How long until noticeable improvement

[LauraF]

Hi all,
My 4 year old GSD Rosie has recently been diagnosed with EPI. I have found this to be the most stressful and confusing few weeks while we try and understand what our girl needs before she becomes any sicker
Previously when Rosie was 1 year old she was diagnosed with Thrombocytopenia (low platelet count) as a result of a hormone imbalance which she has improved greatly from over the last few years.
Our vet has recommended feeding raw pancreas with meals for the first stage in trying to settle Rosie's EPI. So I'm wondering how long should it take before there is a noticeable improvement in her symptoms or are there several things that should be done before any improvement will be noticed?

Thank you!

[jilbert57]

Hi Laura, welcome to you and Rosie. I see you are in Ireland!
I am not that familiar with the ins and outs of using the raw pancreas for enzymes.
Will you provide some information?

What was the test result of the Tli for diagnosis?
Was the B12 level tested also?
Was an antibiotic prescribed for SID/SIBO in gut?

There are 4 things that need to be addressed
for Epi animals to feel good:

Enzymes with all food
Diet of 4% fiber or less (grainfree)
Antibiotic to address SID/SIBO
B12 needs to be upper level to high end

Thanks
Jill

[Olesia711]

Hi Rosie's mom,

Raw pancreas is one option to managing EPI..... with some dogs it works great (if you can figure out the right amount to give- -as the potency varies from one raw pancreas to the next. However, with other EPI dogs, raw does not work as well as expected (sometimes the dogs just don't like the raw pancreas). Over all the more stable option is commercial replacement pancreatin... (see the UK list of possible enzymes to use: https://epi4dogs.com/epi-quick-guides-outside-usa/


There is a standard set of guidelines to treating an EPI dog..... BUT .... once you implement the typical EPI protocol, often you have to adjust the protocol until you find the right balance of the EPI protocol that best suits your dog.

Once you start the enzymes, "usually" there is immediate improvement within a few days..... of course, then what often happens is that a few weeks / month later, the poos start getting slopping again... and this does not mean that the enzymes are not working, but rather that SID (small intestinal dysbiosis) has gotten. out of control and needs to be better managed.

So, in order to effectively manage EPI, you have to find the right balance of:
1. enzymes (type/administration technique)
2. food ( usually a low fiber and often low carb food works best)
3. B12 (make sure the B12 is in the upper mid range. Unfortunately over 82% of all dogs with EPI require proper B12 supplementation.
4. All dogs with EPI have SID to one degree or another. We need to keep it in good control . If needed, use prebiotics. If that doesn't work use Pre+Probiotics, if that doesn't work well enough, then use Tylan (Tylosin Tartrate Soluble Powder antibiotics-originally created for pigs, chickens and honey bees, now used on dogs and cats0... DO NOT USE METRONIDAZOLE!!!!!


If you can share with us, exactly how much raw pancreas you are giving with how much food, how you are preparing it.. and the name of the food/ingredients/analysis... and if your vet has started your dog on any probtioics, B12, antibiotics, etc.... this will greatly help us.

Also.... what were the test results from the TLI blood test to confirm EPI... and did your vet draw blood to test the B12 levels?

[LauraF]

Hi, thanks so much for the replies, apologies for not including all the other important information it's overwhelming the amount of things to consider when trying to treat epi.

Rosie is currently fed 200g kibble (Burns) + 100g lean poultry (chicken/turkey) + 50g of raw sheep pancreas (as suggested by our vet), she gets this amount twice daily, fibre content is approximately 3%.
She seems to really enjoy the raw pancreas and has always had a raw element in her diet over the last few years (liver etc for previous issues with blood counts).
Her B12 was not initally tested but is due to be taken in the coming week.
TLI came back <1.
She is given a 1g sachet of FortiFlora probiotic with food daily.
She was initially prescribed Metrocare (Metronidazole) but that has recently stopped.

Do you have any recommendations for a particular powder enzyme that I could use if the raw version doesnt seem to help? Also is there a particular antibiotic that should be used to treat SID?

Thanks again!

[Olesia711]

Thanks for the added info.

So... since Rosie LIKES and is used to "raw"..... first lets make sure you are giving enough raw pancreas.... and then.... if that still doesn't produce good poos (and if the lack of good poos are not due to SID)... then what you might want to consider is a combo of raw pancreas with some commercial pancreas supplement. Some folks have done this where the raw worked but not well enough... so they did a combo of raw and commercial.
https://epi4dogs.com/enzymes-in-brief/
The first thing is, lets make sure you are handling the raw pancreas technique correctly. The trick though to compensate for the varying potency from one animal pancreas to the next is to settle on a more than needed amount .

Here are the general instructions for raw taken from : https://epi4dogs.com/enzymes-in-brief/
FEEDING RAW PANCREAS: If you would like to try using raw pancreas; fresh beef, pork or lamb pancreas are recommended. If you are in the U.K. you can look into http://rawtogo.co.uk/ . One to three or four ounces of raw pancreas can replace one teaspoon of pancreatic extract. Raw pancreas may be frozen in cubes for future use and thawed naturally, but never heat on the stove or in the microwave.

If possible beef or lamb raw pancreas is recommended over pork pancreas because of the “possibility” of the transmission of pseudorabies, although rare.
http://en.wikipedia.org/wiki/Pseudorabies

Also… raw pancreas is not all the same. Each and every gland has a different potency of enzymes. This is not just species to species. The potency can vary from one farm animal to another farm animal as well. If you use 1 ounce of raw pancreas with the batch you are currently using the next batch may need to be tweaked. Fresh pancreas has a shelf life (in the freezer) of up to 3 months.

Adding enzymes to a raw fed meal:
Since raw food is harder to measure by the cup since the densities of different meat/bones will require different levels of enzymes, it is easiest to go by weight rather than amount! ” To add the enzymes, you can either puree a portion of the raw meat and add the enzymes to that pureed slurry and pour over the remainder of the raw food, let sit for 20 minutes and serve, or you can add the enzymes to something like yogurt/kefir and either add to the food as mentioned above, or serve the enzymed slurry first ahead of the meal. Try both to see which works best with your EPI dog. (Thank you Cait for these great suggestions!)


Next... i noticed you are using Burns food. Although we usually recommend low fiber food, over the years i have repeatedly noticed that many folks from the UK that used Burns food had good luck... so for now, i wouldn't change the food, unless after you have tried everything else and things are still not comping together as expected, then consider changing the food.

Make sure you give the raw pancreas (not heated, not cold) and give the right amount with EVERY meal.... and do not give any treats in-between (for now until you get things under good control).

Also the 3 to 4 tsp of pureed raw pancreas per 1+1/2 cup of chopped/minced raw or 3 to 4 tsp of pureed raw pancreas to 1 cup of dry dog food .

Ahhh... probiotics good.... BUT... just a question for you.... were the probiotics started with a full dose immediately? and has it been just a few days since starting the Forti Flora? If so... this can also account for sloppy stools...... reason being is that "some" dogs don't do well initially when probiotics are first introduced... it take a little time before their gut gets acclimated to the probiotic... so what we recommend (just in case you have a sensitive dog) is when starting probiotic, start with less than h1lf the recommended dose and work your way up to giving a full dose over the course of a week or two.

If you are doing the raw correctly..... and still no positive results, but the dog likes the raw, then try doing a combo ... with maybe some Lypex or... can you get enzymes from the UK? If so, i would try CHemeyes https://www.chemeyes.co.uk/product/high ... -powder-2/ to use in combination with raw... and if THAT all fails.... then i would try one of the commercial enzymes listed on the UK page i posted about above. I will also contact Jean (she is our UK rep and FORUM director) and she can work with directly as to what enzymes would be best for you to access.

And yes.... for an antibiotic, if needed.. have your vet prescribe Tylan (Tylosin Tartrate soluble antibiotic powder).... your vet might need to really look for this, but yes it is available in the UK and used for dogs and cats, even though Tylan was originally designed for chickens, pigs and honey bees. DO NOT let your vet prescribe Metronidazole- -they are not advising NOT to use this for chronic gastrointestinal issues according to recent veterinarian research.
As a matter of fact, here is one place your vet can get Tylan from: https://www.farmacy.co.uk/tylan-soluble ... -100g/p523

[Madelon]

Hi and welcome to you and Rosie! Olesia has given great advice as she always does My only recommendation would be to keep a detailed journal of everything you give and the resulting poop. You might also want to try our carrot trick to figure out your dog's transition time - cut up some carrot and put it in your dog's food - make a note of the date and time you give it and then look for the carrot in the poop - too often we think the poop we are looking at is from the meal we just fed when in fact it could be from a meal given anywhere between 12 and 72hrs ago. This will help you figure out if the change you made is working or not.

[Patsy]

Hello and welcome, I’m from Uk.
Your vet is unusual for knowing that you can use raw pancreas. I hope Olesia has helped you with the quantities. My husband wouldn’t allow it in our freezer! I used various excellent enzymes in my search for the cheapest option . A point about European enzymes is that unlike our US friends, ours must not be soaked before use. They will digest food immediately and turn it Ito something like vomit, so no waiting.
In my personal opinion , these are pros and cons of what I tried.
Panzym powder is the standard. Good very effective/ but tastes and smells unpleasant for some dogs.
Lypex coated granules in a capsule. Excellent and the coating ensures no taste or smell. But it is expensive.
Chemeyes.co.uk make cheaper versions of both of these. The owners have had an epi dog. Very approachable for advice.

Which Burns food are you using? They used to only sell high fibre food,with brown rice, not helpful with epi. But I see from their website that that they have two grain free ones. Duck or turkey with potato and buckwheat, crude fibre 2%.
There is a list of recommended foods on the info pages. I used Millie’s Wolfheart which has lots of choice, or Eden. I needed to avoid chicken and grain.
We do ask you lots of question, but between so many of us, there is a wealth of experience. We have all been in tears and despair at the beginning, but it gets easier.

[Olesia711]

Ahh... thanks Patsy for helping out..... you being from the UK yourself, you have much more insight into what is available and what works better .
Considering that i live in the USA, my knowledge is somewhat limited with UK products/availability..... SO i appreciate you chiming in

[Patsy]

Another thought... my non- epi dogs, and my son’s one , all have Butchers grain free tripe mix. In all supermarkets.

https://www.allaboutdogfood.co.uk/dog-f ... -tripe-mix

I was initially cautious, but it is really good food and cheap. Read their website. The calories may be low for weight gain, but as mentioned before, you can add extras. Dogs adore it too, and poops are perfect. It will disguise enzyme powder.

[Olesia711]

oh wow!!! That looks like a real good food....not only does it sound agreeable for EPI dogs, i like the 13% tripe.... that's loaded with good lactobacillus bacteria!