What to do now?

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.
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Jean
Staff
Posts: 1484
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: What to do now?

Post by Jean » 18 Jan 2022, 13:07

I sent you an email this morning do you want to talk about it over the phone

you say you have never had any tests for anything how was EPI diagnosed

what was the results of the cTLI blood test for EPI and was it 12 hours food fasted

you say you give one Pro enzorb one capsule between her meals how heavy is she, this cannot be right , each capsule gives

Lipase 29,000 Ph. Eur. U. (minimum)
Amylase 22,604 Ph. Eur. U. (minimum)
Protease 1,450 Ph. Eur. U. (minimum)
Cyanocobalamin (Vitamin B12) >1mg

the dog will need more than this to digest foods

this is what it says on the EPI4DOGS SITE

33,600 to 71,400 USP of Lipase (needed to digest fats and oils)
280,000 to 495,000 USP of Protease (needed to digest proteins)
280,000 to 495,000 USP of Amylase needed to digest carbohydrates)

obviously different value


My Kara 90 pounds was on Lypex very similar and needed 3 capsules per meal

Each Lypex capsule contains minimum levels of pancreatic enzymes:

Lipase 30,000 - Ph. Eur. U
Amylase 18,750 - Ph. Eur. U
Protease 1200 - Ph. Eur. U


Pro Enzorb has b12 built into it , but its not enough

Not sure what you mean about tests over here, ie in UK

you can certainly get Tylan here, but you have to sign a disclaimer as it is not licensed for companion animals in Uk

I feel it would be better to have a talk let me know if this will help you


Jean
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

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Olesia711
Founder
Posts: 2435
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: What to do now?

Post by Olesia711 » 18 Jan 2022, 14:55

Hi Sher,

AHhhhh... Jean (also from the UK and is familiar with the UK meds) explained the most likely inappropriate (too little) dosing with the ProEnzorb.... that could explain what is going on. Like i said... the poo does sound like SID, but the watery poo could also be a food intolerance of some sort.

In light of Jean's excellent insight with this UK drug... please do chat with Jean and my suggestion would be to first try increasing the dosage of the ProEnzorb and see if that improves the poo... at this point increased enzymes won't fix the issue because if too low of a dose of enzymes are the problem then it has allowed SID to really accumulate and get bad, so you will need an antibiotic (Tylan) to clear it up... but like i said, please do talk to Jean first- -she can help you with the proper dosing situation and if you see ANY improvement then that would indicate that this was most likely the main issue triggering SID .... and then talk to your vet about a course of Tylan antibiotic. THEN if all this doesn;t help and the loose stools come back...then i would pursue some of the food allergen testing.
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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Patsy
Member
Posts: 206
Country: United Kingdom - England

Re: What to do now?

Post by Patsy » 18 Jan 2022, 17:29

I was doubling checking the instructions for Pro-enzorb, and to my horror made the same discovery. Note, I am not a vet!
I used similar capsules(Lypex) which are broken open so that the enteric coated granules mix in the food. Their instructions are equally inappropriate. Jean has had words with them too!
What size is she?
In my opinion, Under 20kg should be one or two capsules per meal. Over20kg two or three per meal.
Like the others say, you probably need antibiotics by now. Preferably Tylan , but not easy in UK rules, otherwise oxytetracycline, for a two week prescription.
Springer spaniel Marti had Epi, PLE , MMM just to confuse me. She lived till 12yrs, chubby and happy despite eight years of epi.
Capsule enzymes suited her best. B12 supplements made her into a new dog!
After a cocker with PLN kidney disease, I now have two healthy rescues, a lively, suicidal , small ginger terrier, adopted with pneumonia, and gum disease needing nearly all his teeth out, and a fluffy grey toy poodle/terrier from Greece.

User avatar
Jean
Staff
Posts: 1484
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: What to do now?

Post by Jean » 19 Jan 2022, 04:38

at one point my friend Gillian was giving Wallace a GSD, 7 per meal of Lypex, yes 7 ! also from Scotland (south Lanarkshire)
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

User avatar
Patsy
Member
Posts: 206
Country: United Kingdom - England

Re: What to do now?

Post by Patsy » 19 Jan 2022, 13:55

Hi, you must have a terrible time in the last year. Believe me, absolutely every member on epi4dogs joined in desperation, so please don’t feel bad.
Sometimes we get minor confusions with treatments and products that people from the US use.
First of all though, your vet should have tested for Epi with the cTli test. Maybe she was saving you the cost. Did she recommend Pro-enzorb? She wouldn’t have known that the directions were wrong for epi.
There are protocols to follow to treat epi, and these are in official veterinary manuals. I have had to argue with a locum vet to look it up. Your vet can look it up, and follow the treatments on epi4dogs.

B12 levels for normal dogs are 300. Because epi dogs lose B12 constantly, they need it supplemented and maintained at 600. A six week injection course of pure,red, Vit 12 or tablets from Chemeyes.co.uk,called B12 with intrinsic factor. Low B12 causes many side effects, like depression, fatigue, susceptibility to gut infections.
Antibiotics…tylan is used for farm animals,so vets need persuasion to use it. I never have. Oxytetracycline was fine.

Food, Obviously difficult for your pet at the moment. Especially If there is pancreatis, though without the test for that, you can’t tell if it’s actually the epi.
As Olesia suggested, prescription hydrolysed Hills or Royal Canin may be necessary for food allergies until the watery stuff improves. I was so desperate I tried everything, and found that Chappie saved her life, despite having rice in it. I would also suggest Butchers Grain free tripe mix. With more than one enzyme capsule scattered in each meal, depending on dog size. All food and treats must have enzymes.
My dog developed protein losing enteropathy before she got diagnosed, and she was two weeks from total system failure. Once I started to hand feed her, she produced a semi solid poo the next day. Any improvement means that food is digesting.
There’s no reason for any UK vet to flounder. They can contact a gastroenterologist at the Scottish veterinary schools for advice.
There are different brands of enzymes online that we can buy here, which you could change when you finish your own ones, which are expensive. I recommend Chemeyes, a family pharmacy company who own an epi dog. Very friendly and will discuss anything.

I hope we’ve not been too full on and bossy since you posted, every sick dog takes me back to the tears I shed.
Please, please post on the website or send a private message to Jean or me.
Do let us know how the next week goes.
Best wishes
Patsy
Springer spaniel Marti had Epi, PLE , MMM just to confuse me. She lived till 12yrs, chubby and happy despite eight years of epi.
Capsule enzymes suited her best. B12 supplements made her into a new dog!
After a cocker with PLN kidney disease, I now have two healthy rescues, a lively, suicidal , small ginger terrier, adopted with pneumonia, and gum disease needing nearly all his teeth out, and a fluffy grey toy poodle/terrier from Greece.

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