Complicated EPI Case

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.
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DocX
Member
Posts: 18
Country: United States
State: Massachusetts
Pet name: Mina
My name: Doc

Re: Complicated EPI Case

Post by DocX » 17 Mar 2023, 11:07

Hi Miranda,

Because my current dog had high consistently eosinophils and terrible appetite when she presented with EPI, her internal medicine vet was concerned that it might be concurrent IBD, so I tried very hard to get her to eat only hypoallergenic food while I was stabilizing her (with logic that if there was concurrent IBD, it would be clinically very helpful, and it would do no harm if it was only EPI). She was so food averse that I just couldn't do it. So I truly understand what you are going through, we can't sit by and watch our dogs waste away.

The general protocol I used for getting Mina eating again was to cook her some meat and white rice (she likes beef more than chicken). I bought low-fat ground beef and boiled it in quite a lot of water to make "broth". I would feed her about 1/3 meat to 2/3 rice, with plenty of "broth" on the rice to make it very flavorful. Because this is not very nutritionally balanced, I would add a very small amount (like a tablespoon) of some kind of canned dog food. I tried things like canned Z/D and Evangers vegetarian (which at least seemed less likely to add more potential protein allergies if I was dealing with IBD). She liked to eat this while warm, but not too hot. It stinks more when slightly warm. As she started feeling better, I first slowly increased the amount of canned dog food (first up to a quarter cup per meal, then up to 1/3 cup per meal, etc.), then started also adding very small amounts of kibble, ie a teaspoon, I would slowly reduce the amounts of meat and rice so the amount off calories per meal stayed about the same. It took me about a month to get her eating dog food again. I would feed her three or four times a day.

It is important to note that if I had not gotten the SIBO under control, this would not have worked. Given that all new-onset EPI dogs probably have SIBO, and that tylosin is very good for both SIBO and dog IBD, that seems like a very good thing to discuss with vet.

If Mina had ended up having IBD and I had not been able to use beef for that process, I would have either tried harder to get her to eat hypoallergenics, or used novel proteins, as if a dog has never eaten a protein like deer or rabbit or kangaroo before, it will not react to it. Happy to discuss that more if it's something you end up wanting to try.

I am so, so happy that you have an internal medicine vet to help you manage this. I could not have managed my IBD dog without one.

mbellant
Member
Posts: 7
Country: United States
State: Colorado
Pet name: Konan
My name: Miranda

Re: Complicated EPI Case

Post by mbellant » 20 Mar 2023, 16:11

Hi DocX,

I wanted to really thank you for the suggestions. Konan has eaten for the first time consistently 3 days in a row since his surgery 6 weeks ago. He has more energy and is overall happier. I relish in the little victories. I took your meat and rice recipe and created my own for him and so far it is a hit. I am very hopeful for the first time in weeks that we are on the right trajectory for him. Thank you again.

Miranda

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DocX
Member
Posts: 18
Country: United States
State: Massachusetts
Pet name: Mina
My name: Doc

Re: Complicated EPI Case

Post by DocX » 21 Mar 2023, 21:25

Oh gosh I’m so happy to hear that and hope very much that he keeps eating for you! Good luck!

mbellant
Member
Posts: 7
Country: United States
State: Colorado
Pet name: Konan
My name: Miranda

Re: Complicated EPI Case

Post by mbellant » 09 Apr 2023, 10:47

Update! I want to thank every one for their input on Konan. I am pleased to announce that Konan has gained 7 lbs these last 2 weeks and it mostly eating well. Only 17 lbs more to go for his ideal weight. We switched to Pancreaplus enzyme tabs and it was a game changer. We have been crushing the tablets and placing them into capsules and giving with his meal and there is no enzyme aversion and his poops are great. We did run into a hiccup just recently where he suddenly stopped eating but we also found one of his enzyme capsules he spit out under the counter, so we think that is the cause. He was started on Tylosin and we are in the beginning phases of weaning him off Prednisone and Reglan. I did switch internal medicine vets because we found one from CSU that really specializes in EPI and gut biome. For anyone looking for a vet in Colorado, Alison Manchester at CSU has been fantastic. She gives conferences on EPI and is doing a lot of research on IBD and such.

We still have our good days and bad days, but the good are far out numbering the bad. Konan's energy is excellent now and he is enjoying life chasing rabbits and going for hikes again. I wasn't sure we were going to make it with him at first. Thank you for all your support and this EPI forum.

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jilbert57
Staff
Posts: 2089
Country: United States
State: Washington

Re: Complicated EPI Case

Post by jilbert57 » 09 Apr 2023, 10:53

Wow what a great report! 7 lb gain is great..soon to become a member of the Chunky Monkey Club!

We will add that vet to our list of vets in different states.

Keep up the good work.

Jill
My name is Jill and we live on the Hood Canal in Washington State. We currently have 2 Jack russells, TJ is 8 and Sadie is 2.

Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.

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