New to EPI and need some guidance

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

Re: New to EPI and need some guidance

Post by Madelon » 15 Feb 2020, 23:47

Hi there. Your vet should have run the B12 and Folate test with the TLI - it's pretty much standard. I would call and ask for a copy of the test results. You really need to know that the levels were at the time of diagnosis for future comparison.

With regard to the mouth sores, I've always heard not to put ice cubes in the water - can't remember why. What we typically suggest is feed on a flat plate so the muzzle is not down inside a bowl, toss a few kibbles in the water bowl so they "bob" for them and in effect rinse their mouth, reduce the amount of water used to mix the enzymes - you just need enough to dissolve the enzymes and coat the kibble. If none of these suggestions work, try grinding the kibble in a blender then mix in with the water/enzyme mixture - you'll need more water for this - I grind my boy's kibble and for 2 1/2 cups of food I use about 5oz of water.

As for the B12 - can you give us the name of the pills you are going to use? B12 dosing is based on their weight. Most of us use the WonderLabs Pet Factor B12 pills as they contain intrinsic factor which helps with B12 absorption.

Have you tried Slippery Elm Bark powder for the diarrhea? Here is a link to the information and dosing instructions https://epi4dogs.com/slippery-elm/

Hang in there, we'll get you on track!
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.

Mandy
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Posts: 12
Country: United States
State: Arizona
Pet name: Shazam
My name: Mandy

Re: New to EPI and need some guidance

Post by Mandy » 16 Feb 2020, 18:33

I am using a condiment squeeze bottle i bought at walmart. I am able to get the small nozzle inside a his lips and give a good squeeze and he lets me do this without fight. It has just room temp water. (like kids make it fun and they will co-operate) I am using the wonderlab b12.

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

Re: New to EPI and need some guidance

Post by Madelon » 16 Feb 2020, 18:40

Glad you are using the WonderLabs pills. How much does your dog weigh? B12 dosing is based on weight: below 20lbs use 1/4 of the capsule once a day, 20-40lbs use 1/2 a capsule once a day and over 40lbs use a whole capsule once a day,
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.

Mandy
Member
Posts: 12
Country: United States
State: Arizona
Pet name: Shazam
My name: Mandy

Re: New to EPI and need some guidance

Post by Mandy » 20 Feb 2020, 18:49

When i took him to the vets a couple weeks ago he weighed in @ 32 pounds. I do see that he has gained a few pounds, so we will be heading into the vet in a couple more weeks and getting an updated weight on him.

Mandy
Member
Posts: 12
Country: United States
State: Arizona
Pet name: Shazam
My name: Mandy

Re: New to EPI and need some guidance

Post by Mandy » 20 Feb 2020, 18:57

Can anyone tell me what the difference is between porcine and bovine enzymes? Are bovine enzymes less likely to cause mouth sores?

Tuckaboo Pam
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Posts: 1345
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: New to EPI and need some guidance

Post by Tuckaboo Pam » 20 Feb 2020, 19:57

Well, porcine comes from pigs, and bovine comes from cows. I have read hear that porcine is the way to go. --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.

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

Re: New to EPI and need some guidance

Post by Madelon » 23 Feb 2020, 10:55

The porcine (pig) enzymes are the closest to the dog's natural pancreatic enzymes. With bovine you might have a lot of tweaking to do in order to get the right dose. I honestly don't know if the bovine would reduce mouth sores but there are lots of tricks to reduce/eliminate mouth sores. If you're having trouble with mouth sores and have tried the usual tricks (bobbing for kibbles, wiping mouth, feeding on flat plate) - try grinding the kibble in a blender - it has worked for some of our most difficult cases. I actually grind my boy's kibble - been doing it for 5years.
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.

Mandy
Member
Posts: 12
Country: United States
State: Arizona
Pet name: Shazam
My name: Mandy

Re: New to EPI and need some guidance

Post by Mandy » 24 Feb 2020, 21:47

Thank you, i have been so worried about his mouth. I think i may be finally getting close to finding his "magic" amount. We have struggled hard with mouth sores so bad that his poops were extremely bloody. I took him off the enzymes for about 3 days and instead gave about 1-2 tsps of pepto in his food and had it sit for the 20 minutes that his food usually sits and it did help. He did not have diarrhea and his poop started to turn from black to dark brown. The pepto coated his tummy to help with the irritation. I started him back on the enzymes at the end of day 3 and we started small, 1/4 tsp to his full 2 1/2 cups of food for every feeding, we have slowly brought the amount up to not upset his mouth and belly. We are up to just a tiny pinch above 3/4 tsp per feeding. My goal is to get between 1 or 1 & 1/2 tsp per feeding without blood. He is doing super!!! He does not appear to have lost any weight that he has gained and is actually putting more weight on. We are using b12 vitamins from wonderlab and about to order more enzymes before we run out. I do actually have a question about the enzymes though, I live in Arizona and it has been known to get up to 110 degrees and more in the summer time. I am aware that the enzymes are "delicate" how is the best way to order them for the summer? Should i buy in bulk and store in the pantry, or should i but small amounts over the summer with the ice packs? My concern is that the heat will kill the enzymes even with ice packs. (I work for a local privately owned Drs office and we usually have to order for same or next day delivery in the summer if we dont order enough of certain medications that are also heat intolerant. We try to order in bulk for the summer usually in late April to last through September so the meds dont over heat and become void.) I just dont want them to be useless. Also is there anything i should know before i change his food to Taste of the wild? Do i need to make the change slower or faster than normal? do i need to the mixed portions of the two foods the same for a longer period of time? Im a little leary about making the change, but i am confident it will serve him better after reading about both foods and the ingredients labels off the bags. Im wanting to start this week with the change in the food. You all have been such a huge help to us and im so greatful for all the advise i have received im storeing it all up for anything that may come up for the future too. Thank you again!!

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

Re: New to EPI and need some guidance

Post by Madelon » 25 Feb 2020, 19:33

Hi Mandy. Glad you've been able to get close to the "magic" ratio for your pup. Sometimes starting all over is the best thing to do in order to find the exact right dosing of things. As for your question about the enzymes, contact Diane at EnzymeDiane - she has LOTS of customers in Arizona, Texas, Florida where it gets extremely hot - I do know she offers dry ice packing. As for storing in your house, as long as your house is air conditioned you shouldn't have any issues. I would think just ordering a kilo at a time - possibly in dry ice - would be sufficient.

As for switching foods, it's best to do it slowly over about 7 days - starting with 75%old food to 25%new food for two days, then 50% 50% for two days, then 25%old to 75% new for two days and then go to 100% new. Remember to keep detailed notes in your log on how the poop looks and if you notice any itching (I'm always hypersensitive to food sensitivities)
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.

Tuckaboo Pam
Member
Posts: 1345
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: New to EPI and need some guidance

Post by Tuckaboo Pam » 25 Feb 2020, 19:37

I live in FL, and the same thing happens in the summer. We have one of those community metal mailbox systems, in direct sunlight. I can't remember how I did it, but I made sure my order wouldn't lag over a Sunday, and I checked the box every day. I did space out once, and they stayed in overnight, but they seemed to work ok. I also ordered the ice pack, but I think it melts after 24 hours. Maybe you could have them delivered to you at work, so they don't sit in a hot mailbox. ---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.

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