New Member with a few questions

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.
TroyGM
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Posts: 12
Country: United States
State: Texas
Pet name: Troy
My name: Jeanette

New Member with a few questions

Post by TroyGM » 25 May 2020, 20:21

First, I must say THANK YOU for the creation of this board. I have been reading through this board for about an hour taking notes to help the youngest member of our family.

We took in my son's dog about 3 weeks ago who is stationed in Hawaii. Troy (4 y/o GSD) was living with another family member who can no longer care for him. We have spend the last 3 weeks back and forth with the vet to figure out what was wrong with Troy as he was vomiting, has heavy diarrhea and is just skin and bones. Just 5 days ago we were scared we were going to have to put him down. He was so ill that he couldn't stand, walk or even hold his head up. We had to carry him in the house and laid him on his bed. Vet said to do our best to get the meds and some food in him. We were feeding him via a syringe for a few days. Thank the Lord he has since recovered and is doing better. He is now up and moving around and even bringing us his ball when he wants to play. The vet has since told us is conditions are PLE (Protein-losing enteropathy) and EPI and it will be a loonnggg recovery. We have started adding powered enzymes (called DigestZyme - has anyone heard of these?) the vet gave us and started on b12 shots. But I just purchased the WonderLabs Pet Factor B-12 and will start those as soon as they arrive because we can't afford the $50 a week shots. And thankful hee is finally starting to eat the Hydrolyzed Protein food the vet prescribed.

I am hoping you all can help with a few questions I have now as I am still learning about these conditions.

1. Will we always have to have him on the Hydrolyzed Protein food? If not, what do you all suggest?
2. He is currently on Prednisone; will he always have to take that?

And any other tips, suggestions you all may have to help with these conditions would be greatly appreciated!!

I have already learned so much from just reading the boards and you all are so amazing and supportive. I look forward to getting to know you all and am so thankful to have found others that know what we are going through.

Jeanette ~Troy's Grandma

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Michaela
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Pet name: Nikki

Re: New Member with a few questions

Post by Michaela » 26 May 2020, 08:29

Hi Jeanette,

thank you for taking such good care of Troy, he's lucky to have such a a good grandma :)

Can you post who makes these enzymes or a link to them please. If they are the ones I pulled up, they are not the correct enzymes to treat EPI. https://www.transformationenzymes.com/a ... e_info.pdf

Troy needs much stronger enzymes, check out Enzyme Diane: https://enzymediane.com/

B12: Nikki gets weekly B12 shots, the pills didn't work for her. If that happens with Troy you can purchase the B12 at Walmart PetRx and learn how to give the shots yourself. The bottle is around $6 and last about a year if you give weekly shots. https://www.walmartpetrx.com/p-5323-cya ... 00-ml.aspx

It's helpful to keep a daily log on Troy's progress, write down all the changes (meds, food, etc.), it will help you figure out what's working or not. I kept one for the first two years.
Nikki was diagnosed with EPI in 2010
Royal Canin Potato & Duck canned
Slippery Elm syrup for stomach issues
1.5 tsp Pan-Tenex enzymes with each meal
Weekly B12 shots, pills didn't work for her
Tylan for life

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jilbert57
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Re: New Member with a few questions

Post by jilbert57 » 26 May 2020, 09:01

Hi Jeanette, thanks for taking care of Troy. As Michaela pointrled out, would you confirm which enzymes Troy is on? For DigestZyme I found these.

https://www.pureformulas.com/digestzyme ... ation.html

Please let us know.
Was bloodwork done on Troy ar the vet? If so if a Tli test was done to confirm EPI will you please post the results along with B12 and folate? You can call the vet and have them .pdf you a copy
so you have it on hand. The Tli requires a 8 hr fast beforehand.

Once we get a little information we can better help you. Welcome!

Jill
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

TroyGM
Member
Posts: 12
Country: United States
State: Texas
Pet name: Troy
My name: Jeanette

Re: New Member with a few questions

Post by TroyGM » 26 May 2020, 14:47

Thanks so much for checking out the Enzymes; yes those are the ones the vet gave us to use. Guess I better look into Enzyme Diane right away. What do you all suggest in the meantime? I guess I will have continue with these, but maybe use more? I currently add 1-2 capsules to each meal which is about 1 cup of dry food with some boiled chicken on top of it and chicken broth. That is the only way we can get him to eat (to have a bits of boiled chicken and chicken broth mixed in). And he is feeding at least 3-4 times a day.

And yes, we have had a number of tests done. I did receive a copy of them but really don't know how to read them. I attached them so you can review as I am still learning.

Thank you so much for your help!


HPSCAN_20200526175012443.pdf
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HPSCAN_20200526175012443.pdf
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Attachments
HPSCAN_20200526182340903.pdf
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Barb
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Re: New Member with a few questions

Post by Barb » 26 May 2020, 14:51

Hello Jeanette and welcome!

Troy is a lucky boy to have landed in your care. I am so glad he is improving. You are doing a good job. I think there are members here who have dealt with pups with the concurrent conditions of EPI and PLE. Hopefully, they will chime in and help you out with it. And as Michaela and Jill suggested if we can get the name of the company that makes the enzymes, we can help you a little more.

Getting him on the Wonderlabs B12 pills should help a lot. As Michaela said, you can do the shots yourself for a fraction of the cost, which is what we did for a while, but when we switched to the Wonderlabs pills it was so much easier and helped Kolby's B12 to finally reach what he needed. Each dog is different.

Also, we found the food to be a challenge, but many dogs do well on many foods. Kolby ended up on a prescription diet that worked for him, but not all dogs need it. Because you are dealing with EPI and PLE, he may have specific nutritional needs.

And I heartily agree about keeping a log/journal of everything you give him and the resulting poos. The journal will help you to see what is working and what is not.

You are very generous for caring for caring for Troy.
Let us know the results of the Tli test if you have them and the name of the enzymes.

You are doing a great job. Oh, we must have been posting at the same time. I will read your results.

Barb

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Madelon
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Pet name: Doc

Re: New Member with a few questions

Post by Madelon » 26 May 2020, 18:09

Hi Troy! Thank you for helping this sweet pup - he is so lucky to have you. I have contacted our Founder and Director of Research, Olesia as there are some things in the blood work that I think she needs to take a look at. I didn't see the TLI, Folate and B12 test results in the ones you posted - do you by chance have those?

I don't have experience with PLE, but looking through some old threads regarding PLE it sounds like steroids and antibiotics in the beginning are the way to go but don't sound like they will be life long. It does look like with PLE, hydrolyzed food is the way to go.

Glad you are getting the WonderLabs Pet Factor B12 pills. They work with most EPI dogs but if not, you can always try the shots and get a prescription and give at home.

Hang in there, Olesia will be along to give you the best, most experienced advice. Sending you hugs and prayers.
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

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Olesia711
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Location: North Carolina
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Pet name: Izzy

Re: New Member with a few questions

Post by Olesia711 » 26 May 2020, 20:01

DigestZyme.JPG
DigestZyme.JPG (32.63 KiB) Viewed 276 times
Hi Jeanette,

This is Olesia and i would first like to greatly thank you for taking in and caring for Troy..... you are an AWESOME doggie grandma!!!!!!!!!!!!!

So..... i read your post and i suspect the enzymes you have Troy on are not animal (porcine ) enzymes, but rather plant and although they might help a little bit, they are not potent enough to sustain an EPI condition. I did a search on DigestEnzyme... and this is what i came up with... can you let me know if this is what you are using?
Image

If so, this is not the right kind of enzymes, but no harm in giving until you can get the right enzymes. I too strongly suggest getting enzymes from EnzymeDiane and have her ship it to you. But if you want, in the meantime, (if you are in Hawaii and have to wait a while to get enzymes shipped in.) THEN.....talk to your vet and ask him to give you a script for CREON 10 or CREON 12. It is expensive, but if you feel the DigestEnzyme is really not doing much of anything, you can give him the CREON until you get the powdered enzymes. BUT...... if you are in the USA then please just order 6x from EnzymeDiane https://enzymediane.com/product-category/pancreatin-6x/ .

(With CREON, you just open the capsule, sprinkle on the food and serve immediately. This usually works, if not, then we suggest opening the capsule and spreading on top of the food (DO NOT MIX or INCUBATE) and then serve in about 4 to 5 minutes.)

(With powdered enzymes they NEED to be mixed, with a little water or something to moisten it, and then incubate for about 20 minutes (sometimes less with some dogs, but sometimes more)

Also.... i read the blood tests and Troy has low thyroid.... which most likely is a result of his gastrointestinal condition...sometimes the thyroid goes out of whack because of another condition,,,,,, so he needs to be on either Synthroid or Levothyroxine, but the vet has to run some tests to see what strength dose he needs..

And yes, he certainly has PLE according to his stats. Regarding the prednisone,... NO... he will not have to be on this forever, just until the flare up subsides. You are very lucky your vet put him on a hydrolyzed food.... that was a VERY good move! Whether or not Troy has to stay on this food forever, no one can know yet. He "might" be able to come off it and eat certain commercial diets, or a special homemade diet... or he may have to stay on a hydrolyzed diet- - this is going to be a wait and see situation... but there is a good possibility he will have to be on it for a long time........... I noticed you are feeding him chicken and chicken broth.... can't blame Troy for not wanting to eat unless these tasty items are added... BUT.... quite honestly, when doing a Hydrolyzed diet, you are not supposed to feed anything else..... HOWEVER.............that being said.....if his poos have improved and he is doing much better..... and if that is the only way he will eat, then go ahead and continue for now....BUT.... do not try other meats, just stick to the chicken only. And, just a FYI..... depending on the PLE... we have had cold laser therapy done on a dog with PLE that worked... so that might be another possibility, although there are no clinical trials to support this on dogs with PLE (yet) , just on cats.... but this is a conversation for another time and "IF" your vet would consider something like this.

I did not see where he had a TLI blood test, if you have that test can you please tell us what the test results were?
I too am glad you ordered the B12 from WOnderlabs..... they work on "almost" all EPI dogs and often work better than the B12 shots.. however, as Michaela mentioned, there are some dogs (like hers) that just don't respond to the pills and actually do better with shots. However, most of us have had better than expected results with the WOnderlab B12 pills which you will need to give once a day and within 3 weeks you should see a improvement (more perkiness and often the poos are much better too!) Also, the best thing is to retest the B12 levels AFTER being on the B12 pills for about 3 months. Before running the B12 blood test, you need to stop administering the pills for 1 week prior to the blood being drawn.

Now regarding the PLE..... we have a whole page on PLE in the concurrent section of this website. It is a very good read and nicely explains the different PLE types, the condition, treatment and expectation. https://epi4dogs.com/ple/

In the meantime, please feel free to ask any other questions you might have.... and we will help you as best we can.

Once again, thank you SO much for taking in Troy!
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.........

TroyGM
Member
Posts: 12
Country: United States
State: Texas
Pet name: Troy
My name: Jeanette

Re: New Member with a few questions

Post by TroyGM » 26 May 2020, 21:15

Thank you so much for all the great information!

Yes, that picture are the enzymes we have and have been giving to him . SO I will definitely look into the ones you all recommended. Wonder why the vet gave us those then??
And well, those are all the test results I have as of now. So I will ask about the TLI blood test.

You know, i have never been a dog, or even a pet person, but having Troy these last few weeks has so changed my mind. He amazes me on how smart he is and I am loving him more and more everyday. I feel so much better finding this group and seeing there can be hope for him. He was so energetic today that he wore me out! I am guessing the B12 may be starting to work. We go tomorrow morning for round #3 of the shot. And luckily he has taken to the hydrolyzed protein food now and is actually cleaning out his bowl at every meal. Today I only put a bit of chicken and broth in it. I am slowing trying to cut back on it so he only eats the HP food.
His poos are still very running though. So I am guessing I better get him on a better enzyme supplement as soon as I can. That still concerns me very much so.

And thanks for the tips on keeping a log. I have actually been doing that and thought to myself "is that too much?". But I wanted to make sure to log everything (along with questions I have) so when we visit the vet, I have able to answer his questions and ask him mine. I have logged all the medications he has been on and even took notes of what side effects they could have. I am a momma to 4 other children (5 when you count the husband :) ) so I am always trying to be extra careful and knowledgeable about what all my kids put in their bodies.

Thanks again everyone and I will keep you all updated. Crossing fingers we get him to a stable state and some meat on his bones.

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Olesia711
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Posts: 1210
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy

Re: New Member with a few questions

Post by Olesia711 » 26 May 2020, 23:47

Hi again Jeanette,

My APOLOGIES!!!! I just realized two things.... for some reason, i did NOT see your third attachment with the blood values.... AND i missed the cPL test results (thank you Jill for bringing this to my attention!)

The cPL test results are over 200 which "might" indicate possible PANCREATITIS.... vs. EPI.
And this puts a different spin on things.........

Chronic Pancreatitis is when the pancreas doesn't work as it should because everything is so swollen and inflamed.
EPI is when the pancreas has atrophied (destroyed itself) so there isn't anything or enough left to work as it should.

~With Chronic pancreatitis, many vets prescribe the same porcine enzymes that we suggested that you get to help the pancreas do it's job - -usually on a temporary basis or on a limited dose basis. With Pancreatitis, you have to be careful not to feed high fat content food.
~With EPI the enzymes have to be given with all food.... forever.

I suspect this is why the vet has Troy on half canned (RC Hydrolyzed) and half kibble (RC Hydrolyzed)... to further reduce fat content in the kibble..... just in case.

SO........ when you get the enzymes from enzymediane, i would give only 1/2 a dose (1/2 tsp) per 1 cup of food.

If, after receiving the correct enzymes and trying it at half dose, if the poos still do not improve..... then talk to your vet about treating for possible SID (small intestinal dysbiosis) with an antibiotic called Tylan. .... even though usually the prednisone should have straightened out the poo. With some dogs it just doesn't happen as expected.... This actually happened to us with my dog....who was on (at one time) the highest dose possible of prednisone when she had IMHA (a severe blood anemia)..... and yet her SID (small intestinal dysbiosis) which is present as a secondary condition in all EPI dogs and also can be present with many other gastrointestinal conditions.. anyway, even though my dog was on pred for the anemia, it "should" have helped with any SID that was out of control, but it didn't..... so we had to implement a course of Tylan antibiotic to help get the SID back in control. SOOOOOOooooo.... this might be something to talk to your vet about and see what he thinks.

ALSO... in the 3rd test results attachment i noticed that Troy appears to be flirting with anemia.... Depending on the type of anemia, they often give prednisone for this also.. So this might be another reason why your vet has Troy on prednisone. And of course, the B12 supplementation should help too!

This all sounds like a lot is going on with Troy, but, with some of these dogs, but please know that once the immune system is compromised, some dogs develop multiple issues. But this can be managed. My little dog dealt with multiple issues too, she had EPI, Diabetes, IMHA, Low Thyroid, Uveitis, Vestibular disease and amazingly she had a very full and happy life... she fought and won every ailment, was the best, funniest, very active and most loving dog i ever had and lived for 15 years. She was the most vibrant dog i ever had and people who met her could not believe she was even sick.

I am just sharing this in case you have doubts about Troy's ability to overcome any health issues he might have...... my mantra is let the dog tell you how they are feeling, and you can usually tell by their spirit....their eyes, their actions.....they are amazing beings and can amazingly "bounce" back with proper medications/treatment......And it certainly sounds like you also have a very good vet taking care of Troy which is half the battle!

Again, my apologies for not seeing that 3rd attachment.... which had lots more information in it and the fact that i missed the cPL test results.
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.........

TroyGM
Member
Posts: 12
Country: United States
State: Texas
Pet name: Troy
My name: Jeanette

Re: New Member with a few questions

Post by TroyGM » 31 May 2020, 12:09

Thank so much for the added information and reviewing all our tests. It really helps settle my mind and realize we can, and will, get through this.
his poops are starting to take a form to them, so I am thinking the b12 is helping. Once we get the correct enzymes and beginning using them, I guess it will be a waiting game to see how it all pans out.
I have a notebook ready and will take notes every few days on how things are going. He seems to be getting his energy back as he lets me know when it is time to take a break from working and go outside. He even started barking which he never did when we first got him.

Again, thank you SO MUCH for all the great information. You all helped saved my sanity as I had no clue what we were getting into.

Have a great week to you all!

Jeanette & Tory

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