GSD 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.
MICHAELASWITCH
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Country: United States
State: Missouri

GSD with EPI

Post by MICHAELASWITCH » 21 Mar 2019, 22:47

Hello Everyone. I am new to this EPI world with my 1 year old German Shepherd dog. He was diagnosed about 2 months ago with EPI at (11 months) and seems to be doing fine. We did b12 shots for about 6 weeks along with pancreatic enzyme powder. He is still currently on the powder 3 times a day. My concern is, is that we went to the vet the other day and he hasn't gained any weight back, but he hasn't lost any either (which I guess is a positive). We've switched over to a new food recently per the vet and more meals a day hoping that it will help him gain some weight. He has always has solid stools since starting on the powder, except one night he had diarrhea. He acts fine and his energy level is so much higher than it was before this diagnosis. I'm just concerned because he's not gaining weight, and I almost feel at a loss. We've done several things. Has anyone else struggled with this? How long did it take for your dog to gain weight back? I'm wondering if we shouldn't go back on the B12 shots? Any help or insight will be greatly appreciated. Our vet has been awesome to be of help, but as a dog momma I just feel lost because I don't know a lot about it.

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

Re: GSD with EPI

Post by Jean » 22 Mar 2019, 03:59

good morning from the UK

The answer is YES, we struggled for a long time

I wonder, can you be more specific

what food are you feeding

what enzymes are you using, and what ratio to food

you say you are giving enzymes three times per day, is all food, no matter when, enzymed,

the b12 regime at the start is so important and I would say yes to the question you raised, you could always try

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

used widely by our members

are there any tummy rumbles

you say you have done several things can you explain

and finally, what are your names ?

keep a diary on everything you do

ask away

a question not asked is an opportunity lost

Jeanx
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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Riley's Mom
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Country: United States
State: Virginia

Re: GSD with EPI

Post by Riley's Mom » 22 Mar 2019, 09:02

Good morning and welcome to the forum
Jean has asked some good questions that will help us be more specific with our answers.

As far as the weight gain, for some dogs it happens right away, some it takes a bit longer. It is suggested to feed your pup 150% of the recommendation on the dog food bag for his goal weight, not his current weight. You should break this up into 3-4 smaller meals per day. If you work obviously this is more challenging....give breakfast, if you can scoot home for lunch that is great then dinner and a small meal before bed. If lunch is not possible, then you might have to go with 3 meals per day. Stopping the weight loss is huge, so good start!

Enzymes have to be on everything he eats from now on.....they are measured not by the size of the dog, but the amount of food in the meal. The suggested starting point is 1 level teaspoon per cup of food. It also needs to be incubated in broth or water. This is to prevent mouth sores as the enzymes can be a bit caustic. I was not given this instruction at the beginning and it was not on the bottle either :( To incubate, mix the measured amount of enzymes in tepid broth or water with food and let sit for 15-20 minuets. Then stir and serve.

As far as the B12, good for your vet to start him on the injections. The protocol from TAMU is to give 1x per week x 6 weeks then retest. From there, a plan is made to supplement moving forward. Over 80% of EPI dogs can't maintain B12 levels without supplementation, low B12 can hinder weight gain among other problems. Lots of forum members use injections, but many use B12 with intrinsic factor from a company called Wonderlabs. (Some EPI dogs no longer produce intrinsic factor, some do....it is best if giving an oral B12 to include the intrinsic factor because we don't know which needs it to be able to properly process the B12. )
Whichever way you and your vet choose to go, make sure you make a plan for B12 with him/her.
I started out with injections my vet taught me to give at home. Then I moved to the B12 with intrinsic factor from Wonderlabs. My girl is super picky and I open and sprinkle the capsule over the broth as I incubate and she never even notices.

If you haven't already, start a log or journal to keep track of things. It will be helpful!

Glad you found us, ask questions as you have them. I know it can be a bit overwhelming at the beginning, I promise it will become part of your routine.
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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Miss Maddie Moo
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Country: United Kingdom - England

Re: GSD with EPI

Post by Miss Maddie Moo » 22 Mar 2019, 09:06

Hello on the assumption that you are using the correct enzymes and the correct ratio to food i would guess that the B12 is the big factor here this happened to my gal she had good poops but the weight just didn't increase all because the B12 was missing we need to ensure the B12 levels are in excess of 600 and maintained that way for life as the pills were hard to get here in the Uk she had shots every week for nearly 9 months i then imported the B12 as Jean has posted from the states i then monitored her B12 levels to ensure they stayed above 600 via testing once i swooped to the pills.So b12 really can be as important as the enzymes.
Maddie DX April 2011 along with low B12 she was feed with a low fibre food below 3% , fat was not restricted ( she wasnt good on pea based foods ) She initially had a course of B12 shots weekly over a period of 6 months and then we used the B12 pills from Chemeyes in the UK . We used Panzym and slowly had to increase the dose as she aged when she was first DX she was 23kg but she gained weight quickly and got back to 33 kg .
Maddie gained her angel wings in Jan 2018 at the age of 10 to a condition unrelated to EPI.
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Barb
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Posts: 488
Country: United States
State: New Jersey

Re: GSD with EPI

Post by Barb » 22 Mar 2019, 12:23

Hello. A warm welcome to you and your pup! Everyone has given excellent suggestions and if you answer the questions asked, we can give you more specific advice.

With regard to the weight, we had a very slow gainer. Your pup reminds me a lot of him. Kolby was diagnosed at 1 year and once we got everything balanced (the food was the hardest for us), he stopped losing weight, but did not gain. Only when we got the B12 level up, using the pills with Intrinsic Factor from Wonderlabs, did he start to gain. But it took him a full year to get to his target weight, where he has been for 9 years. Not all dogs take this long. Some gain weight right away. But for us, like others have said, it was the B12 that made the final difference after we had everthing else in place.

Don't be discouraged. This takes time and adjustment. You are doing a good job. Ask all the questions you have.

Barb

MICHAELASWITCH
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Posts: 8
Country: United States
State: Missouri

Re: GSD with EPI

Post by MICHAELASWITCH » 22 Mar 2019, 19:01

Thank you all for the replys and kind gestures. My name is Michaela and my puppers name is Shaq. He was eating Zignature, but the vet had us switched over to science diet recently and he is using Pancreplus enzyme medication. He gets three meals a day starting at 9Am, 1Pm, and 5pm, and all of them contain the medication 3tsp each meal, and we always let it sit for 15 min. He does have some rumbling in the stomach but not often. Occasionally he will have gas too, however it's no where near what it was before starting the medication, as most of you may know. The vet wanted us to start Pepcid as well due to some tummy rumbling, and also very rarely throwing up mucus. We have had many labs drawn for diabetes, kidney issues, liver, or any other serious conditions that could be hindering weight gain, but they all came back great-no issues. His pancreatic function was pretty low when he was diagnosed so I'm sure it's just going to take some time to get everything fully back to function. Are any of you continuously doing b12 shots or medictation (shaq did shots), or was it just a one time thing? Shaq did them for 6 weeks-once a week.

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jilbert57
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Country: United States
State: Washington

Re: GSD with EPI

Post by jilbert57 » 22 Mar 2019, 20:19

Hi and welcome. Which Science Diet is your pup on? This brand usually contains grain which does not set well with most EPI pets. This may be why you are hearing tummy rumblings. Also, please check out the list of recalled Hills foods and some Science Diet foods just to err on the side of caution:

https://www.dogfoodadvisor.com/dog-food ... l-expands/
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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Madelon
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Location: Nashville, TN
Country: United States
State: Tennessee
Pet name: Doc

Re: GSD with EPI

Post by Madelon » 22 Mar 2019, 20:54

Hi Michaela and welcome to our EPI family. A lot of vets are unfamiliar with the current protocol for properly managing EPI. There are four cornerstones to properly managing EPI:

1 - Enzymes (the recommended starting dose is 1 level teaspoon per cup of kibble; most of us get our enzymes from Enzyme Diane [www.enzymediane.com] - her enzymes are significantly less than the enzymes you get from the vet - they are shipped directly to you and do not require a prescription). You said you were giving 3tsp per meal - are you feeding 3 cups at a time?

2 - B12 (most EPI dogs have low B12 at diagnosis or will develop it - EPI dogs need their B12 on the higher side of normal 600+; supplementing B12 is FOR LIFE with these dogs - you just have to find the right maintenance dose for your dog; a lot of us after following the shot protocol use WonderLabs Pet Factor B12 pills (www.wonderlabs.com). What was your dog's B12 level at diagnosis? What was the TLI score?

3 - Antibiotics (a lot of EPI dogs are dealing with SID at diagnosis - we recommend when first diagnosing trying the proper dosage of enzymes, food and B12 for two weeks to see if the gut will restore itself - if it does not then we recommend a course of Tylan antibiotics for 45 days)

4 - Food (we recommend grain free with 4% fiber or less - grains and fiber can interfere with the efficacy of the enzymes; we recommend feeding 150% of the food for the weight your dog should be but in smaller meals throughout the day [3-4 meals]; I would not feed more than 2 cups at a time).

Keep a detailed log of everything you give and everything that comes out so you know what works and what doesn't. If you're dog is not gaining weight - some take longer than others - it could be because the B12 is low as you are no longer supplementing; you may also be dealing with SID based on the symptoms and the food may not be the right one.

EPI can be overwhelming and even frustrating in the beginning but we are all here to help guide you along the way.
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

MICHAELASWITCH
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Posts: 8
Country: United States
State: Missouri

Re: GSD with EPI

Post by MICHAELASWITCH » 22 Mar 2019, 23:52

What kind of food do you guys recommend?

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

Re: GSD with EPI

Post by Riley's Mom » 23 Mar 2019, 00:23

Michaela
If you go to the home page and hover over Managing EPI, in the drop down you will see Dog Food Options. The foods listed are by no means the only ones that would work, but there are a lot of options to get you started.
Many EPI dogs can't handle chicken (but not all because mine can eat it), look for a food that is grain free and 4% or less of fiber and try to find one that doesn't have peas listed high in the ingredients or too many times. Many EPI dogs don't do well with too many peas.
I would suggest for you to buy the smallest bag and give it a try for a week or two. Keep careful notes on how your dog responds. 1 level tsp of enzymes per cup of food (mix in water or broth and let incubate). Watch how the poops are and listen for tummy rumbles and gas. Loose poop and gas/tummy rumbles could be signs the food isn't just right. Some dogs are very tolerant and a food is found quickly, some are harder to find that just right food. That's why I suggested buying a small bag to begin with. Then if it doesn't suit, you aren't out too much.
Def look into EnzymeDiane.com. 1/3 the price, same quality as the name brands. She is basically a generic option. I wasn't sure how I was going to afford my girl until I found Diane.
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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