Struggling with Vet

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.
PooganNash
Member
Posts: 9
Country: United States
State: Michigan
Pet name: Poogan
My name: Melinda

Struggling with Vet

Post by PooganNash » 19 Jan 2022, 10:30

My dog was diagnosed in September of 2021. He has not gained any of his weight back. Currently we are feeding Ultimino. I asked my vet about changing food to assist with weight gain, since I believe my dog is under weight by the 10 pounds he lost before he was diagnosed. The new Hill's Biome food was prescribed, however, my dog is not tolerating this food. He is having more stomach noise, bad burps, smacking lips, drinking more water, and tends to vomit after I increase the amount of Biome vs the Ultimino. I called to talk to my vet today and was simple told to increase the amount of famotidine per feeding to 40mg. I believe that my dog should be able to eat his food without doubling the famotidine. My dog's body is telling me that the Biome is not the right food for him. After more discussion my vet agreed to provide the low fat version of the Hill's i/d food, however I do not l think he needs low fat. Before he was diagnosed with EPI he had a stool sample that had large amounts of unprocessed fat. I feel that now that he is diagnosed and on Viokase-V enzymes his body should be able to process the fat.
I am not sure if I need a new vet in order to better assist me with managing Poogan's EPI or if I am being unrealistic in my thinking that he should have gained weight back by now and that fat should be ok for him...... :cry:
Any advise is greatly appreciated!
Poogan Nash
Fortiflora once daily, Hills i/d food, Viokase - V 1 tsp with each meal, 20mg famotidine with each meal

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

Re: Struggling with Vet

Post by jilbert57 » 19 Jan 2022, 12:06

Hi Melinda,
Do you have the test results from Poogans Tli, folate, and B12 ?
It sounds like a case of SID/SIBO . Was Poogan prescribed an antibiotic for this when first diagnosed? We recommend a 45 day course of Tylan, twice a day. You could also try Slippery elm.
Does your pup have allergies hence the Ultamino?
Epi usually is a diet of grain free(try for little to no peas or lentils) low fiber (less than 4%) food.
Low fat is not needed unless fat restriction is in order.
Here are some links:
https://epi4dogs.com/epi-quick-guide-usa/
https://epi4dogs.com/sidsibo-in-brief/
https://epi4dogs.com/dog-food-options/

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: Struggling with Vet

Post by Tuckaboo Pam » 19 Jan 2022, 19:26

Hi Melinda. Welcome to you and Poogan.

Jill, as usual, gave a ton of useful information. It sounds like SID to me, too.

I'm not sure why you need prescription food. Many dogs do well on Sport Dog Elite, herding dogs formula, buffalo & sweet potato. Or, the less pricey Taste of the Wild Pacific stream. Both availble on Amazon, Chewy, or their own website. You need grain free, no peas or white potatoes, and less than 4% fiber.

Please remain active on the forum. This is the best place I know, but FYI nobody in this group will suggest you switch your vet. That decision is up to you. My vet didn't know anything about EPI, and she gave her blessing for me to to find one who did. It can be tricky, and there is a lot of trial & error. Here is a list of vets that have been recommended by EPI dog owners.

https://epi4dogs.com/recommended-vets/

Stay in touch.

---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.

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Montgomery
Member
Posts: 202
Country: Canada
Pet name: Montgomery (I'm a CAT!)
My name: V

Re: Struggling with Vet

Post by Montgomery » 20 Jan 2022, 20:48

I was frustrated, too, when Montgomery was first diagnosed and we were trying to find him something to eat. To make a long story short, I ended up having a very blunt (not rude or angry, just blunt) conversation with her. It really made a difference, and we've had an easier time communicating ever since. I don't know if that helps. I've certainly been very frustrated (as everyone here knows. I'm a ranter, I'm afraid) since, but I've never felt like I was butting heads with a brick wall again. I hope this helps?
Montgomery was born 20 March 2012. He eats extra lean ground chicken 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 one size four capsule of Tylan three times a day. He's a strong, fearless little Spitfire with a real Merlin engine.

PooganNash
Member
Posts: 9
Country: United States
State: Michigan
Pet name: Poogan
My name: Melinda

Re: Struggling with Vet

Post by PooganNash » 21 Jan 2022, 11:19

jilbert57 wrote: 19 Jan 2022, 12:06 Hi Melinda,
Do you have the test results from Poogans Tli, folate, and B12 ?
It sounds like a case of SID/SIBO . Was Poogan prescribed an antibiotic for this when first diagnosed? We recommend a 45 day course of Tylan, twice a day. You could also try Slippery elm.
Does your pup have allergies hence the Ultamino?
Epi usually is a diet of grain free(try for little to no peas or lentils) low fiber (less than 4%) food.
Low fat is not needed unless fat restriction is in order.
Here are some links:
https://epi4dogs.com/epi-quick-guide-usa/
https://epi4dogs.com/sidsibo-in-brief/
https://epi4dogs.com/dog-food-options/

Jill
Poogan Nash
Fortiflora once daily, Hills i/d food, Viokase - V 1 tsp with each meal, 20mg famotidine with each meal

PooganNash
Member
Posts: 9
Country: United States
State: Michigan
Pet name: Poogan
My name: Melinda

Re: Struggling with Vet

Post by PooganNash » 21 Jan 2022, 11:19

jilbert57 wrote: 19 Jan 2022, 12:06 Hi Melinda,
Do you have the test results from Poogans Tli, folate, and B12 ?
It sounds like a case of SID/SIBO . Was Poogan prescribed an antibiotic for this when first diagnosed? We recommend a 45 day course of Tylan, twice a day. You could also try Slippery elm.
Does your pup have allergies hence the Ultamino?
Epi usually is a diet of grain free(try for little to no peas or lentils) low fiber (less than 4%) food.
Low fat is not needed unless fat restriction is in order.
Here are some links:
https://epi4dogs.com/epi-quick-guide-usa/
https://epi4dogs.com/sidsibo-in-brief/
https://epi4dogs.com/dog-food-options/

Jill
Poogan Nash
Fortiflora once daily, Hills i/d food, Viokase - V 1 tsp with each meal, 20mg famotidine with each meal

PooganNash
Member
Posts: 9
Country: United States
State: Michigan
Pet name: Poogan
My name: Melinda

Re: Struggling with Vet

Post by PooganNash » 21 Jan 2022, 11:20

Thank you all so much for the great information and support. I have contacted the vet near me from the list and hope to set up an appointment soon!

Melinda and Poogan
Poogan Nash
Fortiflora once daily, Hills i/d food, Viokase - V 1 tsp with each meal, 20mg famotidine with each meal

PooganNash
Member
Posts: 9
Country: United States
State: Michigan
Pet name: Poogan
My name: Melinda

Re: Struggling with Vet

Post by PooganNash » 21 Jan 2022, 11:37

Jill,
Poogan's last B12 results (12/28/21) 476 ng/L and Folate >24.0 ug/L TLI fasting (9/16/21) <1.0 ug/L No antibiotics have been prescribed ever.
I keep saying that I think he has SID, but my vet does not seem to hear my concern. I started to give Purina FortiFlora once a day, against my vets wishes, and this helped with the rumbles and provides more consistent bowel movements, but no weight gain. Will the SIDS slow weight gain until the antibiotics are provided?
Poogan started eating Ultimino prior to be diagnosed, since he does seem to have food sensitivities and allergies (I had him tested using a Ucari home kit). He is adjusting wonderfully to the Hills i/d food I am switching him to since Ultimino is sold out and I wanted to switch in hopes it will help his weight gain.
I did contact the vet from my area from the list provided and am working to set up a second opinion appointment and will maybe switch vets.
Poogan Nash
Fortiflora once daily, Hills i/d food, Viokase - V 1 tsp with each meal, 20mg famotidine with each meal

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

Re: Struggling with Vet

Post by Tuckaboo Pam » 21 Jan 2022, 19:57

Melinda, this may have already been said, but----

Poogan should be fed 150% of the amount that is recommended for what he SHOULD weigh.

If he weighs 50, but should weigh 80, and the bag says 80 pound dogs get 4 cups/day, you should feed him 6 enzymed cups every day.

ALL EPI dogs have SID. ---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.

PooganNash
Member
Posts: 9
Country: United States
State: Michigan
Pet name: Poogan
My name: Melinda

Re: Struggling with Vet

Post by PooganNash » 22 Jan 2022, 09:35

Pam,
Thank you so much! I have not been told to feed additional food! I will start immediately!!!
Poogan Nash
Fortiflora once daily, Hills i/d food, Viokase - V 1 tsp with each meal, 20mg famotidine with each meal

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