2 yr old Sheltie diagnosed with 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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virtualist
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Location: Landenberg
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State: Pennsylvania

2 yr old Sheltie diagnosed with EPI

Post by virtualist » 08 Jan 2019, 15:34

This is such a great forum and I have been reading many posts. They are so helpful to me. My name is Sara and my Sheltie is Sophie Rose, 2 and a half years old. She is a tricolor and a beautiful puppy with a wonderful personality. We have another Sheltie, Katie, who is 3 and a half years old and is a miniature. Sophie Rose is our 8th Sheltie and our first with EPI.

Sophie was some overweight in September at 31.5 lbs but in November had lost 3 lbs . Then in December she had lost another lb. Our groomer told us in December that she had diarrhea while being washed and had it 4 times. We watched her and saw that it was yellow and very soft like mashed potatoes (sorry for the image!). I took her to the vet and she had lost another pound, now down 5 lbs to 26.6. With the symptoms and my descriptions, our vet immediately diagnosed EPI and explained that it was terminal but treatable. We had a blood test and fecal test at the vet's which showed low pancreatic enzymes. We then sent a blood test to Texas A&M for the definitive EPI test which came back positive. Her B12 is 389 and her enzymes are 1.75.

We started her on Dec. 20 on Royal Canin gastrointestinal low fat dry food and then on Dec 26 she started on the enzyme PancreaPowder Plus 1 t. per 1 c. food. Our vet suggested using wet food. She vomited it the first day and with a call to the vet, she advised using 1/4 t. and transitioning Sophie up to the 1 t. This was very successful and she was eating 4 times a day about 3/4 c.each time.

She was on an antibiotic, a pill, for 2 weeks and then as per your posts, I requested that she be on Tylan which she is at 1/8 t. 3X daily. Our vet also cut her from 4 meals to 3 meals daily. She eats about 3 c. daily, 3/4 c. of wet Royal Canin and 1/4 c. of the dry mixed in with the wet. We also have (Because of reading your posts) a prebiotic/probiotic combo, Entero TruBenefits, one scoop daily which is 1 t. We have not started it yet because of starting the new antibiotic first. I will get it started this week.

Sophie is hungry and eats the food. Her bm's are now dark brown and formed....some soft at times. But a great improvement from the yellow soft mounds. She has never changed personality during these months and very playful with Katie and such a sweet dog!

I do apologize for the length of this. I have seen though that the more info that people have, the better the posts.

My questions: The vet said to incubate 15" then add the tylan and entero. So is it ok to have all three together?
I forgot to add that Sophie has gained 1 lb. Should I be watching her weight and her "poop" mainly to see if things are working? Out vet said to wait on the B12 but I read your saying that EPI dogs should be in the 500-600 range and Sophie is 389. Do pills work? Does anyone with an EPI dog ever leave him/her in a caretaker's care? I don't trust anyone to do her food correctly. Last question: I get the wet food slightly warm, add 3/4 t. enzyme, add 1/4 c of dry food, add the 1/4 t. of enzyme, incubate for 15", add the 1/8 t. of Tylan, and then feed her. Does that sound ok?

Thank you in advance. I promise not to be so wordy after this. We cannot lose this dear, sweet puppy and I just hope this works. I hope to hear from some of you. Sara

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Shirl D.
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Re: 2 yr old Sheltie diagnosed with EPI

Post by Shirl D. » 08 Jan 2019, 21:57

Hi Sara, I'm Shirl, and I have a tri-color EPI sheltie, too! My Pixie is now 12, and was diagnosed when she was about 3, I think. She was 5 when we got her, but wasn't stable. We got her stable and her EPI has been well controlled for almost 8 years now. There is absolutely no reason you should lose your girl to EPI. It sounds like you've already got things very well under control. To answer your questions,
- the usual recommendation is to give the probiotics/prebiotics separately from antibiotics. You said you are giving her the tylan 3 times a day. Texas A&M recommends twice a day. So, I would suggest giving the tylan at her first and last meals, and give the Entero at the middle meal of the day.
- Yes, watching the poop and keeping an eye on her weight are great ways to monitor how she is doing. If either one of those things doesn't look right, you know something needs to be adjusted.
- Do not wait on the B12. Pills work if they have the Intrinsic Factor in them. There are a limited amount of B12 pills that fit that bill. Wonderlabs Trinfac B is one product that I know a lot of EPI folks have used successfully. I give Pixie injections at home, just because that's what I started with and I never switched. If it ain't broke, don't fix it! lol
- There are lots of EPI people who have left their dogs with other caretakers for different reasons. There are also lots of different ways that people make sure their EPI dogs get taken care of properly, from pre-dosing enzymes with dry food, to prepping and freezing food, to leaving detailed notes. I have used one pet sitter a few times, and I left detailed notes and also had the woman come over at a meal time before we left so she could see exactly how it was prepared and ask any questions. Everything went really well for us. Whew!
- Your food prep routine sounds pretty good. You might try reducing the enzymes just a tiny bit since you feed a lot of wet food, as it usually needs a little less enzymes than dry. If you want to try to reduce, reduce it by just 1/8 tsp at a time and keep an eye on the poops to make sure there aren't any negative effects. The wet food needs to be warmed to room temperature only if it's cold (like if it was in the refrigerator). If it's already room temperature it doesn't need to be warmed more. We feed mostly canned, too, with just a little kibble thrown in. I mix all the enzymes into the wet food, then add the kibble and mix it well. The incubating time is important as the enzymes can cause mouth sores, and the incubation time helps prevent that.
I wanted to mention a couple things about the food. Unless there is another medical problem, there is usually no reason for a special veterinary diet. In fact, many EPI dogs do not do well on these diets. The Royal Canin Gastrointestinal food is usually not right for our dogs. The first ingredient is rice, which most EPI dogs cannot handle at all. This could be one reason her poops continue to be soft at times. The canned food doesn't have rice as the first ingredient, but it has rice flour as the 3rd ingredient. My suggestion would be to try to switch to a different food that is low in fiber, does not contain rice, and has no or very little pea. Less than 4% fiber. Most grain-free foods have appropriate fiber. Make sure it has protein sourced from quality ingredients (like meat, not by-products or peas or legumes). There is also no reason the food needs to be low fat.
You might also want to look into getting enzymes from Enzyme Diane. There is absolutely nothing wrong with the PancreaPowder Plus you are using, but Enzyme Diane’s product is comparable and could save you a lot of money.
Good luck, keep asking questions, and keep us posted!

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Jean
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Pet name: Kara, lost 10th May 2019
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Re: 2 yr old Sheltie diagnosed with EPI

Post by Jean » 09 Jan 2019, 03:50

hi there from the UK you struck lucky with Shirl, Pixie is a credit to her

i too think the prescription food is unessessary, our dogs also seem to not tolerate chicken or its fats, apart from anything, its expensive

so keep a journal and record everything, and let us know how it goes

and thank you for your kind comments on our website

Jean
My name is Jean we live in Liverpool in Uk

I am the Forum Director which I am very proud of

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: 2 yr old Sheltie diagnosed with EPI

Post by jilbert57 » 09 Jan 2019, 09:58

You are in great hands with Shirl and Jean. I just want to say you are great to have done research on this site to be armed with so much great information. Welcome to the site.
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.

Barb
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Re: 2 yr old Sheltie diagnosed with EPI

Post by Barb » 09 Jan 2019, 17:36

Hi Sara,

A very warm welcome to you and Sophie. You have done your homework and are off to a good start helping Sophie to good health.You are doing an excellent job.

Shirl and Jean have given you excellent advice. I would just endorse keeping a log/journal to record everything you give Sophie each day and the resulting poos. This helps you to see what works and what doesn't. It also helps you to see patterns that you might miss if they weren't written down. It really helped us with Kolby when he was diagnosed. I still refer back to it.

We have used Trinfac B by Wonderlabs to supplement Kolby's B12 for many years. We did injections at home for quite a while, but have found that the Wonderlabs pills keep him stable. We also use Enzyme Diane's enzymes and they have saved us so much $$$. Kolby was diagnosed when he was just a year old, and he is now 9 and 3/4, so we have used a lot of enzymes.

Welcome again. Please ask any questions you may have. The beginning stage is the hardest while you are trying to get everything balanced. Try not to be overwhelmed.

Barb

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Stacie & Dizzy
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Re: 2 yr old Sheltie diagnosed with EPI

Post by Stacie & Dizzy » 09 Jan 2019, 18:46

Welcome to the group. Sounds like you are on the right track. I’m so glad you found this site early on. It was months into diagnosis before I learned all this great information. I also use the b12 pill from wonderlabs and enzymes from Diane. Please keep us updated on your girl.
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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Madelon
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Re: 2 yr old Sheltie diagnosed with EPI

Post by Madelon » 09 Jan 2019, 21:00

Hi and welcome to our EPI family. You've been given great advice from our very experienced members so I won't confuse thing by adding more. I will, however, say that B12 is critical to properly managing EPI. The WonderLabs Pet Factor B12 pills seem to work for most of our dogs - they have intrinsic factor which helps with B12 absorption. Keep a detailed journal and pictures of poop helps too. Sounds like you have a great vet and a good handle on things.
Madelon, owned by DOC. DOC dx EPI 5/2015 = TLI < .4, B12 406; Folate >24. DOC taught me so much and together we battled and overcame EPI, food sensitivies, environmental allergies but we lost the cancer battle. DOC was dx with hemangiosarcoma 5/2022 and crossed the rainbow bridge July 24, 2022. He is and always will be the love of my life, my soulmate, my heart dog.

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virtualist
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Re: 2 yr old Sheltie diagnosed with EPI

Post by virtualist » 10 Jan 2019, 11:31

You are such a wonderful group! Thank you for your replies which have been a great help. I did start a diary almost immediately because I wanted to document my calls to the vet and her instructions. It naturally went to keeping track of all the details of Sophie's feedings etc. So I do have that covered. I'm a retired teacher after 40 years and I am used to documenting. :D

I have changed to the Tylan at morning and night feedings and the Entero at the mid-day feeding. Thank you for that advice. I truly appreciate the advice about caretakers. I will follow that advice. We don't leave the dogs often but there are times when it is necessary. I got on the EnzymeDiane site but didn't know which product to look at. I don't know which strength would compare to the PancreaPowder Plus. I am going to research the dog food available and particularly look at the foods used by people on the forum. Is it bad to change foods this early in the treatment phase? Also, should I be dissolving the enzyme in 1-2 ozs of warm water before adding it to the wet food?

So Sophie now is getting 3 meals a day, with 3/4 c. of wet food and 1/4 c. of dry plus 3/4 t. of enzymes mixed in the wet food first then I add the dry to that mixture. Then it sets for 15". I then add the 1/8 t. of Tylan, mix it up, and give it to her. At noon, the Tylan is changed to the Entero which I am now giving 1/4 t. working up to 1 t. She is hungry and eats it all immediately and she is hungry after. Should I feed her more? My vet said to do the 3 meals with ~1 c. of food each time. She is very playful and active, We have been so fortunate that she hasn't changed personality.

Has anyone used EpiTreats by Dechra? I wondered if there are any treats available for EPI dogs.

I also believe that I should contact the breeder from whom we got Sophie just as a head up? I thought it would be fair to her to know that Sophie has EPI? And I also feel I should contact my vet before getting the WonderLab B12 pills. She has been so good with us.

Again, thank you all for your support and excellent posts. They are appreciated. Here I am wordy again!!

Sara

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jilbert57
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Re: 2 yr old Sheltie diagnosed with EPI

Post by jilbert57 » 10 Jan 2019, 12:14

How much underweight is she?
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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virtualist
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Location: Landenberg
Country: United States
State: Pennsylvania

Re: 2 yr old Sheltie diagnosed with EPI

Post by virtualist » 10 Jan 2019, 18:21

Hello, thanks for the question.

She isn't technically underweight. She was such a big eater that she weighed 30.5 lbs in September. Our vet wanted her to be around 25 lbs. She is really a medium sized Sheltie where Katie, the little one, is a miniature. So Sophie weighed 28.5 the end of November. I knew then that there was no reason that I was aware of that she should have lost weight. The 20th of December. she weighed 26.6. That was when we were aware of the yellow soft bowel movements. I insisted upon taking her to the vet and she immediately said that Sophie was presenting as a classic EPI dog and we started the testing.

So she today weighed on our scales 29 lbs. We need to take her to the vet's to check on their scales. Long answer but she is gaining back the weight and it's fine with me for her to be over 25 lbs.

Sara

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