My 4 months old puppy may have EPI?

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.
Okii Dokii
Member
Posts: 12
Country: Canada
Pet name: Okii
My name: Maggie

My 4 months old puppy may have EPI?

Post by Okii Dokii » 24 Aug 2021, 01:22

Hi everyone,

I am new to the forum and in fact, just started looking into everything about EPI yesterday. I really need some guidance or just any thoughts since I know many of you here are very knowledgeable and experienced.

I have a 4 months old Australian Shepherd puppy named Okii. He is turning 5 months old soon.
Since Okii was born he has been the heaviest and biggest puppy among his 9 siblings in the litter.
Since he came home, his weight gain seemed to slow down and is not as chubby as before, but I wasn't too concerned at all, just thought he is growing taller and has a lean body, and started to feed him a bit more that what was recommended on the food package. That seemed to help him gain some weight.

Everything has been going well until 2 weeks ago where he had a night of bad diarrhea and vomiting. It stopped after the night. I got some probiotics from his vet the day after and he seemed to recover and had normal poop already. Then the following week after going to a dog park by the river he started to have loose stool again - they are watery/jelly-ish, yellowish, with mucus. I brought him to the vet after a few days of bad poop. Vet gave him antibiotics and FortiFlora probiotics - his poop became firmer again right after I gave him the meds. Blood test and fecal test both came back negative. He finished 5 days of antibiotics and pro-biotics, after that his poop became loose again - that's when I started to become worried..... And I noticed that he has become so skinny within the 2 weeks. Even when diarrhea stopped he did not pick up any weight. The vet kept asking about his appetite, my answer is always yes and he seemed very hungry all the time. His also started to shred/lose more hair than he did.. he turned from having a fluffy thick coat to very dry and dull hair barely covering his body... The vets were not concerned and thought he just needs time to gain weight but I feel like something is just not right..

The reason why I started to suspect EPI is that he has a full sibling born in once of the previous litters who was diagnosed with EPI. The breeder has informed us before we purchase the puppy. Because of that dog's diagnosis, she will stop breeding the same pair again.

Anyway, once I noticed the loose stool last weekend I bought the same probiotics (FortiFlora) and added to his meal again, his poop is firmed again soon after. So the probiotics seem to help with firming up his poop. But I am still worried about is his weight and poor body condition.......

From what I've read about EPI so far, I feel like Okii has some similar symptoms and signs. The loose stool he had before I added probiotics was yellowish, softserve, but did not seem to be greasy or came out as a big pile as described online. For his strong desire for food, I have yet to be able to tell if this is just him being a food motivated puppy or if he is actually staving. I also can't tell if he is just calmer, or if he settles down and take naps frequently because he is feeling tired and weak. But either away, he is definitely skin and bone right now and that can't go on...

I have told my vet about my concern and asked for an iTL test. They said it makes sense and can run the test for him later this week, although he would "be young to develop the disease".

***Finally it came to my question......... Before I get any formal diagnosis, what can I do to help him absorb some nutrition and slow down the weight lost? Would adding enzyme/probiotics affect his EPI test? If not I am happy to just try it for him since it kills me seeing all his other siblings being so healthy and chubby while him being skin and bone :(

Thanks so much in advance for taking the time to read this, and sorry about the disorganized and lengthy post. I'd appreciate any suggestions and advice!

I will try to upload a picture of him if I can navigate the forum. (you can see his pics from past to more recent from his ig: lifewithokii)

Sincerely,
Maggie

Okii Dokii
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Posts: 12
Country: Canada
Pet name: Okii
My name: Maggie

Re: My 4 months old puppy may have EPI?

Post by Okii Dokii » 24 Aug 2021, 01:59

3 months old VS. NOW
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Michaela
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Posts: 148
Country: United States
State: Texas
Pet name: Nikki
My name: Michaela

Re: My 4 months old puppy may have EPI?

Post by Michaela » 24 Aug 2021, 09:16

Hi Maggie,

I agree with your gut feeling that something is just not right. Since he has a full sibling with EPI, I would get him tested for sure.

You could try some of these emergency enzymes until you can get him tested, they won't interfere with the TLI test. https://epi4dogs.com/emergency-enzymes/

Hopefully you will get some answers soon, Okii sure looks like a sweet little guy.

"Administration of oral pancreatic extracts does not affect serum TLI concentrations in either normal dogs or cats with EPI, so withdrawal of enzyme supplementation prior to testing of dogs and cats that are already receiving supplementation is unnecessary.

Additionally, assays of serum cobalamin (vitamin B12) is strongly recommended whenever serum TLI is assayed. Serum vitamin abnormalities are common in dogs and especially cats with EPI. Therapeutic supplementation may be essential before an optimal response to enzyme supplementation is obtained." https://epi4dogs.com/tli-universal-testing/

R.I.P. Nikki 11/21/2009 - 05/23/2023

Nikki was diagnosed with EPI in 2010
Royal Canin Gastrointestinal Low Fat canned
Slippery Elm syrup for stomach issues
1 tsp Pan-Tenex enzymes with each meal
Weekly B12 shots, pills didn't work for her
Tylan for life


"If there ever comes a day when we can't be together, keep me in your heart, I'll stay there forever."

Okii Dokii
Member
Posts: 12
Country: Canada
Pet name: Okii
My name: Maggie

Re: My 4 months old puppy may have EPI?

Post by Okii Dokii » 24 Aug 2021, 12:02

Hi Michaela,

Thanks for the suggestion. Good to know that adding enzyme wouldn’t affect the TLI test result.

If I get the Pancreatin 8X, how do I administer it? Do I need to give it before each meal and how many capsules should he take per day?

Thanks again!
Maggie

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Olesia711
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Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: My 4 months old puppy may have EPI?

Post by Olesia711 » 24 Aug 2021, 12:29

If you give the Pancreatin 8x.. each capsule is 8,000 USP units of Lipase... the enzyme powder that we give is right around 71,400 USP units of Lipase... with a minimum of 33,000 USP units... so.. when giving this (until you can get some appropriate enzymes) start with a minimum of 4 pills per 1 cup of food, but in reality, you will probably need to give more... like 5 to 7 pills.. but start with 4 and watch the poos for a few days to see if this is enough to help or if you need to give more.......... Open the capsules up, sprinkle the 8x powder on the food ... make sure the food is moist (a few tablespoons of water will help) mix, let sit for 20 minutes and then serve.........
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.........

Okii Dokii
Member
Posts: 12
Country: Canada
Pet name: Okii
My name: Maggie

Re: My 4 months old puppy may have EPI?

Post by Okii Dokii » 24 Aug 2021, 12:45

Hi Olesia,

Just want to say THANK YOU for starting this amazing website and forum, although Okii is not diagnosed yet I l’ve found so much useful information here.

I am still feeding a bland diet of chicken breast and white rice. I still have the kibble that he has been on from the breeder (purina pro plan chicken & rice recipe) and same kind of wet food. Should I continue bland or switch to other food? Mix of kibble and Wet food? Less rice and more meat? I’m worried the bland diet does not provide enough nutrients he needs.

Maggie

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

Re: My 4 months old puppy may have EPI?

Post by Montgomery » 24 Aug 2021, 15:02

Young, but not impossible. Even though my Montgomery wasn't diagnosed until he was four years old, he's suffered from EPI since he was eight days old. EPI does not discriminate. Your puppy is lucky he has you looking after him!
Everyone here is brilliant and you'll get good advice from them!
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.

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

Re: My 4 months old puppy may have EPI?

Post by Tuckaboo Pam » 24 Aug 2021, 19:45

I wrote quite a lengthy reply around 12:30, and poof!!! it's gone.

So, welcome to you, Maggie, and your Aussie, who is absolutely precious.

So many people discover EPI on their own, and have to insist on getting their dogs tested. My vet was reluctant because of the cost, but as a scientist he walked me through several trials until he was positive Tucker had EPI. Still, after awhile, I wanted the definitive test & another vet took care of it for me. If your vet will not do the blood draw, you can buy a home test kit that is less accurate, but if it comes back negative, you'll know it's not EPI. (sure sounds like it is, though).

Since you are just in the trial period, and since you obviously are interested in learning more, I suggest you go to the Managing EPI tab, where you can read about other factors that are involved in stabilizing your sweet pup, like B12, SID, and diet.

Ask any questions you have. You will find this is a warm & helpful bunch of people on this forum.

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.

Okii Dokii
Member
Posts: 12
Country: Canada
Pet name: Okii
My name: Maggie

Re: My 4 months old puppy may have EPI?

Post by Okii Dokii » 27 Aug 2021, 21:10

Thanks for the warm welcome:)

So Okii went to the Vet yesterday. The vet suggested to run a “Chronic Enteropathy” Panel instead of just the TLI test. It’ll take another week for the result to come back. It seems like she still think it might not be EPI since she’ve only seen it in older dogs. And she only commented that Okii “doesn’t look like a healthy puppy”. But hopefully this panel will give us lots of useful information.

Has anyone heard of VioKace? The vet were able to find this available at a human pharmacy and ordered for me today. I can pick it up tomorrow. It says it is “pancrelipase” derived from porcine so likely the appropriate kind?

I aIso ordered Pantenex online since I couldn’t get any emergency enzyme for Okii. none of the pharmacy/health supplement stores here carry Pancreatin… The wait for shipment feels like forever….

I’m really hoping to see some positive changes in Okii once I started him on enzyme. This feels like the only hope right now. Fingercrossed…

Okii Dokii
Member
Posts: 12
Country: Canada
Pet name: Okii
My name: Maggie

Re: My 4 months old puppy may have EPI?

Post by Okii Dokii » 27 Aug 2021, 21:24

Oh I forgot to mention, I also got him the Taste of the Wild Pairie High puppy food. It seems to be meeting the low fibre normal fat diet recommendation. Has anyone’s pup tried this? How is this formula compare to the salmon one?
He was previously on Purina Pro Plan chicken and rice puppy formula.

I’m adding the new kibble in a small amount to his Chicken and Rice food, plus FortiFlora probiotics which seems to be the only way to help his poop to be firmer..

Please let me know if there’s anything you think I could be doing to help him gain weight.

Many many thanks!

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