New EPI dog

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

Re: New EPI dog

Post by Tuckaboo Pam » 26 Jun 2021, 11:01

Not sure about the Metro being worth it. My Ruthie took it, and she has had bowel problems ever since. https://www.animalbiome.com/blog/metron ... at-to-know

Try the slippery elm, which is a prebiotic., PLUS the probiotic. Proviable is recommended, and available on Amazon. Probiotics need to be introduced gradually, or your dog will get the squirts for sure. For dosing of slippery elm look here. Less can definitely be more. Tucker does well on half the recommended dose. https://epi4dogs.com/slippery-elm/ In fact, this whole section may be of interest to you and your vet. https://epi4dogs.com/sidsibo-management/ There's more, too!

Maybe your vet could go ahead & order Tylan, to have on hand if this doesn't work. It is a bit pricey, though. I hope we have convinced you to try at least a sample bag of Diane's Enzymes, as they will really save you money. We DON'T work for her! We just love her and her enzymes. Take Care!---Pam & Tucker

The crazy eating will subside. She feels like she is starving, and she's trying to get nutrients. OH! We did tell you to feed her 1.5 times the amount of food she should eat at her IDEAL weight, right? Oh gosh, I'm all over the place. Sorry!!!!
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.

Harper
Member
Posts: 11
Location: Missouri
Country: United States
State: Missouri
Pet name: Harper
My name: Alexis

Re: New EPI dog- TLI results

Post by Harper » 26 Jun 2021, 13:15

I picked up a copy of Harpers test results for the TLI test and her results are 1.6 ug/L. I have no idea what that means, I also have a copy of the bloodwork they did but idk if any of that info is relevant, she was within normal ranges on everything.

-Alexis

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

Re: New EPI dog

Post by Tuckaboo Pam » 26 Jun 2021, 14:52

Alexis, please post everything. Some of the people here are really good at reading the results(I'm not one of them!). Tucker's B12 was in normal range, but not enough for an EPI dog, which I found out by posting all the tests. Also, the TLI number just tells whether or not it's EPI. The treatment is the same, as long as it's in the range. Tuck's was 1.3. Thanks! 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.

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

Re: New EPI dog

Post by Tuckaboo Pam » 26 Jun 2021, 18:08

Also, if your vet thinks it will be weeks before she can get the Tylan, ask her to check out Foy's Pigeon Supply. They have it there, with all kinds of delivery options. I would hate for you to have no other option than the metro. My vet gets it there for me, but then my vet is pretty crunchy, so she does things others may not.
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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Madelon
Staff
Posts: 1317
Location: Nashville, TN
Country: United States
State: Tennessee
Pet name: Doc

Re: New EPI dog

Post by Madelon » 29 Jun 2021, 20:48

Hi Alexis - welcome to our EPI family! Looks like you are definitely dealing with SID.

There are four cornerstones to properly managing EPI:

Enzymes: As Pam said, most of us use EnzymeDiane (I recommend starting with the Pancreatin 6x as it is easier to tweak as it is 1 level tsp per cup of kibble). Glad you are using 1tsp per cup of kibble as dosing as that is what we recommend. Mix the enzymes in a little luke warm water, mix in kibble and sit for 20-30 minutes before feeding.

B12: Most EPI dogs have low B12 at diagnosis or will soon develop it (this will be listed as cobalamin on your blood test). EPI dogs need their B12 on the high side of normal 600+ and supplementing is for life. You can either do the shots to start with or most of us use WonderLabs Pet Factor B12 pills. The dosing is based on weight so let us know how much your pup weighs and we'll give you the dosing. Low B12 will affect appetite, energy, weight gain, mood, etc.

SID (small intestinal dysbiosis): All EPI dogs have SID but it's a matter of keeping it under control - this is the diarrhea/loose stools, burping, farting, tummy rumbling. When first diagnosed we recommend giving the proper dose of enzymes, B12 and food for two weeks to see if the gut will correct itself - if not then we recommend trying Slippery Elm Bark Powder (it's a prebiotic mucilage you can order it from WonderLabs as well and use code EPI4DOGS15 at checkout for a discount). You should notice improvement within a few days - if not, then we recommend getting a prescription for Proviable from your vet) and give that a week or so and if still no improvement then we recommend a 45 day course of Tylan antibiotic.

Food: This can be the trickiest part of EPI. We recommend grain free with 4% fiber or less and avoid/limit peas and legumes. If your pup does indeed have a true food sensitivity then hydrolyzed is the way to go but we have found those that require hydrolyzed tend to do better with the Royal Canin Ultamino.

Keep a detailed log of everything you give and the resulting poops and try to wait at least 5 days between making changes. Hang in there - we will be here to help you along the way.
Madelon, owned by DOC. DOC dx EPI 5/2015 = TLI < .4, B12 406; Folate >24. DOC taught me so much and together we battled and overcame EPI, food sensitivies, environmental allergies but we lost the cancer battle. DOC was dx with hemangiosarcoma 5/2022 and crossed the rainbow bridge July 24, 2022. He is and always will be the love of my life, my soulmate, my heart dog.

Harper
Member
Posts: 11
Location: Missouri
Country: United States
State: Missouri
Pet name: Harper
My name: Alexis

Re: New EPI dog

Post by Harper » 30 Jun 2021, 22:04

I think I have attached pictures of Harpers blood work, I don’t see cobalamin listed and when I asked my vet about it she said “I can take your money and check her B12, or you can supplement her with b12 tablets now” so I ordered the wonderland with intrinsic factor and they came today. Harper weighs 36 pounds, so should I give her one tablet a day?

Thank you for the suggestion on proviable, I don’t think I had seen that yet!

-Alexis
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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: New EPI dog

Post by Jean » 01 Jul 2021, 06:45

sounds like a sensible vet not to take money from you, most dogs have low b12 with EPI so go with the vets thoughts

Metro has side effects which can be neurological, so steer clear if you can

any issues get the vets to prescribe valium/ Diazapan

https://vetgirlontherun.com/metronidazo ... ideo-blog/

as to the b12 capsules, 1 per day sounds ok to me , they will pee out any they dont use

https://www.wonderlabs.com/itemleft.php?itemnum=K9688

just scroll down to doseage

Tylan if you get it is weight dosed

https://epi4dogs.com/antibiotics/

let us know
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

Harper
Member
Posts: 11
Location: Missouri
Country: United States
State: Missouri
Pet name: Harper
My name: Alexis

Re: New EPI dog

Post by Harper » 08 Jul 2021, 20:19

Hey all,

So we started enzymes almost 4 weeks ago now. So far she’s gained just over a pound (I am feeding her 150%) and had mostly firm stools. I would say most of her poops still fall as a 4 on the chart, although she does have a 3 most days. The other issue is the color, I’d say 60% of the time it’s still a little yellow and very light colored. The other 40% are light tan at best. I have been giving her slippery elm for 9 days and started B12 with intrinsic factors 4 days ago.

Her appetite is still insane, and the coprophagy has seemed to be worse the last few days than it was a couple of weeks ago.

I talked to my vet about SIBO again but she thinks we are making progress and should just give it more time. So now I’m wondering if I should try a new food next or talk to another vet about getting a tylosin RX.

Thoughts?

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Madelon
Staff
Posts: 1317
Location: Nashville, TN
Country: United States
State: Tennessee
Pet name: Doc

Re: New EPI dog

Post by Madelon » 08 Jul 2021, 20:47

Hi again! So for the B12 you should be giving 1/2 capsule 1x a day. If you've been on the slippery elm for 9 days and haven't seen a great improvement I would keep giving it as you make a different change because we say only make one change at a time and slippery elm is relatively inexpensive. What food are you feeding? Your options are to change the food or try Tylan antibiotic powder. If I were you and you're feeding a grain free food with less than 4% fiber then I would ask your vet for a prescription for Tylan. At this point the SID is likely too out of control and needs an antibiotic. If you do the Tylan you will need to give it for 45days and slowly wean off. If your vet disagrees with Tylan then you could ask if you try and change food and that doesn't work if they will then prescribe Tylan.
Madelon, owned by DOC. DOC dx EPI 5/2015 = TLI < .4, B12 406; Folate >24. DOC taught me so much and together we battled and overcame EPI, food sensitivies, environmental allergies but we lost the cancer battle. DOC was dx with hemangiosarcoma 5/2022 and crossed the rainbow bridge July 24, 2022. He is and always will be the love of my life, my soulmate, my heart dog.

Harper
Member
Posts: 11
Location: Missouri
Country: United States
State: Missouri
Pet name: Harper
My name: Alexis

Re: New EPI dog

Post by Harper » 08 Jul 2021, 21:49

Hi Madelon!
I have been giving her a B12 capsule 2x a day! I guess that’s wayyy too much. I’m feeding her Hills science diet ID chicken and rice, the fiber is right at 4% before the vet put her on this I fed her Taste of the Wild pacific salmon so I’ve been thinking of switching her back to that.
Thanks for the quick answer!

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