New member. 11 month old GSD with EPI

[Olesia711]

over 80% of all EPI dogs require B12 supplementation as they have trouble maintaining their B12.
Also.... low normal or normal levels of B12 is NOT sufficient for an EPI dog. Their levels needs to be at a minimum in the upper 500's to anywhere in the 600's. Once the levels are where they are supposed to be, you also do not stop giving B12, but rather you reduce the frequency to just a maintenance level.

Either your vet can give simple serum cyanocobalamin B12 shots (do not give the multivitamin B12 shots, they are not potent enough and they sting)
or
you can just order Wonderlabs Pet Factor B12 pills that are made with methylcobalamin B12, folate and instrinsic factor.
https://www.wonderlabs.com/itemleft.php?itemnum=K9688

[Quixotic]

Fantastic. Thank you both so much. Her semi-annual vet visit is in just under two weeks, and I'll request a B12 test. I did have it for the coming Friday, but I had to bump it another week.

My first impulse is to not attempt to address what is likely a low B12 level and to wait the two weeks for an actual blood test from the vet. That way I have a real baseline to better understand where she is compared to where she needs to be.

Sound like an acceptable plan? Thank you again so much. This site is such a relief.

[Quixotic]

over 80% of all EPI dogs require B12 supplementation as they have trouble maintaining their B12.
Also.... low normal or normal levels of B12 is NOT sufficient for an EPI dog. Their levels needs to be at a minimum in the upper 500's to anywhere in the 600's. Once the levels are where they are supposed to be, you also do not stop giving B12, but rather you reduce the frequency to just a maintenance level.

Either your vet can give simple serum cyanocobalamin B12 shots (do not give the multivitamin B12 shots, they are not potent enough and they sting)
or
you can just order Wonderlabs Pet Factor B12 pills that are made with methylcobalamin B12, folate and instrinsic factor.
https://www.wonderlabs.com/itemleft.php?itemnum=K9688

I went back and looked at Freya's test results from December when she had her TLI test. Her Cobalamin/B-12 was 445, so on the lower end of mid-range. What's your recommendation with that as a reference point? Begin the Wonderlabs and look for any changes/improvements over time?

[Olesia711]

that's low for an EPI dog and has probably plummeted if she has not been on a regimen of B12.

WHat you do NOT want to do is give B12 now and then take the test.... cause it will skew the test results.... since you have to stop all oral B12 1 full week prior to having the blood drawn for a B12 blood test, and you have to stop all injectable B12 a full month before having the blood drawn for a B12 blood test.

Based on the symptoms you are seeing, i would not wait for another two weeks for the vet visit to discuss the B12 blood test, but instead, maybe you can call the vet tomorrow and just schedule the B12 blood test sooner rather than later.

[Madelon]

Hi! I'm so glad the B12 was mentioned as it is critical to properly managing EPI. When Doc was diagnosed his B12 was 406 (if I remember right) and my vet did not think it was necessary to supplement the B12 - after reading the research here I went ahead and ordered the WonderLabs Pet Factor B12 and never looked back. His B12 has always been over 1,000 ever since. (if you use the pills use the code epi4dogs15 at checkout and you'll get 20% off)

One thing that stood out to me - I don't recommend worrying about it until you start supplementing the B12 - but the food you are feeding has rice and other grains and the fiber is 5.5%. Some EPI dogs do okay with grains and higher fiber but on average most do not. SO, if after supplementing the B12 you are still having some issues you might consider switching to grain free with 4% fiber or less and avoid peas - one food that has worked well for some of us is Sport Dog Food Elite - it's grain free, within the fiber range and has no peas. It's also a lot denser in calories.

Please let us know how things are going.

[Quixotic]

Freya update.

B12
We had our semi-annual vet visit (she weighed in at 51.8 pounds), and I discussed with the vet my concerns about Freya's B12 and her energy levels. I'm not sure if I mentioned, but my vet has personal experience with EPI with a poodle he had years ago. It was really nice to hear that EPI was something beyond professional knowledge for him. In discussing the B12 issues common with EPI dogs, he mentioned the options of shots and pills and told me it was my choice between them. He also explained the relationship between B12 and Folate, which made the numbers from her test make more sense to me, and it helped him agree that B12 supplementation was likely a good idea. As I had already gotten the Wonderlabs B12, I told him I would begin with the pills (opened and spread over food). I've been doing that since mid-April. He said we could retest if desired, though I told him I wanted to see if supplementing changed her attitude. I believe it has upped her energy and attitude, which is exactly what I was aiming for.

Food
To the point of the higher fiber of Royal Canin, I am transitioning her to Taste of the Wild High Prairie. I'm doing this because she began getting finicky with food about the time of my last message. I thought it may have been the new bag and the mix was a little off, but (don't ask) I have two other bags, and she regularly turned up her nose at her food. I had to coax her with adding yogurt, boiled chicken, or bacon grease to get her to eat. Lately it's been adding a hard boiled egg and mixing that in with everything. That battle is ongoing. Also to the point of the undigested pieces previously seen, I haven't seen that since the end of April when I began adding B12, FortiFlora (from vet), and transitioning to TOTW (much smaller pieces). She's been steady at 1 tsp of enzymes per cup of food giving great poop results.

Enzymes
On the topic of enzymes, the most recent batch received from Enzyme Diane in mid-April was not as effective as the previous batches. Unfortunately, I ordered 500mg this time around and still have over half left. Freya's poop was half normal, half very soft (soft serve) for a coupled of weeks on the new batch. I ordered Pantenex (which I had used prior to finding Enzyme Diane), and Freya's poop went to normal after two days on Pantenex rather than the Enzyme Diane enzymes. Maybe a bad batch, maybe a tolerance issue--not sure. But she's been good with Pantenex, so I may stick with that moving forward. Thankfully that's only a little more expensive than Enzyme Diane.

Poop
One unfortunate thing that happened last week was we went for a walk where she encountered a dog that got her excited--barking, jumping, really wanted to play. This was around noon, and she had eaten breakfast around 7:30, so I knew she was due for a poop. In the middle of the walk, as expected, she found a green space and circled a few times, though I noticed her legs were shaking a little...and then the mess. The beginning of the poop was well formed, as usual, but the latter half was a puddle. Took every bag plus paper towels to clean it up. We turned around and went home. It worries me that I won't be able to go out and do the things like hiking and walking and being around people in people places post-COVID because she'll make an absolute mess, and I don't want to mess public spaces. I'm hoping it was just stress poop, because the next one that evening was just fine.

Spay
Also, she is scheduled for spay surgery on June 2.

In summary:
Weight (April 23): 51.8 pounds
B12 (April 23): Wonderlabs, began emptying one pill onto food per meal
Enzymes: Transitioned from Enzyme Diane (back) to Pantenex
Food: Slow transition to TOTW
Energy: Better outside, more running and excitement and playful attitude. Still very low key indoors
Poop status: Perfect with very few exceptions
Spay: June 2

[jilbert57]

What a great report. Thanks for sharing.
Whenever I got a new mailing of enzymes I would compare strengths on the bags and adjust accordingly.

Jill

[Tuckaboo Pam]

Is Freya being treated for SID?---Pam

[Quixotic]

I tried 2.5 tsp per 2 cup meal, and her poop was still puffy and a little mucousy. I suppose I could push to 3 tsp for a couple of days and see if it is a potency issue. I compared the new to the previous, and the numbers were nearly identical, though.

Is Freya being treated for SID?---Pam

Not directly yet. My vet discussed SID and SIBO in both of our last visits. I think I noted the stomach gurgling above, plus the mucousy stool. That's part of the reason for the FortiFlora, and he said the B12 may help with that as well. I forgot to note above that I stopped the slippery elm as I started the probiotic. Vet agreed we wanted to see if things changed with the introduction of those two things this time around. She hadn't been on a probiotic since she began the enzymes (the last time was when we were trying to figure out what was wrong). She's on 45 days of the probiotic, so we're still doing one of those every day.

Her poop is great, and the stomach gurgling--which the vet listened to--has effectively stopped with the occasional sound here and there.

[Tuckaboo Pam]

You are so lucky your vet has experienced EPI personally, but as you said it was awhile back. My EPI vet was 80 years old, had treated EPI many times, and yet sometimes the info I got on the forum was more current.

You might be interested in reading up on SID, yourself. There is a lot of good information there.
https://epi4dogs.com/sidsibo-in-brief/