New EPI diagnosis

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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CaliGirl
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Posts: 63
Country: United States
State: California
Pet name: Cali
My name: Nicole

New EPI diagnosis

Post by CaliGirl » 18 Jan 2021, 11:43

Hi everyone! I have been frantically trying to get into this forum. I have a brand new pug puppy, her name is Cali. She was a gift from my boyfriend after we lost our dog of 13 years to bladder cancer. We got her from a breeder in California. About 3 days after getting her we found out she had parvo. She was in the hospital for over a week. After her treatment she had about 3 good days, then I became very concerned with her bowel movements nearing Aprox 10 or more a day. She was eating a ton of food but wasn’t putting weight on. Cali girl is now 4 mos old and weighs 2.5 pounds after back and fourth at the vet they said she needed a specialist. After numerous tests they found out she has EPI. We now have the enzymes and I am realizing life will never be the same. Since starting the enzyme she has a ton more energy. The vet wanted me to only give once a day because of her size, I quickly realized that didn’t make sense. She was still bloated and had a ton of gas at meals she wasn’t getting the enzyme. I am now giving it to her at every meal which she gets 3x a day. 1/8 a teaspoon at each meal. She is still pooping a lot about 5/6 times a day, sometimes hard sometimes soft. Is this normal? I’m keeping record of everything. One thing I havnt done yet is changed her food. And I don’t know if I should. She is eating hills science diet puppy kibble with wet hills I/D food. I worry about treats as well. Because she is so young and training, I don’t know what to give her. I feel so confused. This little girl has been through so much and I am trying with everything in me to get her comfortable and gaining weight. She is so tiny. When I asked the vet about antibiotics for SIBO she said no. I feel like I am combating this alone! Anything you can offer would help, I feel like I have so many questions!
I added a picture of Cali under attachments, I don’t know if I did it correctly. 😬
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Olesia711
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Re: New EPI diagnosis

Post by Olesia711 » 18 Jan 2021, 12:05

Hi Nicole,

I am so so sorry your little pug has EPI..... Interestingly enough, there does "appear" to be a possible connection with a puppy getting parvo and then developing EPI. SO this all makes sense.

NOrmally i would say try switching to a food that is low in fiber content because fiber can reduce the efficacy of the enzymes from anywhere between 0% to 50%.... we just don't know which EPI dog will be affected and by how much when eating too much fiber.

BUT.... since you are dealing with a puppy and puppy diet requirements are needed , and since i strongly suspect you are also seeing the results of SID (small intestinal dysbiosis: which fiber actually helps with (this can all gets very convoluted)) ... anyway... SID is something ALL dogs with EPI have to one degree or another, and our objective is to keep it under good control..... so.... what i suggest for you to try first is to increase the amount of enzymes you are giving with each meal.

SOOOOOOOOo... please let me know exactly how much food you are feeding her each meal
NEXT, what is the brand name of enzymes your are giving her?..... and how are you preparing the enzymes with the meal?

And then, i understand your vet not wanting to prescribe any antibiotics yet..... please remember that if this does get to the point where anti's are needed... you need to insist on Tylan... do NOT let your vet give your pup metronidazole.

once i know how much food you are feeding per meal, i can advise how much enzymes to give (with each meal) and then we need to wait and watch to see if this helps.

If the slightly increased enzymes do not make any difference then we will know that what is causing the issue here is SID.... and we will help you try to address it.. in a step-by-step manner.
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.........

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Kodis Mom
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Location: Custer, WA.
Country: United States
State: Washington

Re: New EPI diagnosis

Post by Kodis Mom » 18 Jan 2021, 12:14

Glad to see you made it on the forum. What a cutie ! I will be following your post. Hang in there !
Kodi
B. 8/19/2010 Diagnosed at 11 months.
Kodi is now on Natures Logic turkey and/or pork kibble, 2 cups with 2 teaspoons of enzymes, 1/8 teaspoon of ground coriander, 1/16 teaspoon of cinnamon and ground fennel seed (for tummy upsets) twice a day, plus one one B12 capsule from Wonderlabs. She has been very stable and on occasion needs a dose ofTylan.
She is our second GSD with EPI. It was not so scary this time ! And thank goodness for epi4dogs.com ! 💝 Kodi passed on August 25, 2023 just after her 13th birthday.💝 Forever grateful to Olesia and epi4dogs. She live a long and adventurous life with EPI.

CaliGirl
Member
Posts: 63
Country: United States
State: California
Pet name: Cali
My name: Nicole

Re: New EPI diagnosis

Post by CaliGirl » 18 Jan 2021, 12:25

Thank you so much for your reply. Cali gets 1/2 cup a day of hill science diet puppy kibble, I break that down into 3 meals a day. (1/2 cup for the whole day)again this is what the vet told me to do due to her size. I add about a spoon full of hills science diet prescription I/D food canned food to each feeding . I add 1/8 a teaspoon of PancrePlus enzyme to each feeding. I mix it all together with warm water and let it sit for 20 min to 1/2 hour at room temp , stir up again after sitting and then feed it to her.

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Patsy
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Country: United Kingdom - England

Re: New EPI diagnosis

Post by Patsy » 18 Jan 2021, 13:39

Hello, and sorry to hear you’ve got so much to cope with. Olesia will guide you.
I just wanted comment on the apparent bloat. What has the vet said? My dog had a similar look, and an x~ray revealed that it wasn’t gas, it was fluid in the abdomen and chest cavity! Which was almost pressing on her heart. She certainly had gas too, and farted horribly! But fluid (ascites) is more risky. Marti was put on steroids, but that was years ago, though our epi journey still feels like yesterday.
Springer spaniel Marti had Epi, PLE , MMM just to confuse me. She lived till 12yrs, chubby and happy despite eight years of epi.
Capsule enzymes suited her best. B12 supplements made her into a new dog!
After a cocker with PLN kidney disease, I now have two healthy rescues, a lively, suicidal , small ginger terrier, adopted with pneumonia, and gum disease needing nearly all his teeth out, and a fluffy grey toy poodle/terrier from Greece.

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Olesia711
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Location: North Carolina
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Re: New EPI diagnosis

Post by Olesia711 » 18 Jan 2021, 13:59

Okay... i see what your vet is doing... he is recommending you feed her according to her weight right now.... the problem with that is that with an EPI dog you really need to feed 150% of what they would normally require.

SOOOOOOooooooo.... let's try this....
1. increase her food to 3/4 cup of the kibble daily along with (this will bring her food intake to 150% where it should be) . Break up the 3/4 cup of food into 3 or even 4 meals a day (if 4 meals then recalculate the enzyme dose). Just make sure there is always at least 2 hours apart from one meal to the next).
2. Continue with with 1 spoonful of canned food (mix the enzymes in this, add a pinch of room temp water and mix in with the kibble)
3. If feeding 3 times a day.... start with 1/4 tsp of enzyme + 1/2 of the 1/8 tsp of enzymes (this will give you another 1/16th of a tsp of enzymes to compensate for possible too much fiber) with 1/4 cup of the kibble and a spoonful of canned.... watch the poo.
4. If the poo remains the same after a few days...... then we are most likely dealing with SID.
5. To treat SID, the new protocol is (and by the way... your vet did the right thing for now.... do not "start" with antibiotics to treat SID unless absolutely necessary and even then do not use Metronidazole, but rather use Tylan (SID is formerly known as SIBO).. NEW SID PROTOCOL: (1a) treat with a prebiotic (we recommend first trying SLippery Elm Powder for a 2.5 lb dog try a little less than 1/16 of a tsp https://www.wonderlabs.com/itemleft.php?itemnum=K97024 )...
(2a) if this helps but not enough, then what the EPI vet researchers are recommending is a pre+probiotic. At this time we are suggesting "Proviable". However.... because Cali is so small.... first talk to your vet about using this or any other probiotic at this time........i honestly don't know if this would be appropriate or not....at this time..... If your vet thinks it is okay to use a probiotic.... then....you need to start very slow and use less than 1/2 the recommended dose and work your way up to a full dose over the course of a week or two. OR..... you vet my want to try a different probiotic maybe more suited to puppies

Has Cali's B12 level been tested?
If her B12 level is not upper-mid range (we like to see it in the upper 500's or 600's... then she NEEDS B12 supplementation. If her B12 level is not optimal, then she will never thrive and sometimes this could also be the underlying cause of loose stools, lack of weight gain, etc.
Please let us know if her B12 has been tested.

I would also like to suggest adding cold pressed / organic coconut oil... for weight gain... but not yet... you don't want to try too much too soon... just one thing at a time....................... please keep us apprised of what is going on and be sure to share with your vet everything we are suggesting to you.

And last but not least... i just scrolled down far enough and saw Cali's picture.... Oh My.... what a sweet little thing, but heavens, so little... we need to fix that !
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.........

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

Re: New EPI diagnosis

Post by Jane&Clyde » 18 Jan 2021, 15:11

Welcome! I'm new to EPI, too. Olesia and others give great suggestions and I'm so grateful for this site.

Since you specifically mentioned treats, you probably shouldn't give any treats to your pup, at least not until things stabilize. From what I understand, some dogs are eventually able to handle small treats, but others never can.

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Olesia711
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Posts: 3857
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: New EPI diagnosis

Post by Olesia711 » 18 Jan 2021, 16:20

thanks Jane for addressing the "treats" issue... i was so focused on explaining other stuff... that i didn't say anything about treats.... you explained it perfectly! And thanks!
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.........

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Buttermom1
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Country: United States
State: Texas

Re: New EPI diagnosis

Post by Buttermom1 » 18 Jan 2021, 16:42

Hi, and let me first tell you that Cali is absolutely adorable!
I’m going to agree with Olesia in everything she has advised you of this far. Yes, you’ll be feeding more food to her thru the day, but split into 4 meals would be ideal. I will also ask if the b12 was checked. In the little ones, and especially in puppies, the b12 is incredibly important and seems to need lifetime supplementation, more frequently, than in the larger dogs. B12 in the little ones seems to drop quick and hard. Something to talk with your vet about would be using unrefined, cold pressed coconut oil as a supplement. I say this because there are so many vitamins that are fat soluble that giving a bit of an extra boost might be beneficial as she grows.
Please share everything that has been suggested with your vet. There is a ton of scientific data listed on the pages of this site. Anything can be printed out and taken with you. Explain where you’re discussing these issues as we’ve been acknowledged by the AVMA as the source for EPI.
Most importantly, ask any question you have!!
Susan

CaliGirl
Member
Posts: 63
Country: United States
State: California
Pet name: Cali
My name: Nicole

Re: New EPI diagnosis

Post by CaliGirl » 18 Jan 2021, 17:09

You guys are ALL absolutely amazing!!!! I am so grateful for all your recommendations! And I will read this is it’s entirety tonight when I am home from work and do everything suggested. Thank you for it all. As far as the 4 feedings I was doing that and I believe it is ideal as well unfortunately we are both full time workers and 3 feedings is the best I can do. I come home on lunch to feed her. Before the enzymes we were using an automatic feeder, I don’t know if can leave the enzyme with food in that? Does anyone know? Also the other thing is, when I am at work and she does have a bowel movement and I can’t get to it, she is still eating them, is this something that may stop? Or could it be because she is not getting enough food/enzymes? Obviously when I am home they are picked right up. She is still an indoor dog because she still hasn’t been fully vaccinated and because of the parvo I can’t teach her outdoor potty yet. I can’t wait until I can!!!!! Trust me!

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