Managing EPI need Bay Area vet

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.
Jes

Managing EPI need Bay Area vet

Post by Jes » 21 May 2019, 10:01

Hello, our 14 year old dachshund Rusty has had EPI for several years. He has done very well with enzymes. He was diagnosed with cushings about 9 months ago and takes Vetoryl 10 mg twice a day. He also now has large lump on his throat that is not a fatty tumor (too close to arteries to operate) and vet sees a growth where his prostate would be (he was neutered before puberty) and noted something on his spleen. We did not chose to have further invasive biopsies. Rusty also started peeing tiny bits frequently and taking a long time (but not much pee would come out).

Over the last 6 months, Rusty has had a revolving door of symptoms such as vomiting, "belching" up water, not eating, fatigue, weight loss. He would avoid any food with enzymes (we had used enzymes from enzyme Diane for years and allow to incubate for 20 minutes). We stopped enzymes to see if he would eat and he did eat better. At that point his symptoms were a mess, some days ok others he would vomit, he seemed to have very small diameter poops and difficulty going. Vet prescribed a course of antibiotics (metronidazole). Rusty reacted well and was back to his playful, attentive self.

He still resisted any food with enzymes mixed in. We got PanaKare enzymes from vet so I could just give Rusty a pill (could only be done by "pilling him"). He became very finicky and we started offering him anything he would eat like canned chicken. Rusty weighs about 13 pounds now. His healthy weight is about 17 pounds. It seemed like when he got the PanaKare he would vomit. We backed off enzymes again and Rusty seemed more stable. He has been eating but no enzymes are on board and we see weight loss.

Our vet has told us Rusty has cancer. He prescribed gabapentin 50 mg 2 times a day. Rusty has been in good spirits, attentive and playful, he moves slower than he used to. We do not see pain symptoms such as shaking, panting or refusal to move.

This has gotten very complicated and I want to make sure we are addressing medical needs in a way that keeps Rusty comfortable and stress-free. If cancer is slow moving, he needs nutrition now to continue living his best life.

Does anyone know of a San Francisco bay area (East bay ideal) vet who is good with the management of EPI and other conditions?

Thank you kindly EPIdog caregivers,
Jessica

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jilbert57
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Posts: 2092
Country: United States
State: Washington

Re: Managing EPI need Bay Area vet

Post by jilbert57 » 21 May 2019, 10:35

Hi Jessica, It sounds like you are a wonderful dog mom to Rusty. It is hard when they have a lot of different conditions and symptoms for sure. How are the poops when you don't use enzymes? I was thinking you could try Creon, they are enteric coated enzymes you sprinkle on food and feed. I believe they do not have an odor.
Here is a list of recommended vets:

https://epi4dogs.com/recommended-vets/

Hope this helps. Good luck.
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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Miss Maddie Moo
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Country: United Kingdom - England

Re: Managing EPI need Bay Area vet

Post by Miss Maddie Moo » 21 May 2019, 14:38

I too would recommend that you try creon its what us humans use if we have the some condition and there is no smell no incubation you just get them to sallow a capsule or you can empty the capsule on to the food .Cancer is crap have lost 3 of mine to this so i agree that you need to control the EPi as best you can are you supplementing B12 as well ???
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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Jes

Re: Managing EPI need Bay Area vet

Post by Jes » 21 May 2019, 16:20

Thank you both very much. Is will look up Creon. I assume vet prescribes it? I also con research b12. Can you just buy the supplement or does the vet need to prescribe?

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jilbert57
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Posts: 2092
Country: United States
State: Washington

Re: Managing EPI need Bay Area vet

Post by jilbert57 » 21 May 2019, 16:32

Here are a couple links:

https://epi4dogs.com/enzymes-in-brief/

https://epi4dogs.com/b12-in-brief-2/

There is a lot of great information on the EPI4dogs main page. Go to the 3 lines in upper right and click.
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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Madelon
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Posts: 1317
Location: Nashville, TN
Country: United States
State: Tennessee
Pet name: Doc

Re: Managing EPI need Bay Area vet

Post by Madelon » 21 May 2019, 21:05

Hi. I'm so sorry you are dealing with so much with your little Rusty. It is hard to manage multiple conditions at one time. For B12, a lot of us use WonderLabs Pet Factor B12 pills - very inexpensive, no prescription needed and they have intrinsic factor which helps with absorption. I too would suggest trying Creon and yes you will need a prescription from your vet. Unfortunately with EPI they must have the replacement enzymes or they will not digest their food. We have some vets listed on our vet page that other EPI owners have used and recommend. Please keep us posted on how things are going - sending prayers and hugs.
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.

Jes

Re: Managing EPI need Bay Area vet

Post by Jes » 22 May 2019, 09:57

Thank you all!
I have a call into my vet re Creon and I asked if we have any lab work for B12. I received copies of testing but I think it is mainly Cushings cortisol testing (of course I can't interpret results but main thing that jumps out is very elevated ALP numbers).

I also ordered PetFactor B12. I reintroduced PanaKare plus tablets (gave 1 last night and 1 this morning before meals). Rusty ate decent size dinner and good breakfast and seems to be tolerating the PanaKare right now. He is getting better with accepting me giving him all his pills "by force." He is more compliant and recently he has even barked at me to get things moving when I started taking out his medications (dachshunds can be bossy right?). I feel like he's associating pill "trick" before reward of the meal.

Thanks again - I appreciate everyone's time in sharing thoughts and resources.

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jilbert57
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Posts: 2092
Country: United States
State: Washington

Re: Managing EPI need Bay Area vet

Post by jilbert57 » 22 May 2019, 12:36

Sounds like you are getting things in order. Good luck and keep us posted!
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.

Jes

Re: Managing EPI need Bay Area vet

Post by Jes » 25 May 2019, 01:35

Hi All
Rusty gained .2 lbs :)
I received the Wonderlabs Pet factor B12. Should I get his levels tested before supplementing? If not, what is dosage for 12.8 pound dog?
Thanks! Jes and Rusty

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jilbert57
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Posts: 2092
Country: United States
State: Washington

Re: Managing EPI need Bay Area vet

Post by jilbert57 » 25 May 2019, 08:58

Good morning Jess! Great job on the weight gain. For a small dog that is a great start.

The B12 instructions read under 50 lbs. 1 capsule a day either with food or on the food.

I just reread your posts to see you don't have test results for B12. It is up to you whether to test or just start supplementing.

Do you have Tli test results?
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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