Help Please for Newly Diagnosed GSD

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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denaligator
Member
Posts: 2
Country: United States
State: New Jersey
Pet name: Denali
My name: Erin

Help Please for Newly Diagnosed GSD

Post by denaligator » 29 Sep 2019, 18:07

Hello! Firstly, thank you for taking the time to read this! My dog was diagnosed with EPI less than a week ago and other than loose instructions to start enzymes and return in a month to check his weight, I don't have much to go on. I feel like I've been kind of hung out to dry as far as what to do from here, and have been relying solely on the information on this wonderful site to formulate a plan for him. I was hoping for some insight on whether or not I'm doing this right and what kind of progress I should be seeing and how soon. I'm extremely overwhelmed and anxious that I'm not doing the right thing and making him worse.

My boy Denali is a 15 month old German Shepherd. I've had him since he was 5 months old and from day one, he was very skinny, had little to no appetite, and very pale greenish mushy poop. He was treated for worms and I was told he was skinny because he was young and active and was just going to be small for a GSD. But over the next ten months, I was only able to put about 10 pounds and he recently lost 8. He is normally exceptionally energetic, playful, and "in-your-face". Within the last couple of weeks, he suddenly started acting aloof in random bursts and laying around with no real interest in playing. A vet finally took my concerns seriously and tested him for EPI. His results were Cobalamin (179), Folate (16.5) PLI (<30), TLI (<1). I have a very minimal understanding of what this means for him specifically.

I'm currently giving him:
Taste of the Wild Pacific Salmon Grain-free (dry)- 1 cup, four times a day
Pancreatin 6x (Enzyme Diane)- 1 tsp per cup of food
WonderLabs Pet Factor B12- 2 capsules once a day
Metronidazole (500mg)- twice a day for 14 days (he's about a week in)

He started all of this on Tuesday, 9/24. Yesterday he was acting lethargic and disinterested in play, which is the complete opposite of this normally very in-your-face pup. He was much more himself today but the back and forth has me worried. His stools this morning were the best I've seen them ever, but still not ideal. They were formed but very soft, and light brown in color. So I have a few questions if anyone doesn't mind.

1. Does this feeding plan seem okay or should I adjust it? Is there anything else I should be adding to his diet?
2. I keep reading that EPI dogs act hungry all the time, but I've been struggling to get Denali to eat anything since I brought him home. Since diagnosis, he thankfully seemed more interested in eating. He still never acts hungry, but he finishes each meal. Could the lack of appetite be related to his B12 levels? Also, would it help if I fed him the B12 one capsule twice a day, instead of two capsules at the same time?
3. It's very hard to get him to take pills, and the only way I've found so far is to break the pill in two and put each half in a glob of peanut butter wrapped in pepperoni. I've been putting this on top of his bowl at mealtime, but it isn't treated with the enzymes. Could this be affecting him negatively?
4. I've been training him for search-and-rescue since January, which of course involves a lot of strenuous physical activity. Should I be concerned about this affecting him badly? Obviously, we've taken a break since his health started clearly declining.
5. How soon and how dramatic should I be expecting improvement? I feel like I'm unfairly expecting instant results, but at the same time, I'm concerned he's not improving at all. I know it's been less than a week, but I'm just very worried.

I'm sorry for the huge neurotic post. Thank you so much!
- Erin (& Denali)

Tuckaboo Pam
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Posts: 1346
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: Help Please for Newly Diagnosed GSD

Post by Tuckaboo Pam » 29 Sep 2019, 19:12

Hi Erin---My Tucker, 5 years old, was diagnosed in May, so I'm new, too. Since nobody has commented yet, I wanted to go ahead & jump in with what I have learned here. First, Denali's kibble should contain at most 4% fiber, and you should avoid peas & potatoes. Also, I give B12, one capsule twice a day. Are you marinating his food with the enzymes? It is ideal to add some room temperature liquid, mix the enzymes & kibble, and let it stand for at least 20 minutes before he eats it. I make & use turkey bone broth, and Tucker devours the entire concoction. It took awhile before his poo showed great improvement, and it also took some tweaking...of everything! So, I'll stop, because soon the wonder women who run the foundation will chime in with their expertise. Best of luck to you and your baby. Oh, and I live near Gainesville---Are you a Gator?---Pam
Tucker was a shepherd/lab mix--- TLI 1.3, Folate 9.7, Cobalamin 666, Lipase 38. Took Diane's Enzymes 4 teaspoons/day, Wonderlabs B12 one capsule per day, and Tylan 1/16 teaspoon/ morning (to hold SID at bay). Taste of the Wild High Prairie, 1 1/2 cups/day, with a total of 4 cups of Fresh Pet. Stopped eating everything in sight, and went from 60 to 85 pounds! Tucker was my boyfriend, and my husband was OK with that. Tucker succumbed to hemangiosarcoma, but we cherished every day we had with that wonderful, beautiful boy. I will always, always miss my sweet big boy.

Tuckaboo Pam
Member
Posts: 1346
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: Help Please for Newly Diagnosed GSD

Post by Tuckaboo Pam » 29 Sep 2019, 19:13

Oh, and Tucker's antibiotic is Tylan. It can be taken very long term. ---PH
Tucker was a shepherd/lab mix--- TLI 1.3, Folate 9.7, Cobalamin 666, Lipase 38. Took Diane's Enzymes 4 teaspoons/day, Wonderlabs B12 one capsule per day, and Tylan 1/16 teaspoon/ morning (to hold SID at bay). Taste of the Wild High Prairie, 1 1/2 cups/day, with a total of 4 cups of Fresh Pet. Stopped eating everything in sight, and went from 60 to 85 pounds! Tucker was my boyfriend, and my husband was OK with that. Tucker succumbed to hemangiosarcoma, but we cherished every day we had with that wonderful, beautiful boy. I will always, always miss my sweet big boy.

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denaligator
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Posts: 2
Country: United States
State: New Jersey
Pet name: Denali
My name: Erin

Re: Help Please for Newly Diagnosed GSD

Post by denaligator » 29 Sep 2019, 21:03

Hi, Pam! Thank you for your reply. I’ve been mixing the enzymes with the food and warm water and letting it sit for about 30 minutes. The bone broth is a great idea. I’m always looking for a way to make his meals more enticing to him. I was just afraid of adding anything now.
The vet only prescribed an antibiotic for two weeks, but I’m not sure how to tell if that does what it needs to do.
ps. Aw, I’m not. I’m a Jersey girl- I just use “Denaligator” as a nickname for my pup because he hasn’t quite outgrown that bitey stage ;)
- Erin

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Madelon
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Posts: 1317
Location: Nashville, TN
Country: United States
State: Tennessee
Pet name: Doc

Re: Help Please for Newly Diagnosed GSD

Post by Madelon » 29 Sep 2019, 21:58

Hi Erin and welcome to our EPI family. Firstly, please know that you are not alone. We have been there and understand the heartbreak and frustration you are feeling!

There are four cornerstones to managing EPI: 1) Enzymes: glad you are using EnzymeDiane and following the 1tsp per cup of kibble ratio - be sure to mix the enzymes in luke warm water, then mix in kibble and incubate 20-30 minutes before serving; 2) B12 - glad you are using the WonderLabs pills as the B12 is very low; 3) Antibiotics - we recommend Tylan over Metronidazole - Tylan is gentler and does not kill all of the bacteria the way Metro does - and it's a 45 day course and then slowly wean off; 4) Food - we recommend 4% fiber or less, avoid peas and feed 150% of the food for the weight your dog should be in smaller more frequent meals.

Have you checked for mouth sores? A few recommendations for feeding: try feeding on a flat plate; try grinding kibble in a blender; try using a stinky topper

Keep a detailed log of everything you give and the resulting poops.
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.

Merakai mom
Member
Posts: 3
Country: Canada
Pet name: Merakai
My name: Jenn

Re: Help Please for Newly Diagnosed GSD

Post by Merakai mom » 15 Oct 2019, 21:50

Hi Erin,

I have had the same thing with my gsd pup as well. Brought him home, he was picky with food wouldn't eat despite trying a bit of everything. Tried every food under the sun (raw, air dried raw, kibble). Then I was starting to train more dog sport and he started being lean.. again thought could be a reason beyond a picky shepherd.. nothing ever sat well with what some of the vet or dog ppl I know said. So took a leap back to my holistic vet and I was in the room for 2 mins and she said I think he has epi. So needless to say, bloodwork (everything) was done today.

I just wanted to say that if Kai ends up with this then I too have a pup that presented in an unconvential way.

Jenn

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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: Help Please for Newly Diagnosed GSD

Post by Jean » 16 Oct 2019, 04:20

Good morning from the UK

Firstly we listen and read everything so bring it on

my girl at 5 months old was 43 pounds, at 14 months, 39, this was her lowest and she was mess, so, she has lost a good deal of weight, so feed 150% of what the bag of food suggests for the weight he SHOULD be ovr as many meals as you can, all enzymed

the results you post say thet its EPI for sure , <1, and that means that his pancreas has stopped producing the enzymes his body need to digest any food, this will remain that way for life, the cobalamin at 179 is way too low, it is so necessary to digest food

https://www.petmd.com/dog/wellness/evr_ ... py_for_epi

we suggest at least 6 weeks of b12 injections of generic b12 which is dark pink in colour, maybe your vet can sort that out, my girl had 12 weeks and 1 a month for life plus b12 capsules daily

The PLI is with in paramators,

http://www.cvm.tamu.edu/gilab/service/assays/pli

folate is also within paramators

http://www.cvm.tamu.edu/gilab/service/assays/b12folate

so dont fret too much,

my thoughts are probably, he is having SIBO attacks( small intestinal bacterial overgrowth)

i understand the Metro is a good drug , but Tylan is a much simpler, and effective antibiotic as it doesnt interfere with good bugs so bring that up with the vet

all food must be enzymed except medication and water

he is likely in some sort of pain in his gut especially if he has SIBO. I have a friend who has EPI, and describes SIBO as a very bad period pain multiplied !

so its importand you keep the b12 way up there, so injections next if you can

record everything you do, its really important , and ask away

we ahve all been there


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

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

Re: Help Please for Newly Diagnosed GSD

Post by Barb » 16 Oct 2019, 09:52

Hello, Erin. A warm welcome to you and Denali. I am in New Jersey also, although originally from Pennsylvania. We know how you are feeling, but hopefully you will feel less overwhelmed as you get everything balanced. As Madelon said, the four cornerstones of treatment are Enzymes, Food, B12, and Antibiotics. You have crossed the first hurdle of getting a diagnosis. Now you know what you are dealing with and can proceed to getting your boy to good health.

I heartily endorse keeping a daily log/journal of everything you give your pup, the amounts, and the resulting poos. This tells you what is working and what isn't and helps you to make changes (one at a time) if you need to. There is something about seeing it in writing that helps you to process information and see patterns you might not have noticed if you were trying to keep it all in memory. It saved our sanity at the beginning.

You have received excellent suggestions so far. Keep asking questions One thing I noticed was the B12 dosage. I think you said you give two Wonderlabs pills at the same time. You might want to separate the dose to one in the morning and one at night, since
he will pee out the excess.

Don't worry that you are doing the wrong things. We have all been where you are. You are doing great. Denali is lucky to have you. Keep watching the poos. They will give you the information you need. Who knew it would be all about poop? LOL

Hang in there.

Barb

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wandaMaeZi
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Posts: 11
Location: BC
Country: Canada
Pet name: Maezi
My name: wanda

Re: Help Please for Newly Diagnosed GSD

Post by wandaMaeZi » 18 Oct 2019, 00:49

hello its been a long time since I have been on the forum i dont have a lot of advice wnated to let you know you arent alone much help here If you look in the EPI tails you will see the story of my pup Maezi I can totally relate to you just starting out it can be overwhelming you are doing great one step at a time keep journal helps any questions these guys on here are great tell you at first we really struggled to get things figured out and her weight up took a while she is 9 now and doing amazing good luck keep it up wanda & maezi
my name is Wanda & my girl Maezi is a blue heeler from BC Canada
Our EPI story/journey is featured under "EPI4DOGS story"> EPI Reports> EPI Tails
DX at age one-- feed 1cup now fresh senior w 1 tsp enzyme diane 6x twice daily
She is the most loved & spoiled catteldog on the Planet 8-)

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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: Help Please for Newly Diagnosed GSD

Post by Jean » 18 Oct 2019, 04:42

Wanda hi

long time no hear, goood to hear Maezi is doing well

we sadly lost Kara in May this year, EPI stable to the end

thank you for chiming in

love Jeanxxx
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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