Shiloh not responding to enzymes

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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Kristyn

Shiloh not responding to enzymes

Post by Kristyn » 24 Jul 2022, 20:42

Hi all!
It has now been 3 weeks since we have started enzymes for Shiloh. And still no response. She is an interesting case as she hasn’t shown all symptoms of EPI. Poops are fine. But extremely hungry and losing weight.
We put her on a low fat food and started giving enzymes, their has still been no change.
She does still have pancreatitis. But again showing no symptoms.
Her TLI test was high. But the vet said this can happen when they have pancreatitis anyway, so she would need to be retested once the pancreas settles.
Her b12 is fine.
Also diagnosed with underactive thyroid. Is drinking a huge amount of water which the vet is currently trying to work out why.

If anyone has any ideas they would be much appreciated! As I am at a loss!

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Olesia711
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Location: North Carolina
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Re: Shiloh not responding to enzymes

Post by Olesia711 » 24 Jul 2022, 21:07

I just re-read all the blood test result from your previous posts.... your dog does not have EPI, but as your vet stated Pancreatitis.... which i understand they put your dog on enzymes... which they often do (SHort term) for pancreatitis also.

THe enzymes should do the work of the pancreas enzymes and help digest the nutrients from the food since her pancreas is imflammed and not functioning properly at the moment because of pancreatitis.

SInce you are looking for weight gain, i am not sure you will see a dramatic change in 3 weeks.... however.... i see that you are also feeding low fat which is correct for pancreatitis.... BUT can you check with your vet and find out if you should be feeding more food but in smaller portions (like what we do in the beginning with EPI dogs) so feed 3 or 4 small meals a day... this might help with weight gain.

... the excess drinking.... i think your dog has been checked for kidney and diabetes... yes? if not check those, if you did... maybe check for a UTI/ urinary crystals... and or possible liver issues..........

Also.... any lipase reading from a regular CBC panel does NOT reflect "possible" EPI.... since that Lipase values is only a snapshot in time value and not indicative of EPI.. for that you need a TLI blood test... but if Pancreatitis has been diagnosed, your dog does not have EPI....

Not sure if this helps ...... but hope so... a little.
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.........

Kristyn

Re: Shiloh not responding to enzymes

Post by Kristyn » 24 Jul 2022, 22:30

Thank you for your reply!
That is really interesting, and the first time I have heard she doesn’t have EPI.
Is this because her symptoms are caused by the pancreatitis alone?
Her pancreatic specific lipase was high which confirmed the pancreatitis. But normal symptoms of pancreatitis are loss of appetite, low energy, vomiting etc which she has none of. The huge increase in appetite along with the weight loss and pancreatitis is what (I think) led the pathologists to EPI.
Liver was slightly elevated but vet wasn’t too concerned. Kidneys fine and no diabetes. Her cortisol is through the roof but no other symptoms of Cushings.

I understand the weight gain can be slow, it is more the intense hunger I would like to see subside. She is miserable 😢

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

Re: Shiloh not responding to enzymes

Post by Olesia711 » 24 Jul 2022, 23:23

the gold standard to confirm EPI is with a TLI test...and the rule of thumb is you can't have pancreatitis and EPI at the same time.... so with the high Lipase value your vet is correct in that this is pancreatitis.... not EPI... or at least certainly not yet...... the ONLY thing i can think of is if she is segueing into EPI from chronic pancreatitis... but if this is what is happening, you cannot test her now because you will get a false read.

secondary EPI can be end stage chronic pancreatitis..... but again.... not something you can test for right now while in the pancreatitis phase......
We do have a section on it if you would like to check it out:
https://epi4dogs.com/pancreatitis-to-epi/

If your vet would like, she can contact Dr. Watson for a consult.... this is one area of Dr. Watson's expertise
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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