New to this EPI and feeling crazy

[wsparks2]

Hi all, my 3 year old Newfoundland was just diagnosed with EPI. 8months ago she started lip smacking and stress yawning . She went through many test and we tried many things for acid reflux but nothing was working. Over time it got a little better . She had her GI lab TLI test and it came back low in the 2's but they said at that time it wasn't EPI but probably small bowel disease. Fast forward 6 months and we saw a new internal med vet who retested the GI panel and this time her TLI came back at 1.9 so a definite EPI diagnose. Her cobalamin fasting is above 1000, folate 14.3 and pancreatic lipase immunoreacivity is 55. Right before this test they put her on Visbiome 4 pills per day ( she weights 108lbs) they want to keep her on a grain food since the breed is prone to DCM - proplan sensitive skin and stomach lamb and oats which they previously had her on royal canin vegetarian. During this time we did a animal biome test that showed moderate microbiome imbalance and moderate digestive issues. They recommended the gut restore supplements ( poop in a pill) and she had a biopsy that showed mild small bowel chronic enteropathy. The vet said to wait on giving her the poop in a pill. Her poops have always been pretty normal , she has always been a good weight and in the last few months she has put on to much weight due to them upping her food content on the vegetarian diet. At this time they lowered her food amount to get her to loose about 5 pounds. Here are all of my questions- I have ordered the enzymes from chewy - per the vet before I found this site- the IMS at a teaching hospital suggested the tablets because they are cheaper .After this bottle is gone I will switch to the powder. I show and actively work this dog - water rescue, obedience, drafting - when I asked the IMS about treats she said I didn't need to put enzymes on them. I did order the beef tripe as others have given and been fine with. My dog loves bison and I make bison balls to give her Visbiome in . Is there a way to make bison treats with enzymes or other meats that I can train with? Is the Visbiome something I should continue to give with this new diagnose? Since she doesn't need to gain weight at this time do I still need to over feed her ? I feed her 3 x's per day but lunch is with a automatic feeder and the food would have to be in the plastic bowl feeder for 5 1/2 hours before she would have access to it. Is this to long ? I haven't received the enzymes yet but should in the next few day. Since her B12 is on the higher level my IMS said it was fine to give the B12 pills- should you always start out with the shots when first starting these enzymes? Thank you to anyone who helps - it is very much appreciated .

[Olesia711]

HI and welcome to our EPI family.

I will try to answer your questions as best i can, but some of the suggestions by the vet is rather odd....

1. YES continue the Visbiome for now..... but, if her poos remain good in a few months, then i would revisit with your regular vet if you can stop the Visbiome.
THe reason why i am suggesting staying on it is because ALL dogs with EPi have SID (small intestinal dysbiosis)... however we only treat when out of whack. since the objective is ti keep them in good control. Often when first starting on enzymes things are great... the enzymes are working, etc, but then after a little time passes, slopy stools will appear, and that is SID rearing it's ugly head. In which case you first treat with prebiotics, if that doesn't work, you then treat with pre+probiotics and then if that doesn't work THEN you treat with TYlan antibiotic powder. Well... you are ahead of the game by having your dog on Visbiome already.... so i would continue for now.

2. Humph..... if the B12 levels are at 1000 and this what the B12 level was at when first diagnosed with EPI? If yes..... then you don't need B12 supplementation cause your dog does not have low or low normal B12. But what you can do is just give your dog 1 capsule once a week.... just to maintain....
HOWEVER... if the B12 level is at 1000 AFTER being treated for low or low normal B12 , then yes, give the B12 pills as needed (usually daily... but go by the dose chart here on this page set forth by Texas A&M Gastro Lab. https://epi4dogs.com/b12-protocol/ ....to maintain this improved B12 level.

3. Enzyme pills. sorry..... they usually don't work or don't work as well as needed to support EPI UNLESS you give more than what is recommended AND you most likely will have to crush them.... and in the end, you spend a lot more money. CHeaper and more efficient to go with the powder..... HOWEVER..........just because this is what usually happens with the pills, still go ahead and try them as is and as recommended and see if they work for your dog. But if the poos go south.... you will then know to add extra pills and crush them to be more successful. Glad you ordered the powder though

4. Unfortunately sometimes some internal vets are really not that familiar with the latest EPI treatment or real practical application. It is not okay to give treat with out enzymes... as a matter of fact when first starting out treating your EPI dog, NEVER give treats or any food what so ever without enzymes... Because you are training... what you can do is check out our treat page for some ideas https://epi4dogs.com/treats/ .... you cannot put dry enzymes on a dry treat cause you can cause mouth sores. what you can do IF this works out with your schedule... is ONLY give treats within 1 hr of eating an enzymed meal... however, having trained dogs myself for a discipline, i know that sometime this is not feasible. The other thing you can do is make a paste of their meal with enzymes in it.... put in squeeze tube and squirt in their mouth a blob of the enzymed mush as a treat. buffalo meatballs sound good if you include enzymes in them- -as they are moist.... would they be something that you could individually wrap or something.... so you can have a bunch in your pouch when training? Once your dog is stable for about a month (good poos, good frequency) AFTER starting enzymes.. then you can try cheating with a very tiny amount of treats without enzymes in them to see how well your dog does .....


5. Since she hasn't lost a lot of weight due to EPI, then no, you do not need to feed her extra.

6. I understand what your vets are saying about DCM..... but quite honestly, once you start the enzymes, if the stool go south, it will most likely be because of grain in the food because fiber can inhibit the efficacy of the enzymes from anywhere between 0% and 50%.... we have an 2 tabs devoted to this subject, that you are welcome to read https://epi4dogs.com/why-grainfree-foods/ and https://epi4dogs.com/taurine-grainfree-diets/.... however.... because of your dog's situation what i would suggest is for you to simply stay on the food your dog is now eating... once you start the enzymes watch the poo out put closely. keep an eye on things for about 5 days/ a week. If the poos remain good, then there is no need for you to change, BUT, if the poos go south, then you will ahve to change, in which case i strongly recommend you read the 2 above tabs because it is not so much "grain free" but rather what the ingredients are in the grain free, or lack there of.. SOme EPI dogs do fine with grain, even though the majority doesn't.... so give it a shot and see if your dog can handle grain once on enzymes.

7. good that you feed 3 times a day , but no, you cannot do a free feeder like what you described with enzymes in the food, since you have to moisten the food when you include enzymes and if this moistened food is eft for more than an hour, you are inviting bacteria ... bad bacteria... and that is not something you want to do.... if this is the only way to feed lunch, then skip the lunch meal at this time. What a lot of us do is feed breakfast when we ourselves get up, feed lunch when we get home from work and feed dinner (to get in 3 meals) a short while before bed time...............

hopefully your answers have been answered and if you have any more questions, plese feel free to ask!

[Tuckaboo Pam]

Hi Wendy. Welcome to you and Tilly.

There are people on staff who will understand all of the test results & conditions that you have given, but I am definitely not one of them! So I just want to say that you have come to the right place, and if you keep checking back you'll get some responses & can get a conversation started.

I look forward to learning from reading your thread.

I love, love, LOVE Newfies!!!!---Pam & Tucker (not a Newfie)

[wsparks2]

Thank you for helping me start to understand . Since I don’t have a problem with diarrhea or loose stools I didn’t know this is something that can start once I start the enzymes. She does go more then my other dog but it’s firm. This was her 3rd GI test in the last 8 months and on all 3 her B12 was over 1000 and she has never been given B12 supplements so yes this was pre diagnosis. As far as the bison ball treats I buy 90% lean ground bison and make into balls and bake at 350 for 8 minutes. She gets these everyday to use as pill poppers. We start training again next week so since she is given these everyday can these be used as “treats” ? If yes how would I add the enzymes ? Would it be better to add enzymes to meat and dehydrate ? Or would I add enzymes and put in a treat pouch and hand deliver? It’s a 45 minute drive to class and class is an hour long. But in the summer water training is an all day training outside. Is it okay to give fish oil to a epi dog ? In the summer I use a seresto collar but at this time we are not using heart worm. My vet suggested advantage plus but I am not sure about a product for both. Also I want to be ready in case the grain inclusive food doesn’t work for her. Any suggestions on grain free food ? We tried hydrolyzed dog food and she wouldn’t touch any of it. If she smells medications in her food she won’t eat it . I didn’t know what others have used since I have a dog prone to DCM. I cook for my other dog but just rice and fish. I am not opposed to cooking for my epi dog or trying raw. I have asked my nutritionist and she doesn’t like these ideas but I want to do what’s best for my dog.

[Tuckaboo Pam]

I like this video, in which the vet talks about raw diet for EPI dogs. I feed Tucker Sport Dog Elite for herding dogs, and he does well on it, even though recently he was gassy & I tried to figure out if it was his diet. I think it wasn't. Anyway, here's a link to a very interesting, I think, video---
https://healthypets.mercola.com/sites/h ... -dogs.aspx

This is a couple years old, so more current information is available now.---P

[Olesia711]

Hi!

i will try to answer some of your questions:
1. As far as the bison ball treats I buy 90% lean ground bison and make into balls and bake at 350 for 8 minutes. She gets these everyday to use as pill poppers. We start training again next week so since she is given these everyday can these be used as “treats” ? If yes how would I add the enzymes

In would take the finished meat balls with you and take a small container of the enzymes separately with little measuring spoons... about 10 minutes prior to starting your training.... make a slit in the meatball and insert approx 1/16 or 1/32 of a tsp of enzymes into the meat and then try to squeeze it back together.... do this with a bunch of meatball that you "think" you will be using as rewards.... see how it goes. THis way, she gets her meatball treat and they have enzymes in them and they haven't been laying around with enzymes in them for hours and hours. You can use the dehydrator, but i think your meatball idea is better to start with. Once you get the hang of how much of what she can tolerate as a treat without enzymes (of course this is done AFTER she is stable for about a month) then you can try other treat variations.

YES!!!!! EPI dogs should actually get fish oil supplements...since they have a deficiency in soluble fats because of EPI (see the EPI research tab) and once on enzymes average amounts of fat actually helps the digestive system use the enzymes more effectvely...... crazy, eh?!

I personally like Sport grain free food https://www.sportdogfood.com/products/herding-dog... but there are many MANY foods out there... it all depends which one your dog's unique gut flora best responds to.

[Jean]

welcome from the UK

Tablets are always different to give

let me see if I can find someone who used them

[TerryBin]

Hello and welcome! It seems like most of your questions were well answered. Most people on the forum use powder and tablets are a bit different. We have had 3 Shiloh Shepherds over the years with EPI (all related) and one without. We've always used tablets as that is what our vet had and we had such success we didn't want to change. We use PancrePlus so amounts may be a bit different. We started out with one tablet per cup of kibble plus one for the bowl (so 3 tablets for 2 cups of food) and that worked well for many years. Whether pup is on powder or tablets they usually need more enzymes as they age, which we have found to be true. One of our dogs always had normal poops and only got dx with EPI after she started to eat a plastic tube from our vacuum (really out of character for her). Her younger half brother had already been dx with EPI and she looked like she had lost weight so we had her tested and she did have EPI. Other 2 dogs had sloppy poops as well as weight loss. If we had only looked to her poops we would not have thought of EPI. With all enzymes and dogs it's a matter of finding the right amount. The important thing too is to only make one change at a time. If you change 2 things at the same time and things get better or worse you don't know which made the difference. Best to make a change and monitor for about 3 days before making any other changes. Hope this helps.

[wsparks2]

I received the pancreplus tablets and the vet hasn’t okayed the powder yet so waiting on it. I the mean time I will start the pills. My directions say follow instructions on bottle and there are no instructions on the bottle how did you give the tablets ? She gets 1 cup of food 3x’s per day. Also does anyone give dasuquin or any other joint supplements ?

[Olesia711]

If she gets 1 cup of food 3 times a day.... then start with 2 tablets with each meal..... do this for a few days and if her poos remain firm/normal... then you are all set with the # of tablets and how to give them.

If after a few days... her poos get sloppy, then crush these two pills, mix in the food, let sit for 20 minutes and then feed (make sure the food is moistened so the crushed pills don't sit on top of dry food.

If the above doesn't work THEN add an extra pill to each meal.

And YES!!! Lots of EPI owners give Dasuquin. Just give before or after a meal.... no special treatment . I used to give Springtime joint supplements to my dog, started out with Dasuquin Advanced and it ws expensive... so i switched to Springtime https://www.springtimeinc.com/product/j ... upplements because when i did the calculations (when i bought 2 and got one free) it was WAYYYyyyy cheaper than Dasequin and it had the exact same ingredients and the potency was a pinch more too. I showed it to my vet and she said other folks used it and it seemed to be a good alternative and she had no problem with me switching from Dasuquin to Springtime...... just sharing......