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Is it really EPI

Posted: 29 Dec 2018, 15:40
by Ljsander
My 4 year old Corgi was diagnosed with EPI last week with a TLI of <1. He had lost weight and had the dreaded yellow poop but they treated for a number of gastro problems before finally doing the test for EPI. We had trouble over the holiday of getting the enzymes but 18 hours after his first meal with them all is looking normal. From what I've read it usually takes a few days or sometimes weeks for things to improve. I'm definitely going to continue with the rx low-fat diet and enzymes, but just wondering if this is just a fortunate example of the way some dogs react or if he truly has EPI. Appreciate having found this forum as it has excellent information!

Re: Is it really EPI

Posted: 29 Dec 2018, 22:07
by Jean
a huge welcome from us in UK

With a score of <1 it is definitely EPI

You do not need a low fat diet for EPI unless there is another internal thing going on as well, many years ago the vets preferred it, but it has moved on with research

we recommend grain, and rice free food, preferably with a low fibre , under 4 % and some of our dogs do not deal well with chicken,

feed 150% of the recommended food over the day with small meals if you can, all enzymed, for the weight your dog SHOULD be, and the weight and condition will come back

am pleased your dog has responded so well, and yes it can take a while to adjust, but this regime of enzymes is for life

we recommend the use of a journal, record everything you do

what enzymes are you using ?

finally, was there a result of B12 cobalamin given, ? most EPI dogs need b12 supplementation

let us know and ask anything

what are your names ?


Re: Is it really EPI

Posted: 30 Dec 2018, 09:43
by Shirl D.
Hello and welcome! As Jean said, with that TLI score, it's EPI. And the reaction your dog had suggests that the enzymes was exactly what he needed! Jean has you covered...there's no need for an rx diet or low fat, unless there is another medical condition also. And B12 is very important, too. Good sounds like you're already having good success!

Re: Is it really EPI

Posted: 30 Dec 2018, 10:37
by jilbert57
I agree with Shirl and Jean, <1 is definitely EPI. Just for information, was your pup on a 12 hour fast pre Tli test? Mickey had pancreatitis so was limited in fat but if everything else is good with your pup like Jean mentioned a regular % fat, probably grain free and fiber content of 4% or less might be best.

Re: Is it really EPI

Posted: 30 Dec 2018, 14:51
by Ljsander
His name is Gus and his cobalamin (B-12) was 231 compared to the range of (249-733). His folate was >24 which was high. The vets didn't suggest b-12 supplementation at this time as they said it could self adjust once he started proper digestion. He is on Pancreved now but I have an order of Pancreazyme coming in this week. Pancreved was the quickest one we were able to get. He's also supposed to stay on metronidazole and proviable for four more days. He weighed 27 pound at his lowest and he usually is around 35, he already looks like he's filling out more and certainly has more energy! He did get a milk bone and a small dog treat accidently yesterday in between feedings, but all still looked normal. I just bought a bag of the rx low fat gastro Royal Canin food from the vet but depending on how things go may try a gradual shift something I can buy without a perscription.

Re: Is it really EPI

Posted: 30 Dec 2018, 16:06
by Olesia711
HI and a very warm welcome to you and Gus, althou sorry to hear he has EPI.... and yes... with a TLI of <1... Gus does indeed have EPI.

Regarding the B12, yikes, NO!, his low B12 will not straighten out.... he desperately needs B12 supplementation or else he will never optimally recover. PLEASE have your vet read the B12 page, and the fact that EPI dogs B12 levels are NOT replenished naturally once they are on enzymes.

You can either have you vet do the B12 shot regimen or you can give Gus high dose oral B12 pills, we suggest Wonderlabs Pet Factor B12. this is what many of us here on the forum use.

Also that 24 folate value = bad SID..... but don't worry .. this is very common with EPI).... but.... before automatically prescribing antibiotics.... the more recent protocol is to see if you can get it under good control (FYI ALL EPI dogs have SID ... small intestinal dysbiosis) with the right diet, enzymes, proper B12 AND try pre+probiotics.... this will take longer to get in check vs. using antibiotics, but in the long run, if you can improve the gut flora without using antibiotics, you are better off. Unfortunately, this doesn't always work, and sometimes, you just have to do the antibiotics (Tylan is the antibiotic of choice for SID in EPI dogs)

Re: Is it really EPI

Posted: 30 Dec 2018, 17:18
by Barb
Hello, and welcome! And as everyone else has said, "Yes, it really is EPI." But you are off to a good start and things are improving already. Some dogs have a harder time finding balance, but Gus seems to have adjusted quite well.

And I second Olesia's "Yikes!" on the B12. He definitely needs to be in the 600+ range, so getting him B12 supplementation is really important. Many of us use the Pet Factor capsules from Wonderlabs or you can get injections from your vet.

Also, many of us also use the enzymes from Enzyme Diane ......if you are finding the enzymes you are using too pricey. She is able to provide us with Pancreatin at a much lower cost than the commercial products and give us an excellent product at the same time. She is a member here and you can visit her website or call her directly if you wish.

Ask any questions you have. It sounds like Gus is one of the fortunate ones who has adjusted quickly.


Re: Is it really EPI

Posted: 30 Dec 2018, 21:17
by Madelon
Hi and welcome to our EPI family!

There are four cornerstones to managing EPI: Enzymes (most of use EnzymeDiane - her enzymes are 1/3 of the cost of the enzymes from the vet - your wallet will thank you! The recommended starting dose is 1tsp per cup of kibble, mix with 2-3oz luke warm water, mix in kibble and incubate 20-30 minutes before serving); B12 (your dog's B12 is VERY low - EPI dogs need B12 supplementing for life as they need their B12 on the higher side of normal - you can either do shots or use WonderLabs Pet Factor B12 pills); Antibiotics (for SID which it sounds like your pup has - we recommend a 45 day course of Tylan and then slowly wean off - Metronidazole can have bad neurological side effects); Food (we recommend grain free with 4% fiber or less).

Keep a detailed journal of everything that goes in and everything that comes out - I highly recommend taking pictures of the poop. Don't worry we've all been where you are and we are all here to help guide you!

Re: Is it really EPI

Posted: 31 Dec 2018, 03:33
by Jean

due to time differences I only just saw the b12, that is really LOW, the recommendation is injections weekly for I think the protocol is 6 weeks, but I would go for more

Re: Is it really EPI

Posted: 31 Dec 2018, 19:21
by TerryBin
Welcome.....! And Happy New Year! Now that EPI has been dx and you have a treatment plan it will be a good new year! Every dog is different and some need time to even things out and start to get better poop and gain weight and others do it more quickly. We have 2 dogs with EPI and they recovered quickly and gained back their lost weight (about 15 lbs each) in about 5 weeks....others can take months to gain that much back. Sounds like you are on the right track, though I agree with everyone that you need to do B12 supplementation. Keep us posted.