Veterinarian not up to date on EPI?

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.
Post Reply
Tynk
Member
Posts: 1
Country: United States
State: North Carolina
Pet name: Sahara

Veterinarian not up to date on EPI?

Post by Tynk » 16 Sep 2022, 10:39

Does anyone else love their vet but feel that he/she is not up to date on EPI? I have done a ton of research including a review of Dr. Clark's papers, as well as articles in MerckVM, and other researchers and I feel like my vet is treating my dog for pancreatitis not EPI. She had us on the protocol that is standard to rest the pancreas: low fat, low protein, high fiber diet ($125.00 a bag + $4+/can), pancreatin+ $125.00 a jar, one shot of B12. My dog did not improve until I got nervous about running out of her diet food before her prescription arrived and added a cup of our regular food (30% protein, 20% fat, fiber below 3%) to her diet. The very next poop was her first normal one in her whole life. She is currently on 1c diet and 1c 4Health Endurance 90 with a 1/4 can of 4Health Digestive Health canned dog food, and 1 tsp of Pan-tenex per meal (fed twice a day) and seems to be doing well, she has gained weight and seems to be maintaining. She will be on 1 3/4c 4Health and 1/4c diet starting today until her diet runs out. I do not intend to put her back on the prescription food at this time. Her poop volume is still high, but not as bad as it was before the enzyme therapy started. In fact, the ONLY indicator I had that something was wrong was her loss of weight (we have been trying to get poops right for a long time and shortly before she lost the weight I noticed they were sometimes grey). Up until she was a year old she was a normal GSD.

Also, I just ordered Pet Factor B12 and am wondering how often you give it? Her B12 was low, but not below the range when she had her initial bloodwork done. Her energy is very high, she plays, acts normal - you would not know she has any health issues to look at her.

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

Re: Veterinarian not up to date on EPI?

Post by Montgomery » 17 Sep 2022, 14:42

Most veterinarians are not well-versed in nutrition. Unless they go out of their way to learn, they are given very little instruction. This boggles the mind, considering that nutrition is the cornerstone of health, for all of us animals. If my own veterinarian had her way, Montgomery would still be struggling along on Hill's or Royal Canin. It wasn't until I saw the naturopath that I got some good guidelines for how to feed this little cat.
You have to feed what works for your pet. You have to be happy with the results you see, and your pet has to be happy to eat it.
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.

User avatar
Olesia711
Founder & Research Director
Posts: 3858
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Veterinarian not up to date on EPI?

Post by Olesia711 » 17 Sep 2022, 17:12

I agree.... V said it best..... it does BOGGLE the MIND!!!!!!!!!
AND again, so true... Nutrition is often the cornerstone of health...... BUT.........on the flip side, there are only so many hours in a day for vets to learn about "other" things.... so i just wish veterinarian schools would make the study of nutrition a much more all-encompassing part of the veterinarian education.

So the best thing is to work with your vet but also educate yourself, read, read and read... and keep records/journals on what does and doesn't agree with your pet and hopefully you will discover what benefits your pup or cat :)
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.........

User avatar
KarenC
Member
Posts: 27
Country: United States
State: Florida
Pet name: Luke
My name: Karen

Re: Veterinarian not up to date on EPI?

Post by KarenC » 18 Sep 2022, 13:08

I am fairly new to the whole EPI world but I do feel that my vet, while maybe she is not well versed in the best nutrition aspects, she does consult with other docs and the food companies. And she trusts my research on food which I am pleased about. But that was when we only had to deal with diabetes and bladder issues. Now we have Cushings and EPI in the mix so it is complicated no matter what :)

I do love her to bits, she may be my heart-vet like she suggested Luke is my heart-dog. But I feel like sometimes I mention things that teach her :D As Olessia said, read lots! I research a lot too and it helps to understand and calm myself about whatever might be going on with my dogs.

I know there are vets out there who are not so great and your intuition can guide you on whether to stay or find a new one and educating ourselves as best as we can is a huge help.

I did not get a chance to ask my vet how many EPI cases she has dealt with but I plan to when I see her next, just out of curiosity. Their experience in actually dealing with certain issues gives them knowledge to help others. Maybe some don't have that practical experience to know.
Luke, Basenji/Shepard/Spaniel/Collie mix. DX-Diabetes 5/2021, DX-EPI & Cushings 9/2022, DX-Hypothyroid 10/22

User avatar
Olesia711
Founder & Research Director
Posts: 3858
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Veterinarian not up to date on EPI?

Post by Olesia711 » 18 Sep 2022, 13:23

with EPI..... some of the best vets are not necessarily those who have experience with EPI, but rather are the vets that are so excited to have an EPI case that they do research above and beyond on their own AND they work "with" the EPI parent. Unfortunately some that have a lot of experience with EPI cases feel they know all they need to know and tend not to keep up with the latest EPI findings/ research.... missing out on better ways of working with an EPI case.

Also... the problem with EPI is even though we have a standard protocol to use or start with as a guideline... so many times we have to "tweak" things/the protocol... to get the optimal results with an EPI dog..... most likely because each dog's gut flora is unique and managing the gut flora has a huge impact on effectively managing EPI.

In short... if your vet is willing to work "with" you then you have a good vet to manage your dog's EPI with you:)
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.........

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

Re: Veterinarian not up to date on EPI?

Post by Montgomery » 18 Sep 2022, 14:04

Montgomery's veterinarian, while she was sorry that she had to diagnose him with EPI, was also a bit excited about it because she'd never seen an EPI animal in person in nearly three decades of practise. She likes a challenge, and unfortunately, I've brought her many over the years as my colony consists of the "unadoptables." She's pretty bomb-proof. The only time we've butted heads has been when it's come to nutrition. She bought the clinic around the time Montgomery turned four, so she didn't know him and she didn't know me. She really had a set idea of what. you. feed. your. cat....The next time I came into the clinic, we had a chat and sorted it. You definitely have to be able to talk to your veterinarian and the staff in the clinic. This is the third clinic I've been to in town, trying to find the right one after my original veterinarian moved out of town, and I stay because I can ask questions and get good answers.
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.

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

Re: Veterinarian not up to date on EPI?

Post by Tuckaboo Pam » 18 Sep 2022, 18:56

My wonderful vet, holistic practitioner with eastern medicine credentials & well-versed in nutrition, said she'd never had a case of EPI in 20 years, when I brought the idea to her. She tried a couple of things, then sent me to a vet who had EPI experience. We got Tuck straightened out, but it took a month or so.

After the EPI vet retired (a few months post diagnosis), other vets in the practice failed to keep the promises that were made to me....So, between my own research & this forum, I figured out a way to do it all on my own, without spending a fortune.

Of course we need our vet to approve every change we make, so I now run things past my original vet, to make sure I do no harm, but it is possible to help an EPI dog more or less on your own.

Is your vet unwilling to run the TLI test, to accurately determine EPI? If so, I'd consider a second opinion, or I'd recommend ordering this simple test, which does not give a definitive diagnosis, but if you get a negative result you will know you aren't dealing with EPI.
https://enzymediane.com/product-category/test-kits/

B12 may be in the normal range, but EPI dogs need to be well above normal. Tucker weighs 95 pounds, his cobalamin score was 666, and I give him one capsule per day. If dogs get too much, they just pee it out.

I feel your pain, and I hope this helps. ---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.

User avatar
TrixEPIMama
Member
Posts: 65
Country: United States
State: Texas
Pet name: Trixie

Re: Veterinarian not up to date on EPI?

Post by TrixEPIMama » 19 Sep 2022, 21:04

Oh yeah. This is so true -- and so common -- about vets not being versed in EPI.

The big question is: Are they willing to learn? Also, are they willing to listen to YOU as you learn?

The first vet I went to with my EPI dog knew nothing, but talked as if she were the World's Greatest Expert. She made blanket statements that were untrue (e.g. that my dog couldn't possibly have EPI because she was responding to a treatment other than the expensive prescription enzyme, VioKase (sp?)). Every time I queried her about one of her pronouncements and told her about something I'd read here, she'd backtrack -- then make another statement or recommendation equally off-base and expensive.

This all happened when I was out of state and my regular vet wasn't there for consultations.

My regular vet also knew very, very little about EPI. But by gosh, she listened, she read, and she learned. I can talk with her openly about what I discover here and she doesn't take it as a personal affront or as another stupid dog owner who has gotten bad information from "Dr. Google," but as an opportunity to do better for her patients. (And as it happens, she's had a sudden spate of EPI dogs and cats and has actually asked me to refer others to this site.)

It's a blessed, remarkable, and helpful difference.
Trixie is an Australian cattle dog or mix, likely born in the Fall of 2020. Picked up as a stray, she was already suffering undiagnosed EPI when we adopted her. Test later showed TLI <1 and cobalamin 189.

Her (non-standard) treatment is 1900 mcg of pure freeze-dried pork pancreas from Allergy Research Group per day. Also 1/4 teaspoon of slippery elm powder and 1/2 (previously one) capsule a day of WonderLabs TrinFac-B, all mixed into her food and served immediately, without the usual 20-minute wait.

We feed Canidae Angus Beef and Barley, which may not yet be the perfect food, but she's doing well and has "happy" normal poops.

User avatar
Jean
Forum Director
Posts: 1707
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: Veterinarian not up to date on EPI?

Post by Jean » 21 Sep 2022, 10:18

I was very lucky, my vet dealt with EPI from the mid 1980's and was at university with David Williams who developed the cTLI test in the mid 80's , and they remained friends

You need to ask questions, and dont accept being brushed off , you can print anything off this website which might be of use to your vet

Try to get a double appointment so you can talk things over but dont let them talk down to you

My vet said "you have to deal with EPI 24/7 I am here to listen, treat advise", and he did, you can always say something like that

so its for the vet to listen and learn and accept that you know your animal very well, they spend maybe 30 minutes with the pet you as I said 24/7

Jxx
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

Post Reply

Who is online

Users browsing this forum: No registered users and 240 guests