EPI Dog with intermittent swollen lip

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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jleach04
Member
Posts: 6
Country: United States
State: New York
Pet name: Bruce Wayne
My name: Jen

EPI Dog with intermittent swollen lip

Post by jleach04 » 03 Aug 2022, 16:05

Bruce is a 6yr Shepherd/Malinois mix. He was diagnosed with EPI about 2-3 weeks ago. We feed him RC HP (mostly dry but add some soft). He is on 6X powder and takes mycophenolate for IMHA. The only other food he gets is raw pumpkin with his meds. Over the last 7 months he will randomly get a swollen lip (always in the upper right, same exact spot, roughly the size of a grape) This swelling appears very quickly (as in over 20 mins) and then will slowly go back down over the course of 24 to 48 hours. This has happened 4 or 5 times in the last 7-8 months. He has seen a dental specialist, who found nothing except extremely healthy teeth and gums. He has been tested for all kids of cancer and come up with nothing. While we have sent photos of the swelling to the vet, she has never seen it in person (Given it is not an emergency, it is impossible to get into the vet on such short notice and the swelling is gone by the time she examines him). The current thought is maybe it is some dermatological issue. Could this be related to his EPI and if so, any ideas on what might be happening? Could this be some other autoimmune issue?
Jen
Upstate NY, Bruce Wayne, Belgian Malinois/German Shepherd, 6 yrs, EPI/SID and IMHA.

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jilbert57
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Posts: 2088
Country: United States
State: Washington

Re: EPI Dog with intermittent swollen lip

Post by jilbert57 » 03 Aug 2022, 16:22

Hi Jen does that swelling cpincide with something you feed him only seldom? Just thinking of allergic reaction.

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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Montgomery
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Posts: 418
Country: Canada
Pet name: Montgomery (I'm a CAT!)
My name: V

Re: EPI Dog with intermittent swollen lip

Post by Montgomery » 04 Aug 2022, 01:07

Does he have blackheads or a greasy chin? Sometimes acne can cause swelling.
Montgomery was born 20 March 2012. He eats extra lean ground chicken, lean ground pork and lean ground beef completed with Alnutrin and freeze-dried chicken liver, with hard-cooked egg. He gets two size zero capsules of Enzyme Diane's enzymes at each of his six meals, and a size four capsule of Tylan three times a day. He's a fierce little Spitfire with a roaring Merlin engine.

jleach04
Member
Posts: 6
Country: United States
State: New York
Pet name: Bruce Wayne
My name: Jen

Re: EPI Dog with intermittent swollen lip

Post by jleach04 » 04 Aug 2022, 10:41

Bruce is on a strict diet, so it doesn't coincide with anything he eats. It usually happens within a few minutes of coming in from being outside. I am also thinking possibly some sort of allergic reaction. However, it happens in all seasons from snow to summer, so likely not insect bites or any plants/foliage. We don't use anything/spray anything outside at all. My daughter has eczema so we mostly use vinegar and water to clean with, so it is not something we spray or use inside either. He is not one to eat things he shouldn't and since I work from home, I keep a close eye on that type of thing. We gave him some benedryl and that started to help within the first hour of taking it, which points to some allergy. I wish we could figure out what it is though.
Our cat had those blackheads/acne years ago, so we know what that looks like and it does not appear to be that. We use metal bowls and clean them after every meal. The frequency has no pattern either. The first time was mid December and he has had them as close together as 2-6 weeks through March/April. Then nothing until yesterday. The only thing that seems to be consistent is that it happens after he has been outside and playing (we have another large dog).
The strange thing is that this is the same time line as when we first noticed his EPI symptoms. So I am not sure if this is another autoimmune problem or what. His immune system seems to be at the root of all his issues (IMHA, EPI, SID).
Our vet is not equipped to deal with such unusual issues, the specialist we took him to is 90 mins away, but it is a teaching hospital and never seems to have the same drs. We have a new vet appointment set for one of the Vet's on the EPI vet list (thankfully she is only 10 miles away) but first availability for a new patient was end of sept. So I am hoping she can guide us on the best treatment plan for him. He is doing much better now that he is on the 6x powder and b12 shots. But I still feel like there are other things we can/should do to help him. He has been through so much these last couple of years and I just want him to have a normal happy dog life.
Jen
Upstate NY, Bruce Wayne, Belgian Malinois/German Shepherd, 6 yrs, EPI/SID and IMHA.

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

Re: EPI Dog with intermittent swollen lip

Post by Tuckaboo Pam » 04 Aug 2022, 12:57

Sounds like you've got all the usual suspects covered. Since it happens after rough play with his brother, could there possibly be some sweat gland or other gland located near that spot on his lip? Or a salivary gland that has a blockage? It's not like he would always get bumped or nipped in the exact same spot. And the fact that it goes down seems like it fills & drains, or swells & reduces. Interesting.---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.

Barb
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Posts: 918
Country: United States
State: New Jersey

Re: EPI Dog with intermittent swollen lip

Post by Barb » 04 Aug 2022, 13:31

Has anyone mentioned hair follicle cyst? I would think that the vet who looked at him for cancer would have covered that, but just thought I would throw it out there. These cysts usually last longer than what you describe and don't disappear quickly or at all, but there could be exceptions. It definitely sounds more like an allergic reaction. I hope you get to the bottom of it.

Barb

jleach04
Member
Posts: 6
Country: United States
State: New York
Pet name: Bruce Wayne
My name: Jen

Re: EPI Dog with intermittent swollen lip

Post by jleach04 » 04 Aug 2022, 14:39

I will add follicle cyst and obstructed saliva gland to the list of questions for the new vet. I would think if it were a cyst it would not go away so fast. Obstructed saliva gland might come and go, it has been really warm here lately so that could cause the gland to produce extra spit.
Since neither are emergencies and the benedryl seems to be helping, I think I will keep a close eye on it over the next day. If it gets worse, I can take him to the emergency vet. There doesn't seem to be any infection, he doesn't have a fever and he seems to act fine. He is eating, drinking and going to the bathroom normally. So for an EIP dog, that is really good. If the bendryl doesnt help, we can do a round of pred if we have to. He isn't having any issues with breathing or swelling in his mouth or throat, so I think it is just uncomfortable at this point. I feel like he never has any "normal" dog issues. His are all strangely unique.
Jen
Upstate NY, Bruce Wayne, Belgian Malinois/German Shepherd, 6 yrs, EPI/SID and IMHA.

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