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.
belgin
Member
Posts: 18
Country: United States
Pet name: Elsa
My name: Beckie

Re: New EPI diagnosis

Post by belgin » 07 Dec 2021, 13:03

Your suggestions are so helpful, thank you!

Elsa is actually eating and drinking some this AM, but has had 3 liquid, diarrhea stools since last evening. From what I have read here, she has SID out of control. The protocol for this seems to begin Slippery Elm, so I am going to pick up some today. I've ordered it also, but that won't be here till Friday. Dosage 1/8-1/2 tsp with meals, not sure if that is every meal or twice a day. Will look for that answer.

B12 is coming from WonderLabs too, but I will see if the Vitamin/Health store has an equivalent so I can start that today.

It's a darn good thing I work from home and have a flexible schedule and understanding boss!

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Olesia711
Founder & Research Director
Posts: 3858
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: New EPI diagnosis

Post by Olesia711 » 07 Dec 2021, 20:26

it is indeed wonderful to work from home!!!

Glad Elsa ate a little but not good about that watery stool :(... please be sure to tell your vet about this,,,, watery stools sometimes can be from a food sensitivity... and i think you still have her on Ultamino... yes? Your vet will need to know about this.

REgarding the SLippery Elm powder, try just 1/8 of a tsp with each meal.... and watch the stool output.. With SLippery ELm, Sometimes less is better. If you see a little improvement with the stools, but they could use more improvement, then increase it to 1/4 tsp per meal.....with slippery elm you usually see an almost immediate response.

So glad the vet is going to see her. While checking with the vet, ask her if she thinks it would be beneficial for you to buy and keep on hand some unflavored Pedialyte.... we often suggest this for dogs that don't drink enough/ get dehydrated.... cause at least you can get their electrolytes back in balance with the Pedialyte...
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.........

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

Re: New EPI diagnosis

Post by Tuckaboo Pam » 07 Dec 2021, 21:34

Hi Beckie, and welcome from Pam & Tucker in FL. You will get so much help from this group.

I've only read your first post, but since you mentioned raw food, I thought I'd share this link.

https://healthypets.mercola.com/sites/h ... -dogs.aspx

Dr. Becker encourages a raw diet. 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.

belgin
Member
Posts: 18
Country: United States
Pet name: Elsa
My name: Beckie

Re: New EPI diagnosis

Post by belgin » 12 Dec 2021, 01:30

Hello friends,

I apologize for not writing before now. There has been so much going on with Elsa that I've had hardly a minute to spare. I feel like I'm running my own little veterinary clinic right here in my home!

Since I posted last, Elsa had a long stretch of anorexia, lethargy, and liquid stools. I have been around animals all my life and I've ever seen diarrhea like she had. The poor thing just spouted liquid, it a faucet being turned on. She refused to eat anything and barely drank water. Her energy level was zero.

She has been at the vet three days this week, two days (Wed and Thur) she was there all day receiving IV hydration. She also had labs drawn, received a B12 injection, got started on Tylan, was given Immodium, dexamethasone, etc. And then to make matters worse, her lymphocytes were off the chart and my vet said she may have lymphoma.

They did an ultrasound on Thursday and I was told the results were suspicious of lymphoma. Her spleen was greatly enlarged as were lymph glands in her intestines. Her intestines were swollen and inflamed. The vet did a cytology and sent it off. I have not heard the results yet, but I am very hopeful that these abnormalities are symptoms of the EPI and resultant GI issues and not lymphoma.

Her lymphocytes were WNL in her labs drawn when this all started just after Thanksgiving, and since Thursday, Elsa has shown a great improvement. She is alert and perky, drinking plenty of water, and eating the Royal Canin Ultimino with gusto. She actually ate a total of 6 cups today. And, here is the big news, she has 3 well-formed, normal stools! I believe she is already putting a little weight back on. It's like the difference between night and day. Not sure what to attribute this to, but the hydration helped,

For meds and supplements, she is on Tylan 1/8 tsp BID (twice a day), Slippery Elm--working up to 1/8 tsp BID, Proviable--also working up to 1/8 tsp BID. She completed the Amoxycillin today. We have not started her back on the enzymes yet and I am concerned about this as that is when she had the backslide last week.

All in all, I am so very grateful she is feeling better--eating, active, and pooping normally again. I will hear back on Monday about the cytology and hope and pray it is negative.

Barb
Staff
Posts: 918
Country: United States
State: New Jersey

Re: New EPI diagnosis

Post by Barb » 12 Dec 2021, 08:27

Oh my, Beckie, I am so so sorry you and Elsa are going through all this. I hope that she gets good results from her tests. Fingers and toes crossed. I am so glad she is feeling better. She has been through the mill. I know how stressful this is. We will be waiting to hear the results. It's amazing how resilient our dogs can be. Sending hugs to both of you.

Barb

belgin
Member
Posts: 18
Country: United States
Pet name: Elsa
My name: Beckie

Re: New EPI diagnosis

Post by belgin » 12 Dec 2021, 10:56

Thanks for your kind support, Barb.

It really is amazing how resilient these dogs are. When she hadn't eaten for 4 days, had hardly been drinking, was pooping large volumes, she still found the energy to play with her ball and give me kisses.

Dogs are such loving and wonderful creatures, and well worth all that it takes to get and keep them well and happy.

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Olesia711
Founder & Research Director
Posts: 3858
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: New EPI diagnosis

Post by Olesia711 » 12 Dec 2021, 12:03

Beckie,
I re-read all the posts on this thread to refresh my memory..... since Elsa was diagnosed with a 3.9 TLI score.... she is not clinically EPI (yet) but there is obviously something going on with her pancreas. We are just completing a 5 year microbiome + microbiota study with EPI dogs... and we were lucky enough to test SEPI dogs (sub-clinical EPI dogs) which is what Elsa is at the moment.. since she is not yet "clinically" EPI..... and what they observed from the study is that about 50% of SEPI dogs go on to develop EPI while the other 50% don't. SOOOOOOOOOoooo this being said.... after all is said and done, Elsa may or may not need enzymes.... BUT just in case she does, and for arguments sake...lets pretend she has EPI and a confirmed allergy to pork .where the porcine powdered enzymes cause her dramatic loose stools.... the first thing that we would suggest is to put her on CREON. CREON is enteric coated porcine enzymes and i have no idea why this doesn't appear to affect dogs with pork allergies, but we have had many cases of dogs who can't handle pork, can't handle the powdered enzymes, but were fine with the enteric coated CREON capsules to manage their EPI. And just in case that doesn't work, you can try a heavy dose of specific plant enzymes & beef enzymes. SOmetimes this combo works too.

Just wanted to share this option/possibility cause i know you are worried.. "what if" ..... since it seems like the watery stools started when you started the enzymes....

I am also VERY happy to hear that Elsa appears to be doing much better. that is very good news!!!!!!!!!!!!!!!!!!

Please continue to 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.........

belgin
Member
Posts: 18
Country: United States
Pet name: Elsa
My name: Beckie

Re: New EPI diagnosis

Post by belgin » 12 Dec 2021, 23:52

Thanks, Olesia, for the input, especially about perhaps not needing the enzymes. And if there is any way Elsa could be a part of that study, let me know.

My vet called this morning, as she does almost daily, to check on Elsa. She was thrilled to hear that Elsa is eating well, has good energy, seems to be gaining weight, and is pooping normal stools.

We talked about the next step and that is weekly B12 shots, continuing with the Tylan, and the Ultimino. The vet also said Elsa may not actually need enzymes, that the Ultimino functions similar to enzymes as it breaks down the protein source so it is easily digestible.

What do you think of this? Elsa is doing so well right now that it makes sense to leave well enough alone. But aren't the enzymes essential to prevent buildup of bacteria in the gut? I'm concerned that this will happen and she will start having issues again.

It's difficult for me to think about feeding Ultimino long term, especially when I read the ingredients--corn starch, poultry by-products aggregate, etc. For years now I have made my own very healthy raw diet and I feel strongly about the benefit of this. But I won't think about making a change until Elsa has been healthy for a long time. I just have to not think about it too much. :roll:

No word yet about the lymphoma diagnosis. The vet didn't mention it today so perhaps she feels it's not going to be an issue.

I'm still giving the Tylan 1/8 tsp BID, Proviable (working up to a full capsule) BID, and Slippery Elm 1/8 tsp BID. Does this sound good?

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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 EPI diagnosis

Post by Jean » 14 Dec 2021, 04:46

Good morning from the UK Liverpool

I have been missing in action due to personal issues

Olesia has got you covered, but wow two lots of antibiotics at the same time, and Flagyl being one of them would make anyone not want to eat, I am allergic to it personally, and it has serious side effects,

My Kara had just about everything ! she had a very nasty occurrence of SID and we had to stop meat in her diet, so it was scrambled egg and mashed potato for 5 days, trouble was she insisted on a meal of this just before bedtime for life, we recommend a small meal before bedtome, as it gets them through the night, of course enymed

my mantra was

FOOD IN ENZYME IN

Nothing other than water and medication with out it

You have been advised to keep a log, I had note books, and the vets loved it , your vet is a definite keeper, mine was brilliant, he had dealt with EPI since the 1980's

I also had a cat with it in the 80's

you mention projectile pooing , yes its lovely, all over the walls and the carpets , my carpet washer groaned every time I connected it. but its life with an EPI dog/cat

I am so pleased to see that Elsa is eating , it could well have been her gut was upset with the antibiotics, the one thing my vet insisted on when she wasn't good was glucose , it helps with the gut balance when they dont eat

Tylan is weight dosed

https://epi4dogs.com/antibiotics/

what weight is she ?

the question about enzymes is that if the pancreas has failed, then they cant digest food without the enzymes the pancreas delivers when food enters the digestive sytem , therefore we have to give them orally, Tylan will get the gut back into balance along with the enzymes, yout cTLI result is very close to being EPI

https://vetmed.tamu.edu/gilab/service/assays/tli/

to be honest , if she is doing well at the present I personally wouldnt change anything you are doing, and that includes enzymes short term , get her retested after the holidays

Trust me, whatever you are seeing my Kara had it all, and they become very precious

Take care

Jeanx UK
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

belgin
Member
Posts: 18
Country: United States
Pet name: Elsa
My name: Beckie

Re: New EPI diagnosis

Post by belgin » 14 Dec 2021, 22:54

Hi Jean, and thanks for your comments.

I agree that if my pup is doing well, we should wait and see and not change anything right now. It will be interesting to see what her TLI is now that she's doing better. She weighed 40 lbs when this started and lost at least 5 lbs in the last two weeks. Right now, I'm sure she has put on a couple of the pounds she lost. We go in tomorrow for her B12 so will weigh her then.

She's eating 7 to 8 cups of kibble a day, spread out in 4 or 5 feedings. She's having 3-4 good poops a day so it seems a lot of this kibble is going through her. I'm used to feeding raw and seeing 1-2 smaller poops a day with my dogs. But I'm sure not complaining!

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