New to EPI

[Mandalong22]

Nati is a 1 year old GSD. She was diagnosed with EPI a month ago. After not gaining any weight from December until March. The vet first said she had coccidia assuming she hit it from eating her own feces because of the epi so we treated and still no weight gain. Could see all her ribs and her hip bones started showing. Started encoding aggressive and eating like 12 cups a food a day. I did research and forced my vet to finally after almost 3 months of diarrhea and food changes and she did have it. So now she is on pancrezyme 2.5 teaspoons twice a day with food. They put her in royal cainine gastrointestinal low fat. I do not agree with the low fat but in the first 2 weeks she gained 5 lbs but now 2 weeks later she has stalled. Her poop is. 3 on the chart and she occasionally gets sick in the morning. Maybe once a week. The enzymes are so expensive and of course I want to do what we I can. I just feel like I know more about EPI at this point than my vet. I think I should switch her food. I told the vet and she suggested royal cainine high energy and increasing the enzymes by a half a teaspoon.

[Olesia711]

Hi. SO sorry to hear that your dog has EPI, but we will help as best we can.
Can you share with us the TLI blood test value done to confirm that she has EPI.... and also did your vet also do a B12 blood test? If so, we'd like to know what that value is also.

I understand you are giving 2.5 tsps of enzymes per meal- -how much dog food are you giving with this 2.5 tsps of enzymes?
This dog food may or may not be working....many of our EPI dogs do not need special prescription dog food (unless they are dealing with EPI + another health condition like IBD or food sensitivities) so although you may not need to be feeding this particular special prescription food.... before you change foods, it sounds like what is happening now (which is VERY common) is that your dog's SID is not well controlled.

All EPI dogs have SID to one degree or another.. SID is small intestinal dysbiosis. the symptoms of SID are as follows:
....repeated signs of yellowish-coloring to the stools, loose stools, gelatinous stool coating, upchucking, vomiting with bile, flatulence, lack of appetite, stomach noises, low or low normal B12 then treat for possible secondary SID/SIBO. Previously we automatically treated with antibiotics, however, we now suggest to first try addressing with a “prebiotic” , many of us use Slippery Elm powder https://epi4dogs.com/slippery-elm/
Sometimes using a prebiotic, or even a prebiotic with a probiotic, is enough to get the SID under good control. If not, then we suggest using a course of Tylan (Tylosin Tartrate). https://epi4dogs.com/antibiotics/

So... what i would suggest you try first, is please purchase some slippery elm powder. If you live near a health food store, they will have some. If not you can order it from
https://www.wonderlabs.com/itemleft.php?itemnum=K97024 and it is not expensive, only 12 a bottle.

Follow the SLippery Elm dosage instructions on this page: https://epi4dogs.com/slippery-elm/
Slippery Elm is a prebiotic and a mucilage.... it has a positive effect on "most" (but not all) EPI dogs.
Many times, a prebiotic can be given and it is jsut enough of the right kind of fiber, with butyrate and mucilage and prebiotics to fight SID. If you do not see improved poos within 2 days.... THEN call your vet and ask for a course of antibiotics, specifically ask for Tylosin Tartrate (tylan), to treat the SID that your dog has. And then hang on to the jar of SLippery Elm, because sooner or later your dog will have nother SID flare-up / set back and after a dog is stable with EPI when they have another SID flare-up many times you can correct it then with a short course of SLippery Elm powder .

I hope this helps give you some answers.

With EPI. when you are trying to find the right balance of the 4 aspects of managing EPI, that means you have to find the balance of the Enzymes, Diet, B12 and SID treatment..... BUT........when trying to figure this out, you need to try/test things one at a time. SOOOOOOoo.... after you try the SLippery Elm and if that doesn't work, then ask the vet for some Tylosin Tartrate (45 days/twice a day with food)..... after this, if the poos still don't straighten out to a #2 or #1.... then you will want to look at changing the food to something low in fiber content, less than 4% fiber content is good. There are many, MANY good low fiber foods (check out our food option page https://epi4dogs.com/dog-food-options/) , but two that have worked for me are: SPORT Elite is a good food, https://www.sportdogfood.com/products/sporting-dog and Taste of the Wild Pacific Stream https://www.chewy.com/taste-wild-pacifi ... dp/181318

Then there is the B12, but first i would like to hear from you if your vet tested for it and what the value is.
And last but not least.... trying to find the right balance of all 4 aspects is a lot of juggling... what we strongly suggest is to start keeping an EPI LOG (journal) pleas read this page to get an idea of what to keep track of: https://epi4dogs.com/epi-log/

[Jean]

Good Morning Amanda from the UK

similar story here, I insisted vey vet tested my Kara, he wasnt happy so he said "well its your money" I said "exactly" and its been my mantra ever since

a lot of vets are sponsored by Royal Canin, so they will promote their food which is brilliand, but sadly our dogs do not tollerate it in the main, some do well

b12 is essential to digestion

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

my girl had an injection every month for life, and supplemented by b12 with intrinsic factor from UK ( same as Wondelabs) every day

you now have a star to steer you by in troubled waters

ask anything, and as many times as you need to

Jean (UK )

[Mandalong22]

I need to calm and find out her TLI number is. They never specified. She hasn’t been given a B12 shot either. She is still eating a lot. She eats 4 cups 2 times a day. And the 2.5 teaspoons of enzymes. I may be able to reduce her food she has been taking longer to eat it so she may not need as much as before when her EPI was really bad. Her stools are brown and can pick up easily in my hand. They are just soft/spongy still and at the end of her stool it becomes soft and green. I will try the elm and call the vet to find out her TLI number.

[Olesia711]

Thanks for that information.... if she is eating 4 cups of food in one sitting (meal) then you need to use 4 level tsps of enzymes, make sure you either add enough liquid to moisten the food with the enzymes powder or add a canned food (for the wet) to kibble to moisten the food with the enzymes.

Let sit for 20 minutes, then serve.

The green in the poo that you are seeing just means that the poo transit time is happening too fast "Yellow or greenish stool — indicates rapid transit (small bowel)." and this usually is because there is not enough bacteria in the gut and not enough variety of bacteria in the gut, triggering SID (small intestinal dysbiosis).... SID is present in ALL dogs with EPI.... our goal is to get SID in good control (at least until we discover how to fix it )

SOOOOOoooooo.... do try some Slippery Elm powder. It usually works, but not every time..... so..... if it doesn't work after a few days (it is fast working), then ask the vet for an antibiotic .

Also, when you get the test results, ASK the vet if they tested the B12 levels.... and please share that with us also.

[Dolce_7]

I'm so sorry to hear that.
My dog was suspected EPI some time ago and I'm so scared now. I believe we should be together and support each other.

[Jean]

we are all scared the day it is diagnosed, You walk out of the doctors office and cry

but we are here for all of you , I i am in UK but thats no problem, My Kara was diagnosed at 14 months, and she went down to 39 pounds, we thought we would lose her, but my vet wasnt having it

she stabalised at 90 pounds till we lost her to DM May 2019

please dont panic

Jeanxx

[Olesia711]

i too was numb when my vet gave me the diagnosis of EPI..... what in the world was EPI??? i had never heard of it, and then when i read about it i was so scared.

WELL...........my Izzy lived until she was 15 years old... and 13.5 years was with EPI. Once we found the right balance of the EPI protocol that best suited my Izzy, her EPI was very, manageable. Yes, there were a few set back in the 13/+ years, but nothing that i wasn't able to get back under good control in a few days or a week or two.

You just have to learn what works best for your dog.... and that is what we at Epi4Dogs do... we help you (and your vet) figure this out

[Madelon]

Hi Amanda - welcome to our EPI family! I too am wondering about the B12 as it is a critical part of properly managing EPI. Also, unless your dog has another underlying condition that requires the prescription food, you don't need it and it could actually be part of the problem. We recommend grain free with 4% fiber or less and try to avoid peas. Also, you'll want to feed 150% of the food for the weight your dog SHOULD be until they reach goal weight.

I know it's all a bit overwhelming right now, but it will quickly become a new routine

Oh and be sure to keep a detailed journal of everything you give and the resulting poops - it will help you figure out what works and what doesn't.

[Madelon]

Hi Liza - welcome! You said your dog was suspected to have EPI some time ago - has your dog been tested yet? If you have any questions or would like some suggestions, please feel free to start a new Topic so we can address your questions specifically and they don't get lost on someone else's thread