Newly Diagnosed Corgi w/EPI - Suggestions?

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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Bri S
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Pet name: Opal

Newly Diagnosed Corgi w/EPI - Suggestions?

Post by Bri S » 29 Nov 2018, 12:35

Hello,

I have a blue merle corgi named Opal, who was diagnosed with EPI about 3 weeks ago. Opal just turned 1 year old on 09/05/18. Up until early October everything was normal with her until she started having runny / mustard color poops. I gave her pumpkin in her kibble for a week thinking perhaps she just wasn't feeling good. When that didn't help her poops I took her to the vet. They said she looked a little thin and to increase her food, plus tested her for worms and sent us home with meds. After finishing the meds she still wasn't any better so I pushed back onto the vet again. I was aware of another dog from her same parents (different litter) that had been diagnosed with EPI and the owner had to put the dog down. She just wasn't gaining weight and not responding well to the meds they gave her. I only know this as I am part of a Facebook group for people who have puppies from the breeder that I got Opal from. So I brought that up to my vet and they recommended we test for EPI. Opal's TLI was <1 (should be 5-35), Cobalamin aka B12 <150 (should be 249-733), Folate was pretty normal at 10.1. Opal is usually around 22 lbs and has now weighed in at 19lbs which is a huge deal to such a small dog and weight loss for her really worries me. Any other corgi parents with EPI out there? Anyone with suggestions for a smaller dog and avoiding weight loss while we figure out what works for her? This process has been discouraging thus far but our vet has been very positive that we'll figure out what works for Opal. Opal has lots of energy still (not quite her normal self but energetic none the less) and devours her food so it's good that she has an appetite still. We have worked up to 1/8 TSP PancreaPlus Powder 2 x day, even though she eats 4 x a day because anymore than that and she has gotten diarrhea. When she has got diarrhea we have given her dia-gel from our vet. We switched her to Hills Prescription Diet ID kibble for easier digestion than Blue Buffalo that she previouisly ate. Her new food's fat is 10% and fiber 3.5%. Opal is also taking a chew-able B12 tablet once a day, in addition to 1/16 TSP Tylan 2 x day. We will work in one pro-biotic pill today. So far we've struggled with how much is too much PancreasPlus Powder, we had her on Metronidazole before but read about Tylan having good results on here so we switched her. She is still having yellow stool that is soft no matter what wee've switched. Sometimes it's a little more formed than other times. Any help/suggestions especially for a smaller dog would be appreciated! We have been researching and I know that every EPI dog is different but we want to get this figured out for our baby as soon as we can!
Thank you,
Bri & Opal
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My name is Bri and I have a Corgi named Opal who was born on 09/05/17. We live in Washington State and Opal was diagnosed with EPI in September of 2018 shortly after she turned 1 year old. Opal currently takes the following daily: Pancreapowder Plus 1/16 TSP 3x day - Proviable DC Capsule Probiotic 1x day - WonderLabs Slippery Elm Prebiotic 1/16 TSP 1x day - WonderLabs B12 w/Intrinsict Factor 1x day - Tylan antibiotic 1/16 TSP 2x day - Eats Hills Prescription Diet Dog Food / Dry Kibble / Low Fat i/d 3 x day 3/4 cup

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Olesia711
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Re: Newly Diagnosed Corgi w/EPI - Suggestions?

Post by Olesia711 » 29 Nov 2018, 18:57

my goodness..... Opal is a real cutie and we will help you as best we can to get her feeling better.

First, glad you switched from the blue buffalo food- -it s a good food....but for whatever reason, "most" of our EPI dogs (althou not all) do not well on it. ... however.... the Hills prescription food doesn't always work well with these dogs either..... although (again) some dogs do well on it.... but before you change it... try working in the below changes first...................

If i understand you correctly, you think too much enzymes are giving her loose stools.... and yes too much or too little enzymes will prompt loose stools.... BUT.... you need to give enzymes with every single meal... only giving it with 2 meals and not the other meals encourages SID (yellow / sloppy stools) and in reading your post... i strongly suspect it is not the enzymes but rather the SID and low B12 that is the underlying issue with Opal not improving.

How much food is she getting per meal??

Next... don't bother with the chewable B12 pill.... Opal has extremely low B12.... you either need to have the vet start adminisitering B12 shots weekly (cobalamin serum which usually works but not always) or.... order Wonderlabs "Pet Factor B12" (made with Methylcobalamin + Folate+ Intrinsic Factor) capsules on line
https://www.wonderlabs.com/itemleft.php?itemnum=K9688
.... open the capsule, and sprinkle 1/2 the capsule on her food once a day. Also FYI... her B12 level needs to be upper mid range. normal for an EPI dog is not good enough... you want to aim for a minimum in upper 500's-600's and above.

Continue with the Tylan :)

Also... start with a prebiotic.... we typically suggest Slippery Elm powder... previously we suggested a NOW product from Amazon, but Wonderlabs just started carrying Slippery Elm for us too... and it is the freshest batch that i have tried to date, so i would like to recommend their Slippery Elm product too....
https://www.wonderlabs.com/itemleft.php?itemnum=K97024
For Opal you only need a little less than a 1/4 tsp per meal..... mix in food and add 1 tablespoon of water since it is a mucilage. you should see improvement in the poo within a day.... if not... let us know exactly what you are noticing.

Give the above a few days..... and then slowly introduce a probiotic.... give 1/2 the recommended dose and work your way up to a full dose over the course of a week. A lot of animals have to get acclimated to a probiotic.

Next.... in the beginning, try to feed 150% of what Opal would normally require- -this is only until she gains back most or all of the weight she lost........

Looking forward to hearing more about Opal and hoping we can help her!
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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Olesia711
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Re: Newly Diagnosed Corgi w/EPI - Suggestions?

Post by Olesia711 » 29 Nov 2018, 19:01

oh... also meant to mention that YES, there seems to be an over-representation with Corgis getting EPI :(

There is some research on this that Dr. Leigh Anne Clark over at Clemson genetics did.... i will see if i can find it for you
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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Olesia711
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Re: Newly Diagnosed Corgi w/EPI - Suggestions?

Post by Olesia711 » 29 Nov 2018, 19:03

Found it.... on our EPI research page, back in 2015 there was a publication on Pembroke Corgis and EPI... just scroll downa bit on this page to see the Abstract and for the link:

Association of DLA-DQB1 alleles with exocrine pancreatic insufficiency in Pembroke Welsh Corgis

https://epi4dogs.com/epi-research/
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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Bri S
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Pet name: Opal

Re: Newly Diagnosed Corgi w/EPI - Suggestions?

Post by Bri S » 29 Nov 2018, 19:25

First off THANK YOU SO MUCH for all of the thoughtful recommendations and resources. Opal is a family member and I have been an absolute emotional train wreck doing my own research all while abiding by the recommendations of her Veterinarian. I have read that once you've met one EPI dog - you've met one EPI dog. That they're all different and it's hard to treat in the beginning stages!

To answer your questions, Opal eats 1/2 cup kibble 4 times a day. She is always hungry - and even though this isn't the most convenient feeding schedule I've read that EPI dogs do best with multiple smaller portioned feedings opposed to fewer large portions. Have you found that to be true?

I will definitely ask the Vet how she feels about giving Opal B12 shots opposed to the chewable. Will she need a weekly shot just in the time we are trying to get her back on track/feeling better? Or is that a lifelong things EPI dogs will need?

I researched and found information about pre-biotics this morning.... funny that you mention that! Opal seems to have such an overly SENSITIVE tummy when it comes to meds or foods so I've been hesitant to bring that up to the Vet so far. I just haven't wanted to overload her you know? The Vet has recommended slow and steady thus far. One things at a time. But it is very hard to feel like in the meantime my dog is wasting away and losing weight.

Have you found that it is okay to give all of these meds to a dog at once? Opal is taking the probiotic with 2 of her 4 meals a day - which I can split her dosage into smaller portions so we are covering all 4 meals? She is also taking that chewable B12, about to start the probiotic, and Tylan. Would adding a prebiotic and slippery elm in be too much?

I know all EPI dogs respond differently to meds but we are open to any options! I just want my baby girl to feel better. Are any of these meds needed lifelong to keep her feeling her best(other than the Pancreas Powder, of course).

Again THANK YOU SO MUCH for the information and resources posted. Opal and I appreciate it so much!
My name is Bri and I have a Corgi named Opal who was born on 09/05/17. We live in Washington State and Opal was diagnosed with EPI in September of 2018 shortly after she turned 1 year old. Opal currently takes the following daily: Pancreapowder Plus 1/16 TSP 3x day - Proviable DC Capsule Probiotic 1x day - WonderLabs Slippery Elm Prebiotic 1/16 TSP 1x day - WonderLabs B12 w/Intrinsict Factor 1x day - Tylan antibiotic 1/16 TSP 2x day - Eats Hills Prescription Diet Dog Food / Dry Kibble / Low Fat i/d 3 x day 3/4 cup

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Olesia711
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Re: Newly Diagnosed Corgi w/EPI - Suggestions?

Post by Olesia711 » 29 Nov 2018, 20:12

I am going to respond to your questions in CAPS :)
Bri S wrote: 29 Nov 2018, 19:25 First off THANK YOU SO MUCH for all of the thoughtful recommendations and resources. Opal is a family member and I have been an absolute emotional train wreck doing my own research all while abiding by the recommendations of her Veterinarian. I have read that once you've met one EPI dog - you've met one EPI dog. That they're all different and it's hard to treat in the beginning stages! VERY TRUE! BUT WE WILL HELP YOU AS BEST WE CAN TO NAVIGATE OPAL'S EPI JOURNEY

To answer your questions, Opal eats 1/2 cup kibble 4 times a day. She is always hungry - and even though this isn't the most convenient feeding schedule I've read that EPI dogs do best with multiple smaller portioned feedings opposed to fewer large portions. Have you found that to be true? YES !!! SMALLER PORTIONS VERY, VERY HELPFUL. AND SINCE SHE IS GETTING 1/2 CUP OF KIBBLE..... BUT THAT YOU THINK SHE CAN ONLY HANDLE 1/4 TSP OF ENZYMES - -THEN GIVE HER 1/4 TSP OF ENZYMES WITH EACH OF THE 4 MEALS.

I will definitely ask the Vet how she feels about giving Opal B12 shots opposed to the chewable. Will she need a weekly shot just in the time we are trying to get her back on track/feeling better? Or is that a lifelong things EPI dogs will need? SHE WILL NEED WEEKLY SHOTS UNTIL YOU BRING THE LEVELS UP TO UPPER MID-RANGE AND THEN YOU AND YOUR VET WILL HAVE TO RE-ASSESS TO DECIDE HOW MUCH B12 YOU THINK OPAL WILL NEED GOING FORWARD. EPI IS A CHRONIC CONDITION AND CUZ OF THIS YES SHE WILL NEED TO BE ON B12 LIFE LONG. YOUR VET CAN TEACH YOU HOW TO GIVE THE SHOTS, OR I HIGHLY RECOMMEND TRYING THE METHYLCOBALAMIN ORAL B12 PILLS... WHEN YOU HAVE TO JUST MAINTAIN HER. B12 LEVELS.

I researched and found information about pre-biotics this morning.... funny that you mention that! Opal seems to have such an overly SENSITIVE tummy when it comes to meds or foods so I've been hesitant to bring that up to the Vet so far. I just haven't wanted to overload her you know? The Vet has recommended slow and steady thus far. One things at a time. But it is very hard to feel like in the meantime my dog is wasting away and losing weight. IF YOU READ THE SID/SIBO SECTION AND THE MORE RECENT RESEARCH THEY HAVE DISCOVERED THAT PREBIOTICS WORK MORE LONG TERM AT ALTERING THE GUT FLORA (SID) VS. TREATING WITH ANTIBIOTICS... BUT SOMETIMES, YOU HAVE NO CHOICE AND HAVE TO RESORT TO ANTIBIOTICS. THE NEXT BEST THING IS A PREBIOTIC WITH A PROBIOTIC. THE RULE OF THUMB IS TO GIVE PROBITOICS 2 HRS AWAY FROM WHEN YOU GIVE ANTIBIOTICS (AND A LOT OF ANTIBIOTICS SHOULD BE GIVEN WITH FOOD ) SO THEN YOU NEED TO GIVE THE PROBIOTIC 2 OR SO HRS LATER WITH YOGURT OR SOMETHING. HOWEVER... TYLAN DOES NOT KILL ALL THE BACTERIA LIKE METRONIDAZOLE DOES, SO TECHNICALLY YOU CAN GIVE PRE + PROBIOTICS TOGETHER WITH TYLAN.... BUT TO KEEP IT SIMPLE SO THAT PEOPLE DON'T MISCONSTRUE ANY INFORMATION- -WE CONTINUE TO SAY TAKE PROBIOTICS 2 HRS AWAY FROM ANY ANTIBIOTICS. PREBIOTICS CAN BE TAKEN ANYTIME :)

YOUR VET IS CORRECT.... INITIALLY WHEN A DOG IS FIRST DIAGNOSED YOU TREAT WITH ENZYMES, b12 IF NEEDED (AND OPAL DOES!) FOOD CHANGE IF NEEDED AND IF AFTER A FEW WEEKS THE SID IS STILL NOT UNDER GOOD CONTROL... THEN WE FIRST SUGGEST A PREBIOTIC, THE PREBIOTIC WITH PROBIOTIC.... AND IF STILL NOT POSITIVE MOVES IN THE RIGHT DIRECTION... THEN WHIP OUT THE BIG GUNS AND DO THE ANTIBIOTICS. TYLAN IS THE DRUG OF CHOICE FOR SMALL INTESTINAL DYSBIOSIS AND IT IS MUCH SAFER THAN METRONIDAZOLE. SOME DOGS DEVELOP METRONIDAZOLE TOXICITY SO ALTHOUGH STILL RECOMMENDED...WE JUST LIKE TO MAKE SURE FOLKS ARE AWARE OF THIS (ALSO ON THE SID ANTIBIOTIC PAGE)

THE BIG THING WITH MANAGING EPI.. IS IF THINGS DON'T COME TOGETHER AS EXPECTED, THEN START TWEAKING THINGS ONE-AT-A-TIME / AND KEEP A JOURNAL..... THIS WILL (TRUST ME!!) SAVE YOUR SANITY WHILE YOU AND YOUR VET ARE TRYING TO FIGURE THINGS OUT.

Have you found that it is okay to give all of these meds to a dog at once? YES... JSUT TRY NOT TO GIVE 2 ANTIBIOTICS TOGETHER UNLESS YOU ABSOLUTELY HAVE TO... Opal is taking the probiotic with 2 of her 4 meals a day - which I can split her dosage into smaller portions so we are covering all 4 meals. IF SHE IS HANDLING THE PROBITOIC DOSE WITHOUT LOOSE STOOLS- -LEAVE AS IS.... IF SHE IS HAVING LOOSE STOOLS - -CUT BACK ON THE AMOUNT OF PROBIOTIC TEMPORARILY UNTIL HER SYSTEM GETS USED TO IT.? She is also taking that chewable B12, about to start the probiotic, and Tylan. Would adding a prebiotic and slippery elm in be too much? A PROBITOIC, A B12, SLIPPERY ELM (WHICH IS A PREBIOTIC) AND TYLAN ALL TOGETHER IS NOT TOO MUCH..... BUT..... BIG BUT..... IF THINGS GO SIDEWAYS... BY STARTING ALL OF THIS TOGETHER, YOU WON'T KNOW WHAT WORKED AND WHAT DIDN'T ..... SO.... I SUGGEST DOING ONE AT A TIME WHEN ADDING TO THE MIX AT THIS JUNCTURE SO YOU CAN TELL IF SOMETHING IS NOT WORKING.

IIF THIS WAS MY DOG......
THE 1ST THING I WOULD continue THE TYLAN
NEXT.... TALK TO YOUR VET ABOUT B12 SHOTS (WHAT IS THE NAME OF THE ORAL B12 PILL YOU ARE GIVING NOW?????)
NEXT NEXT... ADD THE SLIPPERY ELM.... GIVE THIS A DAY OR TWO TO ASSESS IF HELPING OR HINDERING
LAST I WOULD ADD THE PROBIOTIC....


I know all EPI dogs respond differently to meds but we are open to any options! I just want my baby girl to feel better. Are any of these meds needed lifelong to keep her feeling her best(other than the Pancreas Powder, of course).

Again THANK YOU SO MUCH for the information and resources posted. Opal and I appreciate it so much!
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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jilbert57
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Re: Newly Diagnosed Corgi w/EPI - Suggestions?

Post by jilbert57 » 29 Nov 2018, 22:47

Opal is absolutely adorable! I don't have much more to add but you might want to keep a diary of foods and meds in and out. If you aren't already.
My name is Jill and we live on the Hood Canal in Washington State. We currently have 2 Jack russells, TJ is 8 and Sadie is 2.

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.

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Bri S
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Re: Newly Diagnosed Corgi w/EPI - Suggestions?

Post by Bri S » 30 Nov 2018, 11:19

Thank you both very much for the information! This is such a daunting thing to have diagnosed and then try to treat it is a whole 'nother beast so I really appreciate the guidance and help. I was feeling overwhelmed and very sad for awhile after her diagnosis but you've really given me some good things advice for moving forward with her treatment!

Opal is doing better this week in general, and I think that is due to the switch to Tylan 1/16 TSP 2 x day. Her stool is definitely still yellow in color and soft but there is much less of it when she goes and the consistency/shape has improved. Last night she didn't have much stool when she did go and it was the right shape! I yelled for my Fiance to come outside and look, we praised her and jumped around the yard for joy. Opal of course didn't understand lol, but that was a HUGE step and very encouraging to see. That was the best stool she's had in MONTHS.

This morning's stool was a bit softer than last night, but a better color. It was more of a dark yellow / almost tan in color. So I think that is good too. Steps in the right direction it seems... finally!

I need to look at the B12 name/ dosage when I get home as I don't remember off the top of my head. I plan on calling Opal's vet this afternoon to give them an update on how she's doing and to bring up the Slippery Elm (as a prebiotic) and what their thoughts are on the B12 powder you sent me vs what we are taking now vs shots. We definitely want to treat ALL area's of her condition and not just some of them. Thank you very much for those recommendations, that was super helpful!

One more question I have is does it matter how you mix the Pnacreas Powder into the dog food? Opal eats kibble, so I put the food in her bowl, put some water in there 2nd, then 3rd I put her Pancreas Powder in the bowl and stir well. I then let the food sit on the counter for 20 minutes (I've read about mouth sores are possible if you don't wait at least 20 mins?!?!) Yikes!!!! So I thought I would check if there is a "best practice" in adding her Pancreas Powder to the kibble - or not? I want to be sure I am preparing it accurately.

I have been keeping a daily planner with her daily med schedule - what dosages / kind of meds do or don't work for her - how her stools are looking each day - and if she has had gas that day. The planner has absolutely saved my sanity! There are so many moving pieces and changes with what she does and doesn't respond well to so that has ABSOLUTELY helped us keep track of everything.

After I talk to the vet I'll post an update next week about how she does over the weekend. Again thank you both so so much for the insight, suggestions, help and guidance. It's fantastic to have options and people who have been in our shoes before. That truly makes me feel more positive that Opal will be just fine. We appreciate it more than you know and hope that she can get back on track to have a normal and happy life :)

- Bri
My name is Bri and I have a Corgi named Opal who was born on 09/05/17. We live in Washington State and Opal was diagnosed with EPI in September of 2018 shortly after she turned 1 year old. Opal currently takes the following daily: Pancreapowder Plus 1/16 TSP 3x day - Proviable DC Capsule Probiotic 1x day - WonderLabs Slippery Elm Prebiotic 1/16 TSP 1x day - WonderLabs B12 w/Intrinsict Factor 1x day - Tylan antibiotic 1/16 TSP 2x day - Eats Hills Prescription Diet Dog Food / Dry Kibble / Low Fat i/d 3 x day 3/4 cup

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Diane S
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Re: Newly Diagnosed Corgi w/EPI - Suggestions?

Post by Diane S » 30 Nov 2018, 13:08

Mixing the enzymes you are doing just fine. just mix the food water and enzymes.

it's great news and very exciting seeing the stools start to change Yeah!!
Diane S.
Executive Vice President, EPI4Dogs Foundation
Chardon, Ohio, USA

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Stacie & Dizzy
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Re: Newly Diagnosed Corgi w/EPI - Suggestions?

Post by Stacie & Dizzy » 30 Nov 2018, 13:16

Just wanted to say Opal sure is a cutie. You have been given great advice already. Please keep us updated.
My name is Stacie and my girl's name is Dizzy. German Shepherd, Age 10-diagnosed 12/24/2011 at 55 pounds, current weight is 93 pounds.
Feeding Taste of the Wild 4 cups a day with Enzyme Diane 1tsp per cup. Wonderlabs b12 once daily.
Dizzy has Pannus, given Cyclosporine drops in each eye twice daily. Pepcid once daily. Apoquel for allergies once daily.

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