New to EPI

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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Linda53
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Posts: 7
Country: United States
State: Arizona

Re: New to EPI

Post by Linda53 » 16 Jan 2019, 09:51

Ok. I will use less enzyme and see how that goes. I started the SE initially because of the liquid stool but now I am adding it to give her prebiotics because I thought that would be beneficial.

Linda
Pearl (Pembroke Corgi) was born on Feb. 28 2017 and tested for EPI Jan. 2019 with results of TLI-3,
B12 -178, and Folate-12.9. She is on a raw diet of Small Batch Pet mixture of freezed dry and frozen raw turkey formula. She is getting 150% of what's suggested for her normal weight and I divide that into 4 meals each day. Each meal is mixed with 1/2 teas. of EnzymeDiane 6x and 1 meal/day mixed with 1/4 capsule of Wonderlabs Pet Factors B12.

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Olesia711
Founder & Research Director
Posts: 3858
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: New to EPI

Post by Olesia711 » 16 Jan 2019, 10:57

Hi Linda and so nice to hear the good report about Pearl.....

Regarding the B12..... i personally have noticed (with my non-EPI dog who was low in B12) that it takes about 3 weeks to see improvement.
Also... Pearl is about 30 lbs.... with the Pet Factor B12 capsule... and her low B12 value.... she should be getting more than 1/4 capsule daily. if you are uncomfortable giving her a whole capsule (which is a pinch more than what she technically needs), then i would at least increase the Pet Factor B12 capsule dose to 1/2 capsule daily. A proper B12 levels is like the underpinning to good health... sometimes you won't even see any low B12 "symptoms", but instead what you will notice is that optimal improvement is just not happening as it should.

Also.... interestingly, i just read today a research report (on humans) that in years past they used to recommend B12 shots for B12 deficiency, but recent research is now indicating that high dose (1000mcg) of oral B12 often works even better than B12 shots. We have also noticed this phenomenon in "some" of our EPI dogs... but actual clinical studies have not been down with dogs to prove this. Maybe someday.

Because Pearl's TLI test results came back at 3... she is a hair's breath away from being clinically EPI. Treating her as if she has EPI is what is recommended, which you are doing with great results.... but as mentioned earlier in the thread.... it is still advisable to do another TLI test to confirm that this is EPI. Some say re-test within 1 month, some say 3 months, i say even 6 months.... simply because we have had dogs here on the forum over the years that start out with the symptoms/signs, but when tested, clinically do not have EPI.... however... a year or two later... when re-tested again in sheer frustration... the dog by then is clinically EPI. So just as long as you re-test at some point that would be very important.

Also.. the Folate score.... please do not pay attention to this... they no longer use it as an indication for SID as it is not accurate. Folate test results such as Culturing, Counting bacterial numbers, and Duodenal juice collection all have majors flaws in their technique rendering them inaccurate indications of SID/SIBO. Recent studies have determined that it is not the number of bacteria but rather “the type of flora and/or how the host and flora interact that are more important than numbers.” If in the end, Pearl does have clinical EPI , then she will also have SID... whether or not the Folate score is high or normal AND whether or not she shows any SID symptoms/signs..... The objective now is to treat SID if it is not well controlled (in other words you are seeing repeated signs of SID such as: repeated yellowish-coloring to the stools, loose stools, gelatinous stool coating, flatulence, lack of appetite, stomach noises, low or low normal B12 then treat for possible secondary SID/SIBO.

The new recommendation for SID is to 1st try prebiotics ...and this is what you are already doing with slippery elm :)... if this helps but not enough, then try prebiotics with probiotics.... if this doesn't improve things for the better and the bad stools are out of control.... THEN the next step is antibiotics. Somewhere in the mix... you also try to better manage the SID along with the EPI via food composition adjustments.

Anyway.. all this to say, you are doing a great job!!! Keep up the good work and i am looking forward to hearing more good updates about Pearl... who by the way is ADORABLE!!!!!
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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