Seeking info re Pomeranians or small dog regime

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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kcblock1
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Location: Cape Cod
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Pet name: Zack

Re: Seeking info re Pomeranians or small dog regime

Post by kcblock1 » 08 Mar 2019, 16:31

Zack Update - 3/7/19

Zack had a dental cleaning last week, without any ill effects to his EPI regime. He does have lots of energy and most days gets an hour of outside walking, etc.

While at the vets, we had his EPI tests, chemistries and LFTs rechecked.

His chemistries and LFTs are within normal range, except for one liver enzyme (Alk Phos), elevation is chronic and most likely due to his long term use of Phenobarbital for seizure control (pre EPI diagnosis).

GI results:

2.8 ug/L - TLI (11/29/18 upon diagnosis)
2.1 ug/L - TLI (2/27/19)

458 ng/L - Cobalamin (11/29/18)
325 ng/L - Cobalamin (2/27/19) - on B12 injections since 12/19, currently on monthly (switching to oral with this little guy is not an option as he is resistant.).

17.7 ug/L - Folate (11/29/18)
18 ug/L -Folate (2/27/19)

Weight currently stable at 9.8 lbs (was in the 10.5 - 11 range prior to diagnosis)

Meds:

Omeprazole - once daily - for gastric reflux (averages 1 day or less, much improved)
will keep on this drug until he has a few weeks free of ‘spit ups’.
Tylan - twice a day
B12 injection - monthly
Gabapentin - 100 mg nightly
Phenobarbital - 8.8mg twice daily

Feedings:

Royal Canin canned food - was tolerating four feedings a day of 4 tablespoons with 1/4 tsp of PancreaPlus Powder. He also gets treats made with in a dehydrator with Royal Canin kibble with enyzme.

Stools remain normal, although at times we think they are a bit larger for a small Pom. We as well as the vet would like to get him above 10 lbs.

I know the literature says to increase feedings to 150% to help with weight gain, but I think we are at our limit with our little guy, otherwise he will spit up more. He does appear hungry and does eat all his food when its offered. we are giving him a full or 1/2 feeding before bedtime.

Even though his B12 is within normal range I wonder if getting it higher would help with weight gain and/or his spit ups. A trial of slippery elm did nothing for the spit ups, but we tried that very early on.

Our Vet. is really attentive and does consult with another Vet. who has had more experience with EPI.
Wonder if anyone has any other thoughts on our regime. Thanks in advantage for any ideas.
Kathy Crocker, Cape Cod, MA, USA, Zack is a 6 year old, 10 lb., Pomeranian dx on Nov 6,2018 with TLI of 2.5 after month of yellow cow patty stool. Lost one pound. Stool converted to normal immediately, main issue gastric reflux. Currently on Royal Canin wet food with bits of kibble, ProcreaPlusPowder, Tylan pinch 2xday, B12 injection monthly, weening off compounded Omeprazole. Also receives twice daily Phenobarbital for history of seizures.

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Jean
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Re: Seeking info re Pomeranians or small dog regime

Post by Jean » 09 Mar 2019, 04:04

Good morning from the UK

The cTLI result has gone downwards which is to be expected

the folate result is within the parameters set

Serum Cobalamin (Vitamin B12) and Folate
Reference Interval
Cobalamin Folate
Canine 251 - 908 ng/L 7.7 - 24.4 µg/L

and although the cobalamin levels are within the parameters for a normal dog, your results are well below the recognised levels of 600, and over for an EPI dog, so therefore, you might want to introduce a capsule form of b12 maybe, daily, from Wonderlabs

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

on top of the Monthly b12 by injection, however, as he has other issues it might be sensible to run this past the vets

i wouldnt worry too much about weight, you seem to be doing just great

j
My name is Jean we live in Liverpool in Uk

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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Madelon
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Re: Seeking info re Pomeranians or small dog regime

Post by Madelon » 09 Mar 2019, 10:43

Hi. Love seeing that cute little pom face pop up on the forum. As Jean pointed out, that B12 is well below what we recommend and has gotten lower since last testing. Low B12 will affect appetite and weight gain. We have seen over the years, for some reason, the little ones need a bit more B12 than the bigger dogs. When you said oral is not an option - is it because she won't swallow pills? You can also sprinkle the capsule on the food or tuck it inside a pill pocket or dollop of cream cheese. The WonderLabs Pet Factor B12 has intrinsic factor which helps in the absorption of B12, but if that definitely is not an option, I would increase the shots for sure - I would go back to once a week and retest after a month - you may have to stay on weekly shots to keep the B12 up where it needs to be. I know one of our staff members that had a Chihuahua had to do a combination of shots and pills to keep her little one's B12 level up.
MADELON and Doc. DX EPI and SIBO: 5/22/2015
Test Results: (1st) 7/2014 = TLI 16.5, B12 894, Folate > 24; (2nd) 5/2015 = TLI < .4, B12 406; Folate >24; (3rd) 10/2015 TLI < .4; B12 >1000; Folate 14.4. Prior to DX: May 2014 (2mos) - DX coccidia/bladder infection; July 2014 (3mos) 1st EPI test = TLI 16.5, B12 894, Folate >24 - Dx SIBO not EPI; Feb 2015 thru May 2015 - weight loss only; May 2015 vomitted several times, diarrhea and eating poop. Regimen: 4 cups Sport Dog Food Elite Herding - Diane 6x 1tsp per cup; 1 WonderLab PetFactor B12 2x day; 1/2tsp Slippery Elm 2xday; Multivitamin; 1 Zyrtec 10mg 2x day; Salmon Oil

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kcblock1
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Location: Cape Cod
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Pet name: Zack

Re: Seeking info re Pomeranians or small dog regime

Post by kcblock1 » 12 Mar 2019, 14:15

thanks everyone for the replies. Zack is pretty smart when it comes to 'knowing' we have put medicine additives in his food, and has never reposed to use of pill packs or hiding capsule in food such as peanut butter or cream cheese. Last night we tried giving him his Gabapentin powder mixing with a soft Royal Canin kibble treat which we make ourselves. He finally took it but then spit it back up. For his Omeprazole as well as his Phenobarbital we have it compounded into liquid form with a chicken flavor. He readily takes the Omeprazole but not the Phenobarbital so the compounded Phenobarbital is added to two of his four feedings.

I will see how he does for the next month with the ordered monthly B12 injection and then speak with the vet about increasing the doses. (He had been at the vet so much these last few months we both need a month away :) .

Anyway in regard to the continued spit up .... I might have mentioned before we tried slippery elm but that was early on and it didn't seem to make a difference. Do you think its worth trying again, might it work better now that he is more stable food / enzyme wise.

If you need a non EPI story:
He is getting what amounts to an extra feeding with enzyme treated treats as we are trying to do some counter conditioning training with him. He is very protective of me, and doesn't let my husband back in bed if Im there first -- this preceded EPI and we attribute it to his first six years living with one woman. This little cutie can growl, bare his teeth and look like he is ready to nip my husband. Its not funny, but its more difficult to deal with than the EPI regime. ;)
Kathy Crocker, Cape Cod, MA, USA, Zack is a 6 year old, 10 lb., Pomeranian dx on Nov 6,2018 with TLI of 2.5 after month of yellow cow patty stool. Lost one pound. Stool converted to normal immediately, main issue gastric reflux. Currently on Royal Canin wet food with bits of kibble, ProcreaPlusPowder, Tylan pinch 2xday, B12 injection monthly, weening off compounded Omeprazole. Also receives twice daily Phenobarbital for history of seizures.

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Jean
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Pet name: Kara, lost 10th May 2019
My name: Jean

Re: Seeking info re Pomeranians or small dog regime

Post by Jean » 12 Mar 2019, 14:32

regarding the guarding of you, have you thought of a cage in the bedroom , or keeping him out all together, we had to this with one of my dogs, very protective towards me

it worked we just had to be very perseverant

jean
My name is Jean we live in Liverpool in Uk

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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jilbert57
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Re: Seeking info re Pomeranians or small dog regime

Post by jilbert57 » 12 Mar 2019, 18:49

Can you put the gabapentin in a little gel cap? I got a gem scale on Amazon and used it for all Mickeys meds.
Our little jack won't take meds, I have started putting some broth on the food and he likes that.
My name is Jill and I live on the Hood Canal in Washington State. I have two dogs: Kiya is an aussie/blue heeler and is 13, TJ is a 4 year old Jack Russell. They keep me on my toes.
Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.
6/1999 - 8/2014

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Riley's Mom
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Re: Seeking info re Pomeranians or small dog regime

Post by Riley's Mom » 14 Mar 2019, 18:59

Welcome to the forum
I also had a free feeder pre diagnosis. She was not happy with the change to regimented feedings, but soon figured things out and does quite well with the routine. So I believe once you get your boy stable and establish the new routine, he will adjust just fine. Sometimes my girl will save a little of her meal and come back a little while later to finish up, her way of still being a free feeder I guess! I don't leave the food down long though, don't want bacteria to begin to grow.
As far as the spitting up and Slippery Elm, I'll leave that to someone that uses it regularly. I don't and don't want to steer you wrong.
Elisabeth

Riley is a 10 year old Labradoodle. She was diagnosed with EPI in 2014.
She currently eats Taste of the Wild, I cup in the morning, 2 cups in the evening, each meal with 1 Wonderlabs B12 sprinkled over her dinner. Enzymes are EnzymeDiane, 1 tsp per cup of food, mixed in home made bone broth. No other supplements or meds at this time.
Riley currently weighs about 44 pounds, which is pretty heavy for her.

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kcblock1
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Location: Cape Cod
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Pet name: Zack

Re: Seeking info re Pomeranians or small dog regime

Post by kcblock1 » 15 Mar 2019, 15:16

Thanks again everyone for the feedback. Its so hard to know whether Zack has a real issue or is just having a 'down' day just like us humans have sometimes. Anyway. He is back to eating the majority of his food, I have resorted to hiding his meds in small bits of peanut butter -- I give it just before his feeding time so he will have enzyme soon after. Today I got the Greenie pill packets - peanut butter flavor - and he did take it - without ill effects. We are going to have his phenobarbital compounded in a peanut butter flavoring next time.

As for the guarding, we tried having him sleep in his crate, but he whined and we couldn't handle that. Also since he has had seizures in the past I didn't want to stress him. Funny new event- he has discovered an old down jacket of my husband and has taken over possession. Last night he slept on the jacket and stayed at the foot of the bed. So we might be on to something - although my husband is mourning the lost of his jacket -- but its for a good cause.
Kathy Crocker, Cape Cod, MA, USA, Zack is a 6 year old, 10 lb., Pomeranian dx on Nov 6,2018 with TLI of 2.5 after month of yellow cow patty stool. Lost one pound. Stool converted to normal immediately, main issue gastric reflux. Currently on Royal Canin wet food with bits of kibble, ProcreaPlusPowder, Tylan pinch 2xday, B12 injection monthly, weening off compounded Omeprazole. Also receives twice daily Phenobarbital for history of seizures.

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Madelon
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Re: Seeking info re Pomeranians or small dog regime

Post by Madelon » 17 Mar 2019, 11:11

Glad to hear Zack is doing better and eating. My Boston was horrible with pills - nothing worked - I literally had to put the pill in and close his mouth until he swallowed - poor guy. Sounds like the jacket might be just the thing he needed to sleep - the sacrifices we make for our fur kids :)
MADELON and Doc. DX EPI and SIBO: 5/22/2015
Test Results: (1st) 7/2014 = TLI 16.5, B12 894, Folate > 24; (2nd) 5/2015 = TLI < .4, B12 406; Folate >24; (3rd) 10/2015 TLI < .4; B12 >1000; Folate 14.4. Prior to DX: May 2014 (2mos) - DX coccidia/bladder infection; July 2014 (3mos) 1st EPI test = TLI 16.5, B12 894, Folate >24 - Dx SIBO not EPI; Feb 2015 thru May 2015 - weight loss only; May 2015 vomitted several times, diarrhea and eating poop. Regimen: 4 cups Sport Dog Food Elite Herding - Diane 6x 1tsp per cup; 1 WonderLab PetFactor B12 2x day; 1/2tsp Slippery Elm 2xday; Multivitamin; 1 Zyrtec 10mg 2x day; Salmon Oil

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Riley's Mom
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Re: Seeking info re Pomeranians or small dog regime

Post by Riley's Mom » 17 Mar 2019, 11:22

My girl is not great at pills, and she is a super picky eater. But....I open the B12 capsule and sprinkle on with the broth that I incubate her enzymes in and she never notices. It's worth a try. I did injections for a long while because she was such a poor eater that I didn't want to rock the boat by adding anything in. But when I changed over to this method she never skipped a beat, and because there isn't as long between doses as with the injections I feel she is doing better overall.
Especially with little dogs, the B12 tends to drop rapidly, daily or every other day B12 could keep that from happening.
Elisabeth

Riley is a 10 year old Labradoodle. She was diagnosed with EPI in 2014.
She currently eats Taste of the Wild, I cup in the morning, 2 cups in the evening, each meal with 1 Wonderlabs B12 sprinkled over her dinner. Enzymes are EnzymeDiane, 1 tsp per cup of food, mixed in home made bone broth. No other supplements or meds at this time.
Riley currently weighs about 44 pounds, which is pretty heavy for her.

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