Diagnosed with EPI

[pratheba]

Hi all,

Recently my dog 'Happy', 2.5 years old Labrador has been diagnosed with EPI. He had diarrhea intermittently right from his childhood but never really lost any weight. He maintained at 63. I was feeding him Orijen kibble food.
This year February I changed him to raw food diet. Then on his diarrhea drastically reduced. But in September he started getting diarrhea and found out about his condition. He still weighed 58-59 pounds. The doctors now are very strict about not feeding him raw food. He has been on enzyme 'vetone' pancreaplus for last 3 weeks but i see no improvement in his weight.

I read in forums that feeding raw beef pancreas and raw food will help their condition. But with the doctor saying no I am very confused. 8oz of the enzyme costs me ~170 $ + the prescription canned food. I cannot afford to spend that much every month given I am a student.

Please help!

[Jean]

HI

And a very warm welcome from the UK

Firstly, what is your name ?

what test did your vet do to diagnose EPI, and what were the numbers they gave you, did they do any other tests for b12, and folate ?

as far as the enzymes are concerned

this is what most folk over there use

https://enzymediane.com/

you will likely need b12 supplement too

either injections or capsules

https://www.wonderlabs.com/itemleft.php?itemnum=K9688

which variety of Orijen do you use, we recommend 150% of the directions on the bag over several meals all enzymed

Cost is the biggest worry, but fresh pancreas is not sterile, and each organ has different make up, you could always experiment later on

the enzyme the vets have given is fine but..........

if you can perhaps give more information

Jean

[pratheba]

Hi,

Am sorry. I am Pratheba.
We did a TLI test and the result is
4.5 - TLI
201 - B12
9.3 - Folate

He is getting his B12 shots for 4 weeks now. I do not see any improvement in his weight, but diarrhea stopped.
He was never a bulky dog. was always thin but the ribs never showed and energy level never went down. Even now.
Doctors always said he is ideal given that he plays a lot and is the high energy kind.

I used to give him a mix of normal + fish Orijen. Gave it according to the recommendation on the package. But he kind of lost interest in the food so switched to raw food after consulting my vet in California. He loved it. Now i moved to Massachusetts, the vet here is not in favor of raw food.

He was totally fine till September, but when i left him at the friends place for a short vacation he was stressed out and started having diarrhea. So tested him this October.

[Barb]

Hello, Pratheba. A very warm welcome to you and your pup, Happy. Lovely name. You have a lot on your plate with your pup not well and a move across the country. Take a deep breath.

It looks like Happy'sTLI score might be approaching EPI levels, but is not there yet.... below 2.5 is considered clinical EPI. Between 2.5 and 5.6 is a grey area that is explained on the Home Page under EPI Diagnosis. He is exhibiting symptoms and therefore, beginning the enzymes to see if they relieve his symptoms can be beneficial.

His B12 level is also very low. So you are on the right track, supplementing his B12. You might not see weight gain at this early stage if it is EPI until you get the four cornerstones of Food, Enzymes, B12, and antibiotics, if needed.

As Jean said, many, many of us use enzymes from Enzyme Diane (enzymediane.com). She is a member here and went into the business of supplying enzymes for reasonable cost when her own dog developed EPI. You can go to her website and /or contact her by phone. She publishes her number on her site. She is wonderful to work with and offers a great product for much less than the commercial brands.

I will let someone who is familiar with feeding raw advise you on the raw food.

I highly recommend keeping a daily log/journal of everything you give Happy, the amounts and the resulting poos. (how many and what they look like). The journal helps you to keep everything organized in one place, and it will show you what is working and what isn't.

Please ask any questions that you have. The beginning stage is the hardest when you are trying to get everything balanced.

Barb

[pratheba]

Thank you, Jean and Barb.

I just ordered enzymes from enzyme Diane. I read that value between 2.5 - 5 will need to be retested.
My vet did not mention anything about it.

For now, I am mixing the enzyme with raw food and giving him. I will wait and see the progress. It has only been 2 and a half weeks now. I will also manage a journal.

Thank you.

[Olesia711]

Hi Pratheba,

With a TLI value of 4.5, your dog does not (yet) have clinical EPI... however.... with a score of 4.5, your pup could very well be segueing into EPI or may never fully have EPI... like Barb and Jean mentioned.

I would TLI retest in about 3 to 6 months if you and or your vet don't find another reason for why your pup isn't doing well.

Feeding raw works very well with many EPI dogs. sometimes to the point where nothing else really worked well enough until the owners started feeding raw... but then, on the flip side.... some other EPI dogs just don't do well with raw. As you yourself experienced, some vets agree with raw, others don't. My suggestion is for you do what YOU think works best with your pup... and sometimes that means "trying" stuff.

With EPI, you usually do not need prescription food UNLESS there is another medical reason for using prescription food.... like IBD and you have to use hydrolyzed food, or kidney disease and you have to use special food. Usually with EPI, "most" dogs do best with a low fiber food..... that's why we suggest grain free (but look for something that doesn't have a lot of pea ingredients in it, no peas would be even better) try to go with foods that have a fiber content of 4% or less (less often works better) ,and also raw often works well with some dogs too. Many times fish based food works better than other foods with some of the EPI dogs.... just know though that just because a particular food works for one EPI is no guarantee that it will work for the next EPI dog....

Glad you ordered the enzymes from EnzymeDiane. Many of us use her enzymes. I have been using hers for almost 12 years now.

Also glad that your dog is getting B12 shots, as the B12 is very low. Just know that once you completely the 6 weeks of weekly shots... DO NOT stop giving B12 completely... with EPI (or any chronic condition) if the B12 is low..... once you bring the B12 level up (to upper mid range) then you and your vet will need to figure out how much B12 is needed and how frequently the B12 needs to be given going forward to maintain the upper mid-range B12 levels. Many of us use these special (and thankfully cheap) B12 pills called Pet Factor B12 from WOnderlabs https://www.wonderlabs.com/itemleft.php?itemnum=K9688

Next... if you give the enzymes, you feed a low fiber food (or raw, or home-made, or a combo) you give the B12 and you STILL do not notice any improvement... in other words, the poos are still sloppy, or stinky, dog farts and or burps, upchucks, goes to the bathroom multiple times a day.... then this would suggest that the SID (gut flora imbalance that accompanies EPI, and many other gastrointestinal conditions) is not well managed and you either can try a prebiotic (many of us like SLippery Elm powder https://www.wonderlabs.com/itemleft.php?itemnum=K97024, and see if that helps, and some have to use a prebiotic and a probiotic... give it a few weeks and see if that starts improving things, but if it doesn't, then you need to ask your vet to prescribe an antibiotic. The antibiotic of choice for SID is Tylan.

Effectively managing EPI or pre-EPI is all about finding the right balance of the suggested protocol . What we strongly recommend is for you to start keeping an EPI Log (journal)..... there is a sample of one here:
https://epi4dogs.com/epi-log/

Please keep us posted... that way we can help by guiding you with next steps.

[pratheba]

Thank you so much for the detailed information Olesia!

His poops are normal and he does not need to poop more than twice a day. I started giving him raw pancreas until my enzymes arrive. I see his poops are small and solid like how it was before his diarrhea started. Have increased his food intake too to see if he would put on some weight. He weighs about 60LB now. He gets supplements of coconut oil, goat kefir, fat-free yogurt, fish-oil, turmeric which I have been giving him from early on.

All in all, I hope he does not have EPI. Even if so am happy seeing him stabilize without losing a bit of his energy.

I will keep you all posted. Thank you once again for your support.

-Pratheba

[Olesia711]

Excellent that his poos are looking good and smaller now too..... that is usually a good indication that you are doing something right

Whatever is going on though.... great that you are trying to feed more.... BUT.... just as a general guideline with possible gastro issues..... try to feed smaller portions.

With our EPI dogs, in the beginning when they are first starting to be treated, we suggest feeding 150% of what they normally require (body type/weight) HOWEVER.... we suggest also feeding smaller portions, so.......to accomplish this we suggest give more meals throughout the day. Many of us work, so what we do to overcome this is to feed breakfast before we go to work, feed lunch when we come home from work and then feed dinner just shortly before we go to bed .

Of course if you don't have to work outside the home then you can feed 3 or 4 small meals throughout the day. This doesn't have to be done forever... just until they gain the lost weight back.

Also... this technique is not exclusive to just EPI dogs, but as i mentioned above, many dogs that have something gastro going on appear to benefit from this little technique.

Keep us posted!

[pratheba]

He actually gets 2 meals per day. One right after he wakes up and then lunch. He goes to day care coz I have to work till evening in lab.
Prob I can portion it out so he gets the food after he comes back home in evening.

Thank you!

[Olesia711]

That would be a good plan... to add an extra meal at night