New to EPI and struggling

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.
Jrusso8
Member
Posts: 5
Country: United States
State: Pennsylvania
Pet name: Millie
My name: Julianne

New to EPI and struggling

Post by Jrusso8 » 04 Jan 2022, 18:34

Hi everyone,

I am about one month into my pups diagnosis with EPI. She is 1 year and 6 months old, Collie & English bulldog mix (yes super strange combination. Was totally an accident). My fiancé and I began our journey into the unknown mid October. Our dog, Millie, had begun having loose, grey colored stools after getting her 1 year vaccines that then turned into yellow cow pattys and eventually into diarrhea. I’m sure you all know how the rest of the story goes… months of testing and antibiotics, fecal samples and food changes… this process was extremely deliberating and made us feel worthless as dog parents..

Millie was diagnosed with EPI on December 6th 2021. Our vet recommended a low fat diet of no more than 10-12% and she prescribed us the tablet formed enzyme called Pancreatabs.
The dosage for the tablets are only 2 per day (at the same time) with breakfast.
We fed Millie Purina Pro Plan Sensitive Skin and Stomach her whole life. This is a salmon based dry dog food. This food is also 16% fat so we spent weeks experimenting with different foods and brands and we hadn’t noticed any improvement at all and we found that any food that has even a smidgen of chicken in it causes her stools to be water.

In between waiting for her diagnosis, we were referred to have a GI ultrasound to check for obstructions…. When we arrived at the specialty vet, I made them aware of the new diagnose and this specialty vet suggested we switch Millie to a powdered form enzyme called Viokase and change her food to a wet food. After communicating this new vets advice with my primary vet, she said the powder would be fine but said the tablets work just as well… she also said we could put Millie back on the Purina food that is 16% fat. (Which was confusing as she originally told me no more than 10-12%) Taking everyone’s advice into consideration, we switched Millie’s food back and had seen somewhat of better progress with her stools but it definitely is nowhere near normal. My biggest concern is with the powdered Viokase enzyme.. I have come to learn that it is $400 for a 12oz bottle. Not knowing how long 12 oz could last us, I don’t feel I can afford $400 medication for the rest of her life.

As you can see, I have been getting two different types of information and advice. I feel very lost with what to do with Millie.

She has lost 6 pounds and I don’t feel she has gained any back. I’m just looking for some guidance from the experts as to the best course of action for our Millie? Should we continue the combination of Purina Pro Plan Sensitive Skin and Stomach with the Pancreatabs only twice a day? Is it a problem that she’s only getting these once a day and not every time she eats? Or is there another route that would be more beneficial to her?

Really would appreciate any advice at all regarding the best diet & enzyme combination for my situation. I didn’t want to bore everyone with the details so I am happy to elaborate if needed.

Thanks so much!

Jane&Clyde
Member
Posts: 124
Country: United States
Pet name: Clyde
My name: Jane

Re: New to EPI and struggling

Post by Jane&Clyde » 05 Jan 2022, 01:11

Hello, and welcome! I'm so glad that you found us because you have been given incorrect information by one or both vets. This isn't meant to be a criticism of the vets. Veterinarians are expected to know about so many disorders and how they affect many different kinds of animals. There is simply no way they can be up to date on all of them. EPI is so rare that it often falls between the cracks and pet parents end up being given out dated or incorrect information. The founder of this site, Olesia, keeps us all up to date with the latest EPI research and treatment protocols. There are four main areas in treating EPI:

1. FOOD: if Epi is the only condition, especially if there is no pancreatitis, then a low fat diet isn't needed, nor is prescription food. The food should be grain free (grain can interfere with the enzymes), have 4% fiber or less, and have as few peas or chicken as possible (these are foods that some EPI dogs can't tolerate). The food that the most dogs seem to do the best on is Sport Dog Elite Series Herding formula. It is usually available at Amazon, Chewy.com, and SportDogFood.com. However, it was out of stock at both Amazon and Chewy the last time I checked. Another possibility that many dogs do well on is Taste of the Wild, but ONLY the Pacific Stream or High Prairie versions because the others have too much fiber. You should feed 150% of what your dog should eat at their ideal weight, divided into at least 3 meals per day.

2.ENZYMES: Enzymes must be given at every meal. Your pup needs enzymes with everything it eats, so this means no snacks or treats for now. The least expensive source of enzymes is EnzymeDiane.com. Her 6x enzymes are essentially the same thing as the Viokase powder, and Diane's are MUCH less expensive. The dose for the powdered enzymes is 1 teaspoon per cup of dry food (1/2-3/4 teaspoon per cup of wet). The enzymes and food should be mixed with a little bit of room temperature water, then let sit for 20-30 minutes before serving.

3. Vitamin B12 (Cobalamin): A B12 test should have been done at the same time as the TLI test for EPI because over 80% of dogs with EPI will need B12 supplementation for life. Dogs with EPI need for their B12 to be in the mid to high range, around 600 or so.

4. ANTIBIOTICS: Antibiotics are sometimes needed to help with EPI/SID (small intestinal dysbiosis...unbalanced bacteria in the gut..all EPI dogs have it to some degree). If they are needed, the antibiotic of choice is Tylan for 45 days, then slowly weaned off. Please do not let your vet prescribe Metronidazole for EPI/SID.

We find it helpful to keep a journal or log of what has been given, supplements and food, and the resulting poops.

I hope you find this information useful. Feel free to ask any questions you may have. EPI can seem a little overwhelming at first, but once you settle into a routine that works for you and your dog, it becomes pretty easy.

Jrusso8
Member
Posts: 5
Country: United States
State: Pennsylvania
Pet name: Millie
My name: Julianne

Re: New to EPI and struggling

Post by Jrusso8 » 05 Jan 2022, 10:02

Good morning!

Thank you so so much for all of this information! I have never felt so much relief! I am so appreciative of the food suggestions as well as the website to buy the powdered enzymes. I will be purchasing all that you suggested very shortly!

I believe her B12 was tested with the all of the other pancreatic tests that we’ve done, however the vet did not mention if the levels were low or not. But I will certainly be calling to get a paper copy to verify. We also have a prescription for the Tylan powder as needed so that’s great to know that it is recommended.

Thank you again for all that you offered for our Millie! I will keep you updated on her progress! :D

Tuckaboo Pam
Member
Posts: 1065
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: New to EPI and struggling

Post by Tuckaboo Pam » 05 Jan 2022, 20:06

Hey, Julianne & Millie! Welcome to the forum, from Tucker & Pam!

As always, Jane has given you great information. Here's the link you need (NO, we don't get a kickback from Diane! We just love her & her enzymes!) https://enzymediane.com/

MANY of use feed Sport Dog Elite, herding dogs formula (buffalo & sweet potato). It is grain-free, no peas or white potatoes, and the fiber count is correct.

FYI, my vet had no knowledge of EPI, and no interest in learning, so I do this pretty much on my own, with the incredible help from the people on this wonderful forum. They/We are here for you. No question is silly, so ask away!

Besides the many pages under the tabs on the home page, you get a lot of information from reading the signatures at the bottom of posts (right down there is mine V ) Take Care---Pam
Tucker is a shepherd/lab mix; he has tested positive on the ScheBo test for EPI, as well as the fasting TLI. Results--- TLI 1.3, Folate 9.7, Cobalamin 666, Lipase 38. Currently taking Diane's Enzymes 4 teaspoons/day, Wonderlabs B12 one capsule per day, two capsules slippery elm/evening, 1 Proviable capsule/day, and Tylan 1/32 teaspoon/ morning (to hold SID at bay). Sport Dog Elite, herding dogs 4 cups/day. No more poop eating, has gone from 60 to 80 pounds, and he is a happy member of the family, though a bit of a stinker, if you ask the other dogs. Tucker is my boyfriend, and my husband is OK with that.

postalrat
Member
Posts: 1
Country: United States
Pet name: Stogie
My name: Steve

Re: New to EPI and struggling

Post by postalrat » 05 Jan 2022, 21:30

Here is my advice after working with a dog with EPI for 13 years:

I don't know if there is a cheaper source of enzymes than enzymediane. I used their enzymes from the start and never had any problems. Great resource for anyone dealing with a pet with EPI.

All the advice you get here or anywhere may be what works best for your dog. It took a long time to find what worked best with our dog and in the end it wasn't some expensive food or even grain free. Lucky for us it ended up being the basic food from costco and later in life the puppy blend.

We mixed with water for years then found for us it worked better to just put the powder on the food then shake it in a container for 30 seconds or so.

I'm sure you will find something that works well, then the rest is easy. The enzymes probably double the cost of food or even less if you are using expensive food.

Jrusso8
Member
Posts: 5
Country: United States
State: Pennsylvania
Pet name: Millie
My name: Julianne

Re: New to EPI and struggling

Post by Jrusso8 » 14 Jan 2022, 08:53

I apologize for my lack of availability to post and respond but I just wanted to extend my gratitude to this team for all of the hardwork they do and the advice they provide!
After just two serving of enzymes from Enzymediane, Millie had normal poops!! We didn’t even have to explore changing her food, all she needed was the consistent enzyme mixed with water every time she ate.

My fiancé and I have never felt so much relief. We honestly felt hopeless in regard to finding a solution for Millie. She has begun to make significant progress with gaining weight. She is full of life and energy. She is more playful than she’s been in the last 3 months and we can see the difference in her happiness. We are so thankful and grateful to have found this source!!
I would love the inform my vet about this platform as a reference for other dog/cat parents going through this experience.

Thank you all so much for your service!!! :D

User avatar
jilbert57
Staff
Posts: 1452
Country: United States
State: Washington

Re: New to EPI and struggling

Post by jilbert57 » 14 Jan 2022, 09:59

Julianne,
what a great update.
Feel free to print any information from the website to help better inform your vet.

Jill
My name is Jill and we live on the Hood Canal in Washington State. We currently have one pup. TJ is a 5 year old Jack Russell.

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: 1065
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: New to EPI and struggling

Post by Tuckaboo Pam » 14 Jan 2022, 10:02

Julianne, this is all great news!!!

Question---Are you able to post the results of the labs that confirmed Millie's EPI? This would be helpful to view. Millie's B12(cobalamin) and folate were probably tested, too.

Hopefully, you have got her under good control but sometimes there are setbacks, at which time you will want to refer to Jane's information, especially the B12 & SID portions. For some of us, EPI is an ongoing work in progress, and if that happens you'll get lots of help from this group.

But, YEA to your healthy puppy and the weight she is gaining! I know this is a great relief to you.

WOOT!---Pam & Tucker
Tucker is a shepherd/lab mix; he has tested positive on the ScheBo test for EPI, as well as the fasting TLI. Results--- TLI 1.3, Folate 9.7, Cobalamin 666, Lipase 38. Currently taking Diane's Enzymes 4 teaspoons/day, Wonderlabs B12 one capsule per day, two capsules slippery elm/evening, 1 Proviable capsule/day, and Tylan 1/32 teaspoon/ morning (to hold SID at bay). Sport Dog Elite, herding dogs 4 cups/day. No more poop eating, has gone from 60 to 80 pounds, and he is a happy member of the family, though a bit of a stinker, if you ask the other dogs. Tucker is my boyfriend, and my husband is OK with that.

Jane&Clyde
Member
Posts: 124
Country: United States
Pet name: Clyde
My name: Jane

Re: New to EPI and struggling

Post by Jane&Clyde » 14 Jan 2022, 17:25

Wow! Such a terrific update! I'm glad we could help and that things are much better for the whole family.

Jrusso8
Member
Posts: 5
Country: United States
State: Pennsylvania
Pet name: Millie
My name: Julianne

Re: New to EPI and struggling

Post by Jrusso8 » 17 Jan 2022, 21:25

Pam - Yes! I will post her results as soon I get my hands on them. It’s been a busy week and the winter snow storm on the East coast set us back pretty good! I’ll swing by the vets office sometime this week and ask for copies of her test results. Definitely would be helpful to catch if she would need the B12 injections well in advance.
But so far, we’re so pleased with her progress!

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