Diabetes and EPI- What to Feed?

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.
plilak
Member
Posts: 8
Country: United States
State: Ohio
Pet name: Bambi
My name: pam

Diabetes and EPI- What to Feed?

Post by plilak » 14 Jul 2020, 15:19

Hello,

I am fostering a sweet girl who was left for starving in a local animal shelter, untreated. She has diabetes and just found out EPI. I started with insulin two weeks ago and feeding her 4 times a day. She weighs about 9 pounds. The vet food- Hills prescription W/D chicken for glucose, Feeding her the soft and kibble. But the second ingredient is corn so I wonder how good this really is. I also pour goat milk in the mixture of kibble, soft, powder enzymes.

I let it sit for 20 minutes.

1) What should be happening with her stools? Sometimes the stools are small and brown, look normal. Other times they are large, loose formed, grayish. She goes to the bathroom A LOT and is very skinny, but has gained weight since she left the shelter.

2) Second question- I want to get her off the Hills vet food. Anybody out there who has a diabetic dog with EPI? What do you feed?

3) Since I feed her 4 times a day, to gain weight, I put 3/4 tsp powder on her food each time. Is this too much for a small dog? Instructions say 3/4 to 1 tsp each feeding. I assume the powder is not harmful if fed a lot.

Thank you :)
Pam

Barb
Staff
Posts: 468
Country: United States
State: New Jersey

Re: Diabetes and EPI- What to Feed?

Post by Barb » 15 Jul 2020, 12:08

Dear Pam,

A warm welcome to you and Bambi. First, thank you so much for fostering this sweet girl. She is certainly fortunate to have landed with you.

If you go to our website, scroll down to EPI and Diabetes and you will find a lot of information that the owner has published about dogs who have these two conditions. Her own EPI dog, Izzy had diabetes and EPI, so she is a wealth of knowledge and good information. She is currently away, but due to return shortly. Meanwhile, the information on our site may be helpful for you until she gets back.

Barb

User avatar
Jean
Staff
Posts: 992
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: Diabetes and EPI- What to Feed?

Post by Jean » 15 Jul 2020, 12:15

warm welcome from me too

I did post a reply and its gone into cyberspace

I will put feelers out for you

Jean
My name is Jean we live in Liverpool in Uk

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

User avatar
Olesia711
Founder
Posts: 1249
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy

Re: Diabetes and EPI- What to Feed?

Post by Olesia711 » 15 Jul 2020, 13:27

Hi Pam and thank you SOOOooooo much for fostering this little gal!
My EPI & Diabetes gal had EPI for 13+1/2 yrs and then developed Diabetes for the last 8 years of her life.... so i will try to help you as best i can.

When dealing with both EPI + Diabetes... keeping the Diabetes will always be your first priority.
So... my first question to you is what kind of blood sugar reading are you getting on the average from her readings? If she is staying under 250 with the highest around 250, then you've got her Diabetes under great control.

Regarding the poo issue.....sometimes dark brown and sometimes gray mush..... that is EPI related. So here are my questions:
1. is this the food you are feeding? Image
2. If the Diabetes blood sugar is really good, and the poo is good "sometime"..... then, giving preference to the diabetes, i would increase the enzymes that you are giving her to compensate for the excessive fiber content in this food
3. So.... if you want to stay on this food, how much food are you feeding at each meal ? I understand you are giving 3/4 tsp of enzymes per meal...... My next suggestion (if you stay on this food and depending on each meal amount) i suspect you will need to increase the enzymes up to 1 tsp per meal .........

If you want to change foods........ try Taste of the Wild - Pacific Stream - - only buy a small bag and maybe a couple of cans.... give half and half... this has only 3% fiber content where as the food you are currently giving has 20% fiber content.

If you can feed her 4 times a day and keep the blood sugar stable and under 250, that would be awesome,.... i never could do that with my EPI + Diabetes dog... i was only able to feed twice a day due to the fact that her blood sugar went extremely high and was given insulin twice a day... if i gave more, she went into a coma.

SOOooooooooo... if you want to change foods try the TOTW- Pacific Stream version first. lets see how she reacts with her Diabetes and her EPI (poos) the ratio for the enzymes would be 1 level tsp of enzymes per 1 cup of food... adjust accordingly... and be sure to give the enzymes with every meal and no snacks in between.

With my gal.... i had a LOT of trouble with the Diabetes part... i finally had to switch her to home made and her Diabetes came under fabulous control... but then she wasn't maintaining the weight.... I finally ended up giving her 80% homemade food to keep the Diabetes in check with 20% kibble to keep the weight on..... this kept her well managed for the remainder of her life. WHen i fed the homemade... i did over 50% baked skinned and defatted chicken breast, baked skinned and mashed sweet potato, no fat cottage cheese and a little bit of cooked kale, supplemented with bone meal, fish oil and a quality dog vitamin. If you want to switch to something like this AFTER your little gal puts on a wee bit more weight, and if she is having trouble maintaining her Diabetes, with the EPI.... then i will be glad to work with you on this....

i hope this give you some insight on what to do next........
Attachments
WD Diabetes food.jpg
WD Diabetes food.jpg (21.57 KiB) Viewed 697 times
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
Jean
Staff
Posts: 992
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: Diabetes and EPI- What to Feed?

Post by Jean » 15 Jul 2020, 13:29

Thank you Olesia for giving your time when you are so busy, but sometimes it takes your mind off ............
My name is Jean we live in Liverpool in Uk

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: 468
Country: United States
State: New Jersey

Re: Diabetes and EPI- What to Feed?

Post by Barb » 15 Jul 2020, 13:52

Pam,
I'm so glad you are able to have the benefit of Olesia's wealth of knowledge and experience. Let us know how Bambi is doing. Thank you again for fostering her.

Barb

plilak
Member
Posts: 8
Country: United States
State: Ohio
Pet name: Bambi
My name: pam

Re: Diabetes and EPI- What to Feed?

Post by plilak » 20 Jul 2020, 14:49

Hello Everyone and Thank You So Much for your replies. Gosh, I love this little dog and she is doing better, but I am not sure about if I am giving the shots right.  She has so much more energy and even goes on walks now and gained 2 pounds. She was 8 pounds when I rescued her from the shelter and now she is almost 10 pounds after having her for 2 weeks. The vet tech showed me and I practiced on a stuffed animal, but you know these days, no one can go in the vet and we did this in the parking lot.  

My friend will come over to help me be sure about the shots, since she had a diabetic dog.  Sometimes there is a small amount of wet fur, even though i feel the needle going in. Thank you Olesia for your reply and to answer some of your questions.

1) "my first question to you is what kind of blood sugar reading are you getting on the average from her readings?" PAM- I am not doing readings at home. I looked at buying a monitor device.  I saw the ones that I can dip in her urine. This seems easier as I am getting used to the needle stuff. Are these dip sticks accurate 'enough'? I realize I cannot really know anything on what food works or not unless I test.

2)  "is this the food you are feeding?" Image, PAM- Yes, that is the food. That plus the soft WD in the can. But, today I am testing something. That soft food is not working for her. Large stools, more frequent. If I just give the kibble with 1/4 cup warm goat milk and the enzymes then poo is better. So she gains weight, I am giving her, started today: 1 cup at 8am with 3/4 enzyme, 1/2 cup plus a cooked egg at noon with 3/4 enzyme, 1 cup 4pm, and 1 cup 8pm. Do you think this is too much food? The vet wanted me to give her 1 1/4 can and 1 2/3 cup kibble a day. Since I am testing to cut out the can food, I plan to increase her kibble. Trying to help her put weight back on.

2. "If the Diabetes blood sugar is really good, and the poo is good "sometime"..... then, giving preference to the diabetes, i would increase the enzymes that you are giving her to compensate for the excessive fiber content in this food."   PAM- Since she only weighs 10 pounds is the 3/4 to 1 tsp ok for her?  It seems to be, I just did not know side effects. Since I am giving her 1 cup of food each meal then I may need the 1 tsp amount of the enzymes.  

A few more questions:

1. I read that I need to feed her the same time each day and also the exact same quantity. Is this correct?  
2. I asked the vet about grain free and they said they don't like that since it could cause heart issues. I am confused about that. I thought diabetics need complex carbs to help regulate glucose, like whole wheat, brown rice, barley.  Do the sweet potatoes, potatoes and peas in food act as a carb? I did read your post about your sweet dog and you used to give her sweet potatoes, so they must be good.
3. What about fat?  I thought to give her a tsp of ghee in her food along with the goat milk. Ghee is pure, clarified butter and very soothing on the GI tract.
4. I looked at the food you suggested. There is another one called Ancient stream with ancient grains like quinoa and sorghum. It has 5% more protein than the other one.

I think that is it for now :)  She's drinking a lot of water and her little belly is full. I assume the insulin is not regulated now. I do need to test it daily and I think that is my next step, to buy something.
Pam

plilak
Member
Posts: 8
Country: United States
State: Ohio
Pet name: Bambi
My name: pam

Re: Diabetes and EPI- What to Feed?

Post by plilak » 20 Jul 2020, 17:40

One more thing to add to this that will help. Bambi weighs almost 10 pounds. On June 5, when she was brought to the shelter she was 11.80, In one week she dropped to 10.20 and when I 'rescued' her from the shelter she was 8 pounds. So this is why I feed her a lot of food. She gained about two in 2.5 weeks, so this is good.

User avatar
Olesia711
Founder
Posts: 1249
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy

Re: Diabetes and EPI- What to Feed?

Post by Olesia711 » 20 Jul 2020, 20:41

Hi Pam,

This is Olesia again and i will try to answer your questions as best i can.

*** when giving the shots, what you can do (this helped me tremendously because i am a real weenie when it comes to giving shots) take the skin and kind of tent it and then inject at a slight angle. It sounds like you are popping the needle right thru and that might be why the fur is wet... which also means she is not getting all the insulin, which is not a good thing. You want to give a consistent amount of insulin when injecting.

1. forget testing the urine... that only gives you a moment in time reading . If you are going to test at home (and this is the best way to effectively monitor a Diabetic dog..... then get either the real doggie monitor, or get a human one Ultra Touch II.. which will be a little off, but not by much. THis is what i used.

2. If this produces better poop, then stick with it :) "If I just give the kibble with 1/4 cup warm goat milk and the enzymes then poo is better"
Regarding your new food plan " cup at 8am with 3/4 enzyme, 1/2 cup plus a cooked egg at noon with 3/4 enzyme, 1 cup 4pm, and 1 cup 8pm. Do you think this is too much food? ", Because she is a tiny thing (for now) Maybe try giving 3/4 cup of kibble with 3/4 tsp of enzymes at 8am, noontime, 4pm, and 8pm..... and give half the cooked egg beginning of day and the other half of the egg end of the day.... see if this works, Since she is a diabetic,, i am trying to even out the food distribution and not overload, cause that will also jack up the blood sugar, and yet on the flip side you do want her to gain weight....... so...... i am just wondering if the "better" poo might be attributed to the warm goat milk... so... just on a whim, if the stools are not optimal when doing 3/4 cup kibble to 3/4 tsp enzymes... before upping the enzymes, try adding the warm goat milk and see if that produces better poo. If it does please let us know . This might be interesting!

3. just going to the 1:1 ratio of enzymes to food, you are already increasing the enzyme amount.... watch the poos and see if they are normal looking when giving 3/4 tsp of enzyme per 3/4 cup of kibble. If the stools are loose, then try increasing the enzymes by 1/8 of a tsp.
OR..... (and i am just guessing here) i am wondering if the goat milk that you are giving without the canned food, if that is why the poos are better... it could be the natural enzymes and good bacteria in the goats milk...

4. "I read that I need to feed her the same time each day and also the exact same quantity. Is this correct?" YES!!!!! you have about a 30 minute leeway on either side of the hour when feeding a diabetic dog, but that is about it. Try to be as consistent as you can with the Diabetes.

5. Unfortunately, too many vets bought into grain free cause DCM. There is so much more to the story, but for now, an EPI dog almost always needs low fiber content ( grain free labels) because of the enzymes. The main issue with grain free foods causing DCM is that in the grain free foods, they are stuffing them with cheap fiber, like peas instead of meat which is more of what they need, that does not give the dog all the nutrition they require. and then add to the fact that certain breeds are prone to DCM..... Sadly this DCM is real, many dogs get very sick and yet instead of researching how to improve the food source the sound bytes that are pushed are stay away from grain free foods. If we did this with our EPI dogs, many of them would forever be sick ......... we have a ton of detailed research on this matter... please, if you have time, do read it.

6. "I thought diabetics need complex carbs to help regulate glucose, like whole wheat, brown rice, barley. Do the sweet potatoes, potatoes and peas in food act as a carb?" Yes, but when you look at the ingredients on the package of the dog food, the real % of what is in there is mostly fillers, vs. the right amount of complex carbs. If you prepare your own food, you can control the diabetes is so much easier to control, since YOU control what and how much of what you are feeding your dog. The commercial foods on the market , no matter what the marketing claims, the bottom line is that they are there to make a profit. whole wheat, brown rice, barley are some of the worst things you can feed an EPI dog, so even if good for a diabetic dog, you have to kind of walk the middle of the road, put diabetes first but within reason,..... as whole wheat, brown rice, barley will most likely trigger diarrhea, so what good is feeding it if the dog can't digest it....On the flip side, YES, sweet potato is very healthy for diabetes and EPI dogs and most dogs can eat cooked & mashed (and skinned) sweet potato. However, every so often there is a person on the forum who has reported that there dog doesn't do well with sweet potato. ... so the best thing is to just try it and see if it (sweet potato) is tolerable. We have gone round and round with veterinarian nutritionists who have insisted that quiona is good and healthy for EPI dogs. Over the years we have had some EPI parents report to us that they paid a lot of money to have a ctf;d vet nutritionist create a healthy diet for their EPI dog. Every single one who did this ended up with sick EPI dogs, and it was all because of the fiber that the nutritionists kept recommending...they just didn't get it, that no matter how healthy something might be, if it doesn't agree with an EPI dog's system it is just not going to work.

7. Ghee. Hmmmmmmmm i honestly don't know! Before giving enzymes to an EPI dog they have trouble digesting fat. After you start giving enzymes to an EPI dog, unless there is some other health condition going on where they need to limit their amount of fat, then they can have normal amount of fat that a dog their size can handle. Actually, normal amount of fat content helps the enzymes activate better. However on the flip side of this, they now know that all dogs with EPI also have SID (small intestinal dysbiosis). For now, we treat if needed. (in other words if SID is not in good control). unfortunately with SID... higher amount of fat make SID worse... so although normal amounts of fat is fine for an EPI dog on enzymes, the concurrent condition of SID in all EPI dogs, lower fat is better. But then, when you don't feed enough fat their fur and skin is not as healthy. SOOOOOOOoooooo its a crazy decision, how much fat to feed and what kind of fat. Medium chain triglycerides MCT fat like coconut oil is supposedly much better tolerated than lLCT Long chain triglycerides like animal fat . Again, this is a situation that you just have to try and see what works and what doesn't. and you can tell by the poo condition.

8. Stay away from "Ancient stream with ancient grains like quinoa and sorghum. It has 5% more protein than the other one". DOn't worry too much about 5% more protein... 5% is not much in the big picture when looking at protein.... HOWEVER 5% makes a HUGE difference is when it is computing the fiber content. My guess is that 90% of EPI dogs do not do well on dog food that is 5% fiber content. 5% fiber content will probably send the poos dramatically south and the quionoa will most likely make a mess of your dog's digestive tract,,,,,,,,,,,,,,, maybe not, but most likely.

Hope i didn't bore you to tears with all this detail.... but many times with these dogs, its a fine line for what will or will not work. Sometimes it is not so much the actual ingredient that you have to avoid completely but rather how much of that particular ingredient is used in the food.

In short, used what we are telling you as guidelines, BUT, do not let what we tell you prevent you from "trying" something... cause sometimes, trying something is often the only way we learn what works or doesn't work for our dogs.

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.........

plilak
Member
Posts: 8
Country: United States
State: Ohio
Pet name: Bambi
My name: pam

Re: Diabetes and EPI- What to Feed?

Post by plilak » 21 Jul 2020, 20:29

Thank you so much Olesia :) I will read this again in detail and keep you all updated.

Post Reply

Who is online

Users browsing this forum: No registered users and 56 guests