Feel Like Giving Up with EPI Pup

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.
Tiredofepi
Member
Posts: 2
Country: United States
State: Indiana
Pet name: Tank

Feel Like Giving Up with EPI Pup

Post by Tiredofepi » 08 Jan 2022, 15:17

Hi everyone, I am hoping to get some insight or advice.

My GSP was diagnosed with EPI a year ago with all of the standard symptoms. I have followed all of the advice from vets, pages, etc and am feeling so hopeless with my dog.

He is at a healthy weight now and has no issues with weight loss but no matter what I do I can’t seem to get him to 100% and it’s causing me stress daily I’m sure him as well. He is eating the right food, and I’ve tried upping his enzymes and cutting back on them for extended amounts of time but he never has solid poops. He always has soft poops which is always getting on his hair and I can’t keep bathing him every time he uses the bathroom. He also is still always eating his own poop as if he is starving. I do B12, have tried slippery elm which made it all worse, but just can’t find anything to help.

He is always covered in poop wether on his mouth or his behind and while I know it’s not his fault but I am starting to lose it! Please if any of you have any advice I am desperate.

He currently has 1 tsp per two cups of food and that has been the closest to solid I have ever been able to achieve. He is a healthy weight and the vet says he is otherwise healthy.

Jane&Clyde
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Posts: 157
Country: United States
Pet name: Clyde
My name: Jane

Re: Feel Like Giving Up with EPI Pup

Post by Jane&Clyde » 08 Jan 2022, 17:22

Hello, and welcome!

I'm going to start out with some basics about treating EPI. There's a good chance you already know these things, so, if so, I apologize. I just want to be sure we are starting from the same point. There are four cornerstones in treating EPI:

1. FOOD: The diet for an EPI dog should be:

a. Grain free: Grains can affect how the enzymes work anywhere from 0-50%. Unfortunately, we don't know which dogs are going to be affected, so we recommend grain free to everyone.
b. 4% fiber or less: NOT low fat as long as the dog doesn't have any other conditions, pancreatitis for example.
c. have limited peas and chicken: These are foods that some dogs with EPI can't tolerate.

It helps if the food is spread out over at least three meals per day. We usually recommend increasing the food amount, but if Tank is maintaining a good weight, there's no need. The food that the most EPI dogs seem to do well on is Sport Dog Elite Series Herding Dog formula. This doesn't mean that it is the best food for every dog, but the odds are good that it will work for a dog with EPI. It is usually available at Amazon, Chewy.com, and Sportdogfood.com. However, it was out of stock at Amazon and Chewy the last time I checked. Another food that many dogs do ok on (if they tolerate peas) is Taste of the Wild, but ONLY the Pacific Stream and High Prairie versions because the others have too much fiber.

2. ENZYMES: The dose should be 1 teaspoon per cup of dry food, 1/2 to 3/4 teaspoon per cup of wet. It is exceptionally rare for a dog to do well on only 1/2 teaspoon per cup of dry. What kind of enzymes are you giving? Prescription? Over the counter? The only 3 brands of over the counter enzymes that are appropriate for a dog with EPI that I am aware of are Enzyme Diane, Pantenex, and Dogzymes Pancreas Support. Are the enzymes that you are giving prescription or one of these three? If not, could you let us know exactly what you are giving?

3. B12: Are you doing injections from the vet? Over the counter oral supplements? The only over the counter supplement we recommend is Wonderlabs Pet Factor B12. It has a slightly different form of B12 and also has something called "intrinsic factor" which seems to help with the absorption of B12. This sometimes works even if the injections don't.

4. Antibiotics: sometimes dogs need antibiotics to help control EPI/SID(small intestinal dysbiosis...unbalanced bacteria in the gut...all dogs with EPI have it to some degree). If antibiotics are needed, please don't let your vet prescribe Metronidazole. for EPI/SID. The antibiotic of choice is Tylan twice a day for 45 days, then slowly weaned off.

We find it helps to keep a journal of the foods and supplements given, plus the resulting poop.

Again, I apologize if all of this is repeat information, but it helps us to know the exact place to begin to unravel this mystery.

Tiredofepi
Member
Posts: 2
Country: United States
State: Indiana
Pet name: Tank

Re: Feel Like Giving Up with EPI Pup

Post by Tiredofepi » 08 Jan 2022, 17:38

Hi Jane&Clyde,

Thank you so very much for the detailed response. I am using Pantenex and the Wonderlab B12. He is not on any antibiotics but I’m not sure why he seems to get much looser stools with more enzymes. I will begin slightly upping the dose again and looking into switching the food. Again, I really appreciate the response. Need to get this boy healthy and happy!

Jane&Clyde
Member
Posts: 157
Country: United States
Pet name: Clyde
My name: Jane

Re: Feel Like Giving Up with EPI Pup

Post by Jane&Clyde » 08 Jan 2022, 17:49

You're welcome! If the poop gets worse again with more enzymes, it's possible that Tank could have a porcine (pork) allergy since the enzymes are made from pig pancreas. If so, you might need to use enzymes made from beef.

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

Re: Feel Like Giving Up with EPI Pup

Post by Tuckaboo Pam » 08 Jan 2022, 19:40

Oh, Tank's person, I am so very sorry for you and Tank. That is really hard. Tucker's poop is soft, but pickup-able, and I don't believe he will ever be 100%, so I kind of know how you feel. It's a constant balancing act, with these dogs, and you are at a low point.

It looks to me, like you are not treating SID, which all EPI dogs have. Can you please ask your vet to prescribe Tylan for Tank? At this point, and with the amount of frustration you are feeling, I would not bother with slippery elm (recommended, but results may take longer) for now & go straight to this very good antibiotic, which doesn't kill off good gut bacteria. It just inhibits the bad stuff from growing & gets the SID under control. There is a dosing chart on the website here.

Here is some info you may want to share with your vet---https://epi4dogs.com/sid-sibo-microbiome-research/. There is an entire section on SID, under the Managing EPI tab. It has been researched and proven, all EPI dogs have SID.

In the meantime, there are some products I've read about, that won't cure the SID, but may firm up Tank's poop. Here's one---Diggin' Your Dog Firm Up, from Chewy or Amazon. It is a pumpkin product, so you may be able to just feed some canned pumpkin, while you wait for Diggin' or Tylan.

Poop Eating---YUCK---he is either feeling undernourished, or he is unwilling to stop a bad habit.

Try adding some MSG to Tank's food. It is not a healthy additive, but it makes the poop taste bitter (I think), and can break that nasty habit. After a time, you can stop adding it. I have also heard pineapple works, but it didn't for me. Also, can you or a groomer trim the fur around his hiney? Would that help? You may also just feed him a little more & see if that works. Tucker had stopped, then my crazy hound girl started eating poop, and so I started adding 1/2 cup kibble to her meals & she stopped.

Please express your desperation to your vet, so if there is any hesitation to giving you the Tylan, they will know you are feeling like you can't do this. Some vets are reluctant to prescribe it, for some reason, though many of us have to keep our dogs on a small maintenance dose for life. Best of luck, and please come here back to vent, so we can help you get Tank back to his healthy self.

Take Care--Pam (have you ever looked into enzymediane.com ? they are good, and less expensive)
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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Jean
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Posts: 1707
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: Feel Like Giving Up with EPI Pup

Post by Jean » 10 Jan 2022, 06:27

good morning from the UK

i agree with whats been said here

the amount of enzymes is generally critical, and maybe its time to try something new like Enzyme Diane

I have looked, and cannot find the food you are using, I wonder, can you let us know

My Kara was difficult, and it took way over a year to get her anyw years here near stable , please dont give up, I have never cried so much over a dog as I did with her, but my vet was determined to keep her going, she was stable for 8 years

go back to basics , get yourself a note book, and record everything you do

are you giving ANYTHING without enzymes ?

are you just worried about the consistency of the poop, and I see he is eating the poo, therefore, its not being digested properly, do try pineapple it works, but if he is hungry he will eat anything

what weight is he ?

Tylan is the antibiotic of choice, and if there is SID in play the bugs will destroy any B12 reserves the dog has, so its essential that b12 is given as you are , will the vets give injections ? they must be the generic type, dark pink in colour, so please ask your vet for Tylan ASAP, refuse Matronadazole , it had side effects

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

these are far superior , although the wonderlabs are really good and widely recommended

I would not recommend MSG for a dog,

You know where we are
My name is Jean we live in Liverpool in Uk

I am the Forum Director which I am very proud of

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

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Johnnycake
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Posts: 51
Country: United States
State: Texas
Pet name: Johnny
My name: MacKenzie

Re: Feel Like Giving Up with EPI Pup

Post by Johnnycake » 10 Jan 2022, 13:02

You've already gotten some good advice from the experts here so I figured I would just add a few things that have worked for me when we were struggling to get solid poops and had tried a lot of what is typically suggested.

- Food! Johnny seems to do best if his food is switched up every once in awhile - I don't know if this is typical or not. He has done best on the Acana limited ingredient diets lately - they are a bit pricey but nothing else has worked as well for him. Green tripe (the unbleached stuff, so it still has enzymes) helps him as well.

Supplements:
-A few days a week we use a mineral supplement, it's made out of ground elk antler.

- A good probiotic has been super important for him. We've tried a few different ones and have had the most success with Purina Fortiflora. If he's getting probiotics every day, we typically only have to add on prebiotics/slippery elm when he is having a flare up.

- We also add in either goats milk or a bone broth/turmeric/pumpkin powder and have found that to be very helpful as well.

- Clay/dirt - it might sound weird, but Johnny will actively seek out certain spots in our local park, dig up clay and dirt and eat it, and have way better poops the next day! I just got the powder clay supplement I ordered in the mail yesterday and I am happy to come back and let you know if it helps at all - seriously nothing has helped like the stuff he digs up and eats at the park!

-B12 - for some reason, Johnny started doing a lot better when we switched to injections. He also does better with a higher dose than most dogs, we've ended up using twice as much as what his vet originally prescribed for him.

Good luck! I know it is frustrating but you guys will figure things out! Johnny was in horrible shape when I first adopted him - a little over a year later and he works full time as my service dog. We've been where you are and I promise it gets better!

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Johnnycake
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Posts: 51
Country: United States
State: Texas
Pet name: Johnny
My name: MacKenzie

Re: Feel Like Giving Up with EPI Pup

Post by Johnnycake » 10 Jan 2022, 13:07

I remembered two more things, sorry!

We had to drastically decrease the amount of enzymes when we switched to Acana foods, and also started incubating food in enzymes for longer. The incubation really helped!

For the eating poop - you can try modifying the behavior. For example, if you have a high value treat he really likes (it can be a food he does wel with - for Johnny nothing beats a squeaky ball) you can call him over or give it to him the second he is done pooping. Eventually, if you are consistent, he will start looking for that treat when he's done instead of going to eat his poop, at least if this is a behavioral thing/bad habit and not something going on internally. Pair a word or cue with the treat and you should be able to ask him to leave the poop that way!

maya193
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Posts: 77
Country: United States
State: Rhode Island
Pet name: Maya
My name: Debbie

Re: Feel Like Giving Up with EPI Pup

Post by maya193 » 10 Jan 2022, 15:46

Hi there....I'm kind of new as well so just thought I would chime in too to offer support. I too wish there was one magic formula that worked for our pups, but unfortunately, that's just not the case. I'm still doing trial and error and it's frustrating a lot of the time. But the one thing I found to be so beyond helpful that I would be lost without it is the daily diary that I use to capture everything...food, type, amount, enzymes, poo's, etc. It's a slow process to be sure but I am finding things that help and things that do not. When you have a good day celebrate that moment. If it's not so great the next moment, just say ok let's try again... Hang in there.....your pup is depending on you! I think they pick us as their pack leaders because they know we won't let them down.
Maya is a belgian mal/german shep diagnosed with EPI on 10/12/21. TLI 1.2, B-12 196, Folate 4.8. Currently on Maximum K-9 raw diet, beef and vegetable, Enzyme Diane, Wonderlabs B-12 with IF, Proviable and Slippery Elm.

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

Re: Feel Like Giving Up with EPI Pup

Post by Tuckaboo Pam » 10 Jan 2022, 19:31

I was asked to clarify that MSG is monosodium glutamate. I have always heard that you could just use Accent meat tenderizer, but I see that it has some spices & sugar in it, so just be aware of that. You can also get plain MSG.---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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