EPI /diabetes complication?

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.
Eden66
Member
Posts: 14
Country: United Kingdom - England
Pet name: Minnie
My name: Eden

EPI /diabetes complication?

Post by Eden66 » 15 Sep 2019, 20:11

Hello ,
Apologies in advance for the length of this post , i've just joined on behalf of my 2 1/2 yr Boder Collie Minnie who my Vet has just confirmed her with EPI.
Minnie has always been a walking mystery - to condense it , she was diagnosed when very young as hypoparathyroidic and has been on Vit D drops since a puppy for this to correct her low calcium .
However i have always been convinced there was something else underlying her condition and gave repeated descriptions of her behaviour to Vet's about what i have observed from her daily habits - which i can now see were classic signs of EPI.
To cut a long story short - Minnie has always been small and underweight and been a "difficult" feeder ,especially when younger , but recently increased her drinking and urinating which led to urine & blood tests showing very high glucose levels .Diabetes was diagnosed so she went in for her first insulin and curve .
This is where it gets strange - after one insulin jab , the vets plotted her blood glucose levels which went back to normal .....and stayed there , so Diabetes was ruled out ! Instead EPI was suspected so the Vet advised going on prescription low fat food until EPI was confirmed , but on taking her back in for tests a week later it was found her glucose levels had gone back up !
Tests have now confirmed EPI and also her B12 tests showed she was showing virtually nil ( afraid i don't have the exact levels but the vet said they were very low)
She had the first B12 shot but currently i am awaiting the enzymes to arrive with the Vet - hopefully i will get that this week but in the meantime i am desperately seeking any help on feeding practice and food types etc .

Additionally her case is complicated by the blood glucose levels being high and the vet is thinking she will have to go on low insulin doses .
I should just add that the vet is also now thinking it likely that Minnie may not have been hypoparathyroidic after all , and that the syptoms and hormone imbalance and problem with her pancreas is genetic .
But my immediate concern of course is what i should feed Minnie when i have the enzymes - i have read conflicting advice regarding fat in the diet- should it be high or low ?
And if she is diabetic how will this affect what food to give her - the Vet put her on Prescription Low fat (wet food) in cans but she stopped eating that so they said give her chicken & rice , but this is now proving difficult .
In light of Minnies fussy eating - can the enzymes be added to her normal food or has it got to be prescription food - i usually give her a mix of meals inc cooked beef mince or chicken and some canned food.

Please can anyone help with any advice or tips -

Eden

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

Re: EPI /diabetes complication?

Post by Olesia711 » 15 Sep 2019, 20:54

Hi Eden and so sorry Minnie is having such struggles!

My gal Izzy was diagnosed with EPI when she was 1+1/2 yr old.
Then at 7 yrs old she developed Diabetes..... OMG... what a challenge and for the first year/+ is was a roller coaster ride.

In general we suggest that with EPI, once the dog is on enzymes, unless another health condition dictates it, an EPI dog may have normal amounts of fat content in it's food.................WELL.......................... Diabetes with an EPI dog..... is one of those other "health conditions" that now dictates low fat.

Your vet is 110% correct in steering you towards a diet that is low in fat.

However, with Diabetes + EPI..... you might find a commercial diet that works, but often ... because of trying to deal with a combo of both of these conditions, many people have found that preparing a home-made diet, where you can control the ingredients and the amount of each ingredient often works best. And sometimes, (like for us) a combo of mostly home-made with a little bit of commercial kibble works well too.

In general, too often prescription dog foods don't work well.... this is not to day that they won't, but with EPI + Diabetes, usually they don't work out so well.......

When using commercial dog food, what seems to work better is an over the counter commercial dog food but one that is very low in fiber content and one that is not top loaded with a bunch of peas & lentils.

For now, if your dog is doing better with the home-made food, but the poops aren't so great.... with the chicken & rice, exchange the rice for baked, peeled and mashed sweet potato (yams) give about 75% baked, skinned and defatted chicken breast (beware that dark meat on a chicken is too high in fat content and will raise the blood sugar!) and 25% mashed sweet potato.

I just worked up 2 diets for 2 other dogs dealing with EPI + Diabetes..... if you can share with me how much Minnie weighs, i can work on a diet for her too ... the only thing i ask is to share with your vet first before starting Minnie on it to make sure your vet approves and is comfortable with the ingredients and amounts and supplements.

Definitely start her on B12.... and just a FYI.... once you and our vet are able to bring up her B12 levels... DO NOT STOP the B12 supplementation completely, but rather at that point in time you and our vet will have to then figure out how much and how often Minnie will need B12 going forward (for the rest of the life) to maintain upper mid-range B12 levels.

Many of us use high dose B12 pills with Intrinsic factor, others do B12 shots (if you prefer the shots, ask your vet to sell you a bottle of serum and teach you how to give shots at home. If you decide to go with the pills, many use Chemeyes B12 pills https://www.chemeyes.co.uk/product/vita ... ic-factor/

Hope this helps!
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.........

User avatar
jilbert57
Staff
Posts: 2092
Country: United States
State: Washington

Re: EPI /diabetes complication?

Post by jilbert57 » 15 Sep 2019, 21:02

Hi Eden and welcome to the forum.
An Epi dog does not have to be on a fat restricted diet. The food needs to be 4%fiber or less and a diet free of grains tend to be more suited to them. The grains in the food can interfere with the efficacy of the enzymes. Here is a list of foods that have set well with Epi pups:

https://epi4dogs.com/dog-food-options/

What was her normal food before the prescription? She doesn't need prescription unless she has a concurrent issue that needs low fat.

Good starting the B12 shots. Here is the B12 protocol:

https://epi4dogs.com/b12-protocol/

If the regular food meets the fiber content and grain free you can mix the enzymes with that food. Let us know if she was on dry.

Not sure regarding diabetes issue.

Please feel free to share information from the site with your vet and run changes by your vet.

Jill
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.

Eden66
Member
Posts: 14
Country: United Kingdom - England
Pet name: Minnie
My name: Eden

Re: EPI /diabetes complication?

Post by Eden66 » 16 Sep 2019, 08:14

Hi Jill ,
Thank you very much for the welcome and helpful advice and tips .
Food for Minnie was always tricky since her troubles began as a puppy which meant we have tried just about every commercial food around .
In general the sort of food/meals she settled into before this latest episode - when her calcium was at it's lowest (before her Vid D daily regime) she was starving because she couldn't digest vomiting etc . This time is different because shes eating and yet wasting away and drinking noticably more than usual .
It feels like catch 22 - feeding her low fat food due to diabetic "condition" ( i won't say diabetes because i & the vet doesn't seem to know if it's full diabetes or something else pushing her glucose up ) but she evidently wants/needs to eat better food but can't because she's EPI and until i get the enzymes there seems nothing i can do to help .
Sorry - to get back to your question , the sorts of food/meals Minnie had before this -i would try to give a varied diet which include -
commercial canned foods - Butchers Tripe , Butchers Simply Gentle and Cesar
https://www.butchersdogfood.co.uk/wp/re ... -tripemix/
https://www.butchersdogfood.co.uk/wp/re ... ly-gentle/
https://www.uk.cesar.com/

I would vary this with meals of home cook Roast chicken twice a week and once a week boiled lean minced beef .
Occasional foods she will eat are cooked liver and i will also add that she usually likes cooked fish as a treat .
One other consideration - i usually have to give Magnesium Oxide pill a day for her Hypoparathyroidism - and i give this in raw beef mince ball which she absolutely loves .
When she is eating normally - these are the foods that she generally enjoys and will eat .
But are any of these ok mixed with the enzymes - and also suitable if she has a diabetic condition ?

The Vet gave Hills Digestion Low Fat canned food which she ate for 2-3 days and then said "no more" so for the last week or so has been basically on cooked chicken breast since ...she doesn't like boiled rice !
As regards the B12 shot - the Vet gave her her first shot 2 days ago (still waiting for the enzymes to arrive) but she gave it in the skin ... i had read and expected iit would be intramuscular - but i'm not sure if it makes a difference ?

Oh - not on Dry food .
What i ( and i think the Vet too ?) is unsure of - is whether getting her on an enzyme food protocol will maintain or keep her glucose in check ?
The main urgent concern is trying to stabilize her strength and body weight which worryingly is falling by the day .

Thanks again

Eden

Eden66
Member
Posts: 14
Country: United Kingdom - England
Pet name: Minnie
My name: Eden

Re: EPI /diabetes complication?

Post by Eden66 » 16 Sep 2019, 09:11

Hi Olesia ,

Thanks very much for your reply and very helpful advice and information .

Perhaps i should have replied to you & Jill together but to save space and repeating myself you will see Minnie's usual food meals /types in my previous post .
Naturally i am unclear on many things with this situation but first queries i have are - is she losing this dramatic weight due to the high glucose ie diabetic state or the EPI . In other words , i worry that i might put her on the enzymes and give the right food but she'll still be going downhill because of the diabetes ?
This may sound stupid but i have a million annd one similar thoughts going round my head ...i desperately need something stable or sign of improvement to encourage me ...sorry i'm feeling very down at the moment .

One thing i forgot to add previously is that Minnie's feeding routine which developed due to her HPP regime is to have 3-4 meals throughout the day - rather than just the one . I understand this might be best for EPI feeding too ..small meals spaced out ?
Minnie's just had some food today at lunchtime - roasted chicken breast but i found a new product which i gave because it has sweet potato in it -
https://forthglade.com/shop-dog/wet-dog ... -food-395g

Sorry i don't know if links are allowed but i only include to give an idea of ingredients etc ?

Anyway she ate half the chicken breast and all the pot of Forthglade Turkey & Sweet Potato ....i'm basically doubting anything i do now so i may have done the wrong thing but i can tell she's starting to get fed up with the chicken ...which is understandable .

Thank you so much for your offer of diet advice - i would be very grateful for any help with suggestions and what i can and can't give her .
As i said in my reply to Jill - i do some home cooked foods for Minnie and her sister but it's a question of knowing what i should do and if my usuals are now unsuitable ?

As regards her weight - this is my biggest fear because at her heaviest when weighed at the Vet's back in June for her regular calcium check she was 13kg ...which was a big thing for her .
But this has been falling over the past few weeks whereby 3 wks ago she was just over 11.5kg , 2wks ago abt 10.5kg and by the time she had her B12 jab this past Saturday she was 9.5kg .As the Vet told me - being on the low fat food ( Hills Prescription ) contributed to this increased weight loss .

I feel so helpless and i still can't get hold of the enzymes to even start her on some different food .
I'm sorry i haven't any actual levels to report as i only got the confirmation from my Vet by phone and still waiting to hear before going in for the enzyme .

Thank you so much for your time

Eden

User avatar
jilbert57
Staff
Posts: 2092
Country: United States
State: Washington

Re: EPI /diabetes complication?

Post by jilbert57 » 16 Sep 2019, 09:54

Eden, you can mix the enzyme with any of those foods. Since the meals are moist and not dry kibble, you would use 3/4 teaspoon enzyme powder per 1 cup of wet food. Stir the enzyme in to coat all the food then let it incubate for 15 to 20 minutes, stir again then serve. The food must be room temperature so if it was in the fridge, let it warm up.

Jill
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.

Eden66
Member
Posts: 14
Country: United Kingdom - England
Pet name: Minnie
My name: Eden

Re: EPI /diabetes complication?

Post by Eden66 » 16 Sep 2019, 12:44

Thanks Jill ,
I'm still waiting to hear from our Vet about getting the enzymes if/when i get it i will follow the method you describe.
What complicates it of course is the apparent high glucose level and diabetic "state" and whether those foods are ok for me to carry on with - i hope so as i really don't give much chance of getting her to eat the VetPrescription cans .

It's difficult enough trying to learn about the EPI - what i don't see a connection to ,ora reason for the high glucose , and why that should have dropped back to normal after just one shot , which led the Vet to say it wasn't diabetes !

One of the symptoms she has - is leaking an oily amber yellow liquid with her poo which has always been yellowish /grey/ fawn colour and greasy and of course plentiful.
What about raw food or in particular frozen pancreas to add to food and benefits -anyone have any thoughts or suggestions on that ?

Thanks again

Eden

User avatar
jilbert57
Staff
Posts: 2092
Country: United States
State: Washington

Re: EPI /diabetes complication?

Post by jilbert57 » 16 Sep 2019, 18:03

Has she had her anal glands expressed?

Jill
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.

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

Re: EPI /diabetes complication?

Post by Olesia711 » 16 Sep 2019, 20:39

Eden,
all the foods you mentioned are agreeable with EPI once you start including enzymes.
You desperately need enzymes to stop the weight loss.
You can contact Chemeyes regarding their high does enzymes here https://www.chemeyes.co.uk/product/high ... -powder-2/ until your vet can decide on what enzymes he wants your dog on. Your dog really needs to be on enzymes ASAP.
You can also get the right kind of B12 pills here too for EPI dogs.

The problem is that not all those food items are agreeable with Diabetes or simply high blood glucose or high cholesterol which can trigger high blood glucose.

The one ingredient that jumps out at me is the liver..... super healthy .. BUT... avoid with any dog with high blood glucose and 'or high cholesterol..

The dry food you found Forthglade sounds great... but whe i clicked on the link i was not able to read the individual ingredients and the %s of the individual ingredients.... jsut avoid any commercial foods that are overloaded with too many pea/lentils ingredients(cause of the EPI)
And avoid commercial foods with high fat.... try to stay under 18% fat content and you should be okay. My gal was on a kibble that had only 7 to 9% fat content and it was great...but then they started filling it with more peas, so i switched to a little higher fat content food of 16% fat content..her blood sugar went up a little bit, but not enough to worry about.

If your dog is getting bored with chicken breast... you can always do a lean pork loin meat or a lean beef ... but red meat is "fattier"

I see that you are in the UK...our Forum Director is also from the UK and she can help a lot with the right kind of enzymes, but she is on holiday right now...

the 3 to 4 meals a day is PERFECT ... if you can continue with that that would be awesome :)
I will work on a diet for you based on 10kg... most likely i will have it done for you by tomorrow.
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.........

Eden66
Member
Posts: 14
Country: United Kingdom - England
Pet name: Minnie
My name: Eden

Re: EPI /diabetes complication?

Post by Eden66 » 17 Sep 2019, 09:15

Olesia ,

Thank you so much for your very kind help and advice .
To give the latest update on Minnie - i heard from the Vet today to say her Pancreatic enzymes have finally arrived ( from Chemeyes) but she wants her in overnight to try to deal with her high glucose with insulin etc and of course to begin a food /enzymes protocol .
So that is what i am going to do now and hope we can get her back - she has eaten some plain chicken twice this morning and lunchtime so that is something i suppose , but i just pray that we can get her on your diet advice and what is good for her condition .

I will post back when i have any more news and try to get the test readings for you .

Thanks again

Eden

Post Reply

Who is online

Users browsing this forum: No registered users and 362 guests