negative for parasites and normal blood levels. They said the on,y thing that they could think of would be EPI but that required testing. They offered to do a trial period of enzymes first to see if that worked. So Felix has been on the tablets for 3 days now. He still has watery diarrhea (but I’m assuming it takes awhile for the enzymes to start taking effect).
The symptoms he’s been having are : 1) watery diarrhea that starts 10 mins after he has eaten. It’s a greenish color that are either like cow patties or sheer liquid. If it’s a bit more “solid”, you can clearly see none of the food has been digested. 2) he is ravenous all the time. He even started counter surfing! 3)in the last two weeks he has now started eating his poop! 4)significant weight loss

So here are my questions…how long does it take to see any results with enzymes? Is it worth it to just get him tested for EPI right now, or wait to see if the enzymes are having success? How much did EPI testing end up costing and how long did it take to get the results back?

[Olesia711]

Welcome and thanks for contacting us.

First of all, i understand why your vets want you to "try" enzymes" first.... but... if they gave you pancreatic pills.... that may be the problem.
Although the pills are made for EPI... they don't always work.... we strongly recommend using porcine pancreatic powder.... but..... your vet might have difficulty accessing enzymes powders at the moment.... SOOOOOOoooooo since you have the pills...first i need to know EXACTLY what the brand name is of the pills.... how many pills are you giving per how much food, and how much your dog weighs, what is the name of the food you are giving your dog and how much of this food are you giving the dog .

Once i have these details, i can advise you how many pills to give with how much food and that you will then need to crush them into a fine powder , mix in with the food .. let sit for about 20 minutes and then serve.

This is the first part.... and there is more.............

EPI is all about finding the right "balance" of the recommended EPI protocol.... and there are 4 parts to that!
1. enzymes
2. food
3. B12
4. SID

attached is an overview of how to manage EPI.

EFFECTIVE EPI MANAGEMENT-revised 10-21-2020.pdf

(294.84 KiB) Downloaded 83 times

[greekolive]

Ok so the label says “pancrezyme tabs”, 3 tabs 10 mins before every meal. I do not see how many mg they are. And I was told just to give them to him because they are chewable and taste good. However, yesterday I ordered from Dianesenzymes, so he will be having the powdered form as soon as they arrive. He is 61 pounds right now.

As far as his food, this has been sooooo hard! They put him on the prescrition Hill’s, but I’ve just switched him back to his Nutro, changing from the large breed one to the Grain free lamb and sweet potato. I WAS told to add in pumpkin to his food by one vet assistant and to stop putting plain yogurt in his food. then another employee just told me NOT to add pumpkin and to add yoghurt. UGH!! conflicting instructions!!!

[Olesia711]

Okay.... so... easy answer first. if the poos remain mushy,,, you can add a tsp of canned pumpkin to a meal... usually that helps.

So... Pancrezyme pill ... correct enzymes (porcine)... but OMG... WAYYyyyy to low in Lipase.


the average USP units of Lipase is approx 71,400... one pill is 8,100 ... so you need to give approx 9 pills CRUSHED per 1 cup of food.
This is probably why your dog has not improved at all..............

i would start with at least 6 or 7 crushed pills and see if you notice a difference within 2 days...by then hopefully enzymediane's enzymes will be in.

[Olesia711]

Next... the Nutro food...... doesn't look that bad to start with.... BUT.... feed 3+3/4 cups of food a day.....but break it up into 3 or 4 meals throughout the day.... do not feed in just 2 meals.............. with EPI you want to feed more food but smaller portions.

give this (with hopefully EnzymeDiane's enzymes being used soon!) a week or at least 5 days.... and let us know how things are going.

take pictures of the stools and post here ... even a progression of poop pics.... that will great help.
And then we will see , depending on how things work out, if pre or pre+probiotics are needed and if that doesn't work, THEN we bring out the big guns and treat with Tylan antibiotics for SID.... do NOT use Metronidazole for SID (small intestinal dysbiosis).

Also.... please share the test results with us.... the cTLI score and if your vet also ran a cobalamin (B12_ blood test).... over 80% of EPI dogs need B12 supplementation ....depending so please let us know these scores.

Hope this helps!

[greekolive]

Thank you SO MUCH!! I feel better already with all your recommendations and info. And that is so crazy about the low levels in the tablets! I am so glad I ordered dianes, I feel so hopeful now. I will feed him your suggested amount of food and add another meal for him. I also have the same food in wet as well, so I’ve been adding a bit if that to the kibble.

So I’m about to get his dinner ready, so after I crush tabs do I put them in any sort of liquid before I add them to food?

[Olesia711]

crush the pills and put them in food and add enough liquid (water, or broth or something wet that is acceptable for dogs to consume) to moisten the food (kibble)... mix and let sit for 20 minutes.......

(sorry my answers have been so far apart.... i had an event i had to attend and then my company arrived)

[greekolive]

Here are pics before he started getting sick and currently.

[Tuckaboo Pam]

Awww, Jamie, your pictures are heartbreaking, and they remind me of Tucker's before & afters. It is so hard, watching them waste away.

I have nothing to add, because you got all your answers from Olesia! But, did she suggest writing down everything you do, and then documenting the results? This can really be helpful, when you need to look for patterns.

In closing, you are in a good & happy place here, and your beautiful Felix will be good as new before you know it. Ask all your questions, and be patient. Sometimes you have to tweak things a little, along the way.

Take care---Pam & Tucker

[greekolive]

Hi Pam, thank you so much for your message! And that’s a very good idea to log everything. I will start doing that tomorrow.
Yes it’s so hard seeing him waste away, but this forum has helped me see light at the end of the tunnel already. Thanks so much for your support!