GSD with EPI not responding to meds

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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Jean
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Posts: 1707
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: GSD with EPI not responding to meds

Post by Jean » 13 Mar 2019, 05:32

hi there

we are always happy to help, a lot of us have many years of dealing with EPI, and its ups and downs, and we have had many downs, sadly its patience and determination that got me through, and I am not patient !

make a list of what you want to bring up with the vets, and ask can you record the consultation, we did this many times, and its a 12 hr fasting test for cTLI and cobalamin/folate

we dont have Enzyme Diane over here, but I know her products are very highly rated, and lets face it, costs are way up there with EPI, I saved £4.000 a year by changing enzmes , I know, its incredible

Jeanx
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

Barb
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Posts: 918
Country: United States
State: New Jersey

Re: GSD with EPI not responding to meds

Post by Barb » 13 Mar 2019, 17:33

I also have used Diane's enzymes for many years with very good results and very significant savings. I'll be anxious to hear what your vet says and to get the results of your retesting. There are often many pieces to the EPI puzzle.....looking for the missing pieces can be challenging......but there are lots of people to help you look.

Barb

sgcavasos
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Posts: 8
Country: United States
State: New Mexico

Re: GSD with EPI not responding to meds

Post by sgcavasos » 13 Mar 2019, 23:00

Hi everyone! I really appreciate everyone's advice, it's been a huge help! I'm hoping it's nothing major and just adjusting her enzymes will do the trick. Do you need a prescription to order from Enzyme Diane? Either way, I think I'm going to switch her to those once we get all of her results back. I'll post an update in a few days once we get her results back!

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Jean
Forum Director
Posts: 1707
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: GSD with EPI not responding to meds

Post by Jean » 14 Mar 2019, 04:52

hi

you do not need a prescription to order from Diane

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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Riley's Mom
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Posts: 203
Country: United States
State: Virginia

Re: GSD with EPI not responding to meds

Post by Riley's Mom » 14 Mar 2019, 17:28

Hi and welcome to the forum
I'm sorry you have had a setback. As several people have said, EPI can be a bit of a roller coaster.....but we're here to hopefully help you figure things out!
Did your vet completely stop all B12 supplementation? B12 is vital to managing EPI. Most EPI dogs can not maintain their B12 levels without help, either B12 injections or pills with intrinsic factor (these can be found from a company called Wonderlabs).
So, low B12 could be a part of your problem.
Typically, we suggest to start the enzyme dose at 1 level tsp per cup of food given. As a dog stabilizes sometimes you can reduce the amount of enzymes given. But this is not true with every dog. And as was said earlier, as many dogs age, they need a bit more to do the trick. My girl began to have return of symptoms when she turned 8, I increased by 1/4 tsp and we are back on track.
If you could give us some information about how you prepare the food, that might also help.
Do you have the numbers from the initial testing?
It could be something as simple as needing a change in food. Some of these pups are very sensitive.
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.

sgcavasos
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Posts: 8
Country: United States
State: New Mexico

Re: GSD with EPI not responding to meds

Post by sgcavasos » 14 Mar 2019, 19:25

Hi everyone!

I just got back from the vet with Xiva, the poor thing had to stay there all day. We ended up doing a complete work-up on her. The in house bloodwork came back fine. The vet also did x-rays while she was there and said that her liver is exceptionally small given her size. So in addition to the GI panel, she ran a test to check her liver functionality and to check for Addison's disease based on the signs that she saw in her. She said it will likely take several days to get all the results back. She's hopeful it's just the EPI causing her problems, but she also told me to be prepared in case it comes back to be Addison's disease or a liver problem. It was a lot to take in today, but I'm trying to be optimistic that there's nothing else major going on. I'll post an update once we get all the results back.

Barb
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Posts: 918
Country: United States
State: New Jersey

Re: GSD with EPI not responding to meds

Post by Barb » 14 Mar 2019, 21:21

It is always nerve wracking to be waiting...and never easy. Let us know when you get the results. Keeping our fingers crossed that there are no serious issues.

Barb

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Madelon
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Location: Nashville, TN
Country: United States
State: Tennessee
Pet name: Doc

Re: GSD with EPI not responding to meds

Post by Madelon » 17 Mar 2019, 11:33

Hi there and welcome to our EPI family. Sorry I'm late chiming in. The first thing that popped out at me was the dosing of enzymes and B12. EPI dogs need their B12 in the higher range of normal 600+ and supplementing is for LIFE. Once you get the B12 levels ups after the initial protocol with shots, most of us switch to WonderLabs Pet Factor B12 pills - they have intrinsic factor which helps with absorbing B12. Unfortunately stopping B12 supplementing is not an option for these dogs as they are unable to maintain their B12 without supplementing. You need to find the maintenance dose of B12 your dog needs - some need more than others. Was the B12 tested with this latest blood work?

EnzymeDiane is WONDERFUL. I've been using her enzymes for 4 years - I wouldn't have been able to afford to keep my boy without her enzymes. The recommended dosing for enzymes is 1tsp per cup of kibble - unfortunately the big manufacturers don't have the correct information on their bottles. So if you are feeding 1 1/4 cups of food you would use 1 1/4 tsp enzymes, mix in luke warm water, mix in kibble and sit 20-30 minutes before feeding.

Please feel free to print out anything from our website to share with your vet. Let us know when you get the results back on the other tests - hopefully it's nothing major - paws crossed.
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.

sgcavasos
Member
Posts: 8
Country: United States
State: New Mexico

Re: GSD with EPI not responding to meds

Post by sgcavasos » 19 Mar 2019, 08:45

We got Xiva's test results back yesterday. Her B12 is low, which I kind of figured would be the case. Her liver is functioning just fine despite its small size! I was so worried we were going to have to put her through that big surgery to try and fix it. Her cortisol levels are low so the vet still isn't ruling out Addison's disease. We are going to repeat that bloodwork in a few weeks and go from there. Right now she wants to focus on getting her leveled out with her enzymes and the B12 to see if we can get some weight back on her. She ended up dropping almost 13lbs since the middle of February. The vet mentioned switching her to a low-fat prescription food. I'm not really sure how I feel about that because I looked up the food that she told me about and it seems like it's not very good. Has anybody else ever tried any of those prescription foods? I'm looking at other low-fat alternatives for her or something that may be easier for her to digest. Does anyone have any suggestions?

I really appreciate everyone's feedback and support through this, it made this easier being able to reach out to people that have dealt with this before!

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Patsy
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Country: United Kingdom - England

Re: GSD with EPI not responding to meds

Post by Patsy » 19 Mar 2019, 16:47

Hello Sharon, sorry things went downhill.
Obviously the enzyme amount has to be balanced, but in eight years with an epi dog, I found the culprit every single time she went sloppy was the sibo/Sid infection . Every time it cleared up with antibiotics.
The idea these days is that , unlike pancreatitis, you do not need a low fat food. You are already providing enough of the enzyme amount yourself ! Your vet may not have read this.
You do want to put weight on, and in a grain free diet, the fat provides calories. And using extra food, of course, ideally 50% more, spreading out into maybe three meals.
I am across the Atlantic, so I don’t know your food choices, but loads of people here can advise.
Springer spaniel Marti had Epi, PLE , MMM just to confuse me. She lived till 12yrs, chubby and happy despite eight years of epi.
Capsule enzymes suited her best. B12 supplements made her into a new dog!
After a cocker with PLN kidney disease, I now have two healthy rescues, a lively, suicidal , small ginger terrier, adopted with pneumonia, and gum disease needing nearly all his teeth out, and a fluffy grey toy poodle/terrier from Greece.

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