New EPI diagnosis, Felina does not like the enzymes

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sue_annie
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Posts: 6
Country: United States
State: Oregon
Pet name: Felina
My name: Sue

New EPI diagnosis, Felina does not like the enzymes

Post by sue_annie » 06 Nov 2022, 14:09

Hi there EPI4Dgs Community!

I am thrilled to have found this forum, and can't thank all of you enough! I am learning so much reading your posts and info on this site.

My 2 yr. old Mexican Street dog Felina was just diagnosed with EPI a few weeks ago. We'd been home cooking her meals after a few months of picky eating and crazy gurgly belly, so we were relieved to have a diagnosis and that it wasn't IBD as this 'seems' more treatable.

She was prescribed Royal Canin or Hills I/D low-fat food; kibble and wet. She is supposed to get 1 1/2 dry and 1/2 can kibble with 1Tbsp of enzymes 2x/day. She was not prescribed B12 or any of the other supplements I'm reading that people are giving (antibiotics, slippery elm, etc.)

Felina did not have diarrhea, her main symptom was gurgly belly and an intense need to eat grass- waking us up multiple times in the morning from like 4am onwards to go eat grass. She has not lost weight thankfully.

The biggest issue is she does NOT want to eat food that has the enzymes on it. The enzymes also seem to bother her stomach when we do get her to eat it. She gets a pepcid once a day to help with the gurgles, sometimes twice. Vet prescribed to give her 1 every 12 hours, but it seems like at night is the only time she usually needs this.

Anyone have any suggestions on how to get her to eat the enzymes? We're using EpiZyme, usually mixing that with either warm chicken stock or water, waiting 5 min as directed by vet and on packaging, then mixing with her food. We've tried a variation of methods of how we're incorporating it and regardless of what we do, she just does not want it.

Thanks for any help/tips/suggestions!
Felina is a 2 yr old Mexican Street Dog (she's all the breeds) Diagnosed with EPI via TLI blood test 10/2022. B12 was 356, Folate >24, TLI 0.2
She has not lost weight, does not have stool issues, but has crazy gurgly stomach issues and an intense need to eat grass in these times.
She's on prescription diet for now: 1 1/2 C Royal Canin GI low-fat kibble, 1/2 can Hill ID low-fat wet food and 1 1/2 tsp of Enzyme Diane (just switched from EpiZyme at 1 Tbsp) per meal. 2 meals/day
SHE HATES THE ENZYMES!! Does NOT want to eat them, and currently figuring out our delivery method to get her to eat them

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

Re: New EPI diagnosis, Felina does not like the enzymes

Post by Tuckaboo Pam » 06 Nov 2022, 17:19

Hi Sue, and welcome! Here are a few pointers, to get you on track---

Could you possibly post the test results from the fasting blood test, as well as telling us a bit more about her?

What breed is she? How much does she weigh, and how much SHOULD she weigh? What were/are her symptoms?

I have been involved with the forum for 3 1/2 years, and in that time my Tucker has gone from a 60 pound weakling, to a robust 95 pounder. I feed him mainly https://www.amazon.sg/Elite-Herding-Buf ... B07QD2QVM3.

There are four cornerstones to treatment:

ENZYMES Many of us use https://enzymediane.com/ 6X. 1 teaspoon enzymes/1 cup kibble, add room temp liquid & let sit 20-30 minutes. EVERYTHING she eats has to have enzymes with it. Treats may have to go, for awhile. Try adding a dollop of cottage cheese, yogurt, tuna, etc, to the top of her meal, to get her excited about eating. You may also want to use broth, instead of water, for mixing in the enzymes.

DIET Grain free & less than 4% fiber. Some, but not all, EPI dogs do poorly when they are fed poultry. Feed 150% the amount you would feed at her IDEAL weight, divided into 3, or preferably, 4 meals.

B12 Needs to be above normal, 600+. Tucker's score was 666, but I supplement him anyway. They just tinkle it out if they get too much. https://www.wonderlabs.com/itemleft.php ... gSEALw_wcB

SID All EPI dogs have it. May be controlled with slippery elm, slippery elm + probiotics, and/or Tylan antibiotic. Good info on this tab https://epi4dogs.com/sidsibo-in-brief/

Keep a journal, and once you gather all your goodies, make only one change at a time. We have all had to tweak our routine, because each dog is different.

Feel free to ask as many questions as you have, and stay on the same thread here. You may want to share the forum with your vet, too. You've come to the right place, where you and Belle will get lots of help!

Take Care---Pam & Tucker
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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sue_annie
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Posts: 6
Country: United States
State: Oregon
Pet name: Felina
My name: Sue

Re: New EPI diagnosis, Felina does not like the enzymes

Post by sue_annie » 08 Nov 2022, 00:57

Hi Pam,

Thank you so much for the thoughtful response! I have read much of this on this site, and some of it as well from what the specialist relayed to us, but there are some marked differences in advice which I am very curious about.

Felina is a 2 yr old Mexican Street Dog, so lots of breeds in her. She has NOT lost weight and is her regular healthy weight of around 48 pounds. She's a tall, long, lean girl and always has been. She has not had issues with diarrhea thankfully, and so far doesn't seem to have issues with absorbing nutrients. Her biggest issue has been a really rumbly tummy that's hard as rock and you can hear the grumbling from feet away from her. She's been getting us up in the wee hours of the morning with a dire need to go eat grass. Sometimes 2 or 3 times. And then being picky with her food. So after trying many types of food and vet visits, we had been cooking her food (chicken/sweet potatoes/brocolli/rice) and that worked really well. That and giving her Pepcid at night. Both of these things were what the vet recommended and the vet tried/tested everything she knew to do.

So we landed at the internist/specialist and did ultrasound/2 sets of x-rays/2 types of blood panels to rule out all the scary possibilities. Her TLI blood test came back showing 0.2 ug/L and saying 'consistent with EPI' (Lowest value 5.0, Highest 35.0 is the range given for this test) Her COBALAMIN (B12) came back as 356 ng/L (Low range 284, High is 836) so looks good there. Her Folate is >24.0 ug/L (Low range 4.8, High 19.0) and noted that increased serum folate is consistent in dogs with EPI and/or small intestine bacterial overgrowth.

I had read about Enzyme Diane on this site, but of course AFTER we had already ordered enzymes. I did order some of those though, and I'm hoping they'll be easier to get her to eat- we got the 8x so that I can use less. That's the biggest issue so far- girl does NOT like the enzymes! So it's been a real struggle to get her to eat enough of them. They also noticeably make her feel not too hot after eating them. She gets pretty dumpy and just looks super bummed. It does pass in about 30 min-1 hr and then she's ok. It also seems to be getting a little better.

I'm guessing she's on the milder end of EPI so far, and I'm really hoping she doesn't get worse and start experiencing some of these more difficult symptoms (losing weight, really loose/voluminous stools).

Curious if you experienced any issues with your dogs in getting them to eat the enzymes, and then the enzymes messing with their stomach? Maybe it takes a while to adjust? The Enzyme Diane will be here in a few days, so I'm curious to see the difference.

My specialist vet also mentioned nothing about fiber- he's worried about fat content. So she's on a low-fat diet that's around 6% fat, which concerns me long term. We go see a nutritionist soon, and she's had some experience working with EPI so I'm curious what her take will be too. I am going to share this with the vet too and see what he has to say- I think you all have more experience with this than he does!

I'm glad to hear Tucker made such a great turn around, and hoping he stays happy and healthy!
Thanks again Pam- I appreciate this so much :-)
Felina is a 2 yr old Mexican Street Dog (she's all the breeds) Diagnosed with EPI via TLI blood test 10/2022. B12 was 356, Folate >24, TLI 0.2
She has not lost weight, does not have stool issues, but has crazy gurgly stomach issues and an intense need to eat grass in these times.
She's on prescription diet for now: 1 1/2 C Royal Canin GI low-fat kibble, 1/2 can Hill ID low-fat wet food and 1 1/2 tsp of Enzyme Diane (just switched from EpiZyme at 1 Tbsp) per meal. 2 meals/day
SHE HATES THE ENZYMES!! Does NOT want to eat them, and currently figuring out our delivery method to get her to eat them

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

Re: New EPI diagnosis, Felina does not like the enzymes

Post by Barb » 08 Nov 2022, 11:32

Hello, Sue. A warm welcome to you and Felina.

I totally sympathize with your pup's anti-enzyme situation. Our Kolby HATED the enzymes. I'll never forget the expression on his face when we put the enzymed food in front of him for the first time. He looked up at us like, "You have got to be kidding. You want me to eat this? Are you trying to kill me?" It was not fun. Other dogs dove into their food and hardly noticed the enzymes. Kolby would put his nose in the air and walk off . This was especially difficult to watch because he had lost so much weight and we wanted him to eat, eat, eat. So mainly we had to entice him with teasers like parmesan cheese or other smelly temptations to attract him to the food. Of course, he was way too smart for that. He would lick off the cheese from the top of the food and then walk away, giving us a sideways glance of contempt as he passed us. Some things helped.....like feediing him by hand for a while. Then he didn't have to put his head in the bowl. Feeding him from a spoon also helped. Eventually, I used a flat plate which also prevented him from having to put his head in the bowl.

Eventually, he got hungry enough to eat, but it took quite a while......and he was never a fan of the enzymes. But he went from 54 pounds to his target weight of 85 pounds over the period of the first year and a half of treatment.... and he maintained that weight for 11 years until we lost him to cancer. He did eventually forgive us for what he saw as attempted murder and became once again the happy hilarious dog we loved so much.

So hang in there. Try the enhancers. Try the flat plate, a spoon, your hand....... Eventually, she will eat.

Barb

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dcougman
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Country: Canada
Pet name: mensch
My name: David Kauffman

Re: New EPI diagnosis, Felina does not like the enzymes

Post by dcougman » 08 Nov 2022, 12:02

Good morning ;-)
It has been interesting to me that the "little" changes in feeding and timing have outsize effects on my dog. One variable that was counter intuitive to me was to lessen the amount of water to dissolve the enzymes with. I started with a cup and half of water to 2 tsp of either of Enzyme Diane or Nature Farmacy Dogzymes pancreatic support . He always had large quantity of water previsouly with his kibble and I thought that more water would make him less aware of the enzyme. For both types of enzymes I noted that my dog was VERY uncomfortable. THinking of how I react to hot chile peppers and water to wash them down (burned more) I thought I would lessen the amount of water. I did lukewarm water at 1/2 cup of water to 2 tsp of enzyme and incubated still for 20 minutes on the food. Mixing well 4 times in the 20 minutes. That seemed to absorb most of the liquid and made the kibble more "mushy".
Lo and behold he ate the food way faster and had absolutely no side affects that I could see. I have since lowered the enzymes to 1.5tsp in 1/2 cup of water for 2 cups of kibble. I feed Go Carnivore which is 3% fibre and 16% fat, 34% protein grain free turkey chicken duck 3 times per day (for feeding more seemed to be better ;-)

Good luck
Mensch is a 2YR old Czech Working line GSD; he has tested positive Sept 2022 on the fasting TLI. Results--- TLI <1, Folate 21, Cobalamin <111. Currently taking Dogzymes Pacreatic Support 1.5 teaspoons/2 cup feeding (feed 3x per day GO Carnivore GRAIN-FREE CHICKEN, TURKEY + DUCK ), Inject B12 1000ml 2x per month. No more poop eating, has gone from 60 to 81 in two months. Works as SAR K9. SO happy to have found this site. Thank you all!!!

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sue_annie
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Posts: 6
Country: United States
State: Oregon
Pet name: Felina
My name: Sue

Re: New EPI diagnosis, Felina does not like the enzymes

Post by sue_annie » 09 Nov 2022, 00:59

Evening David,

Thank you for the reply and info! Yes, I can see that 'little' changes seem to make a big difference. There are so many variations of how you incorporate, how you build the bowl of food, how long to let the enzymes sit, etc.

So far (and really just the last few days is the best results) the thing that works best is to add @ 1 Tbsp of enzymes (that's the dose the vet wanted us to start on, then re-check in a couple months and possibly decrease) to some kind of delicious/thicker/wet food then put dollops of that on her kibble that has been mixed with chicken stock. THEN add some tasty beef liver/tumeric shake on top of it all, possibly some treat 'dust', crushed up treats, whatever it takes to get her to eat the food! It's a struggle.

It's concerning to me that she doesn't feel well after eating the food. Regardless of the tricks to get her to eat it, once the enzymes are in she's uncomfortable for a while. I'm guessing it's just her stomach getting used to the enzymes and what not. Hoping this gets better by the day.

I'm also super curious about the %s of fat and fiber. Our specialist vet is real concerned about fat content, mentioned nothing about fiber. Also said we could give her treats, and just to make sure they weren't super fatty- which is nothing we've ever given her anyway.

It's a chess game of little tweaks, and I sure hope I've got this EPI in checkmate sooner than later!

Appreciate your feedback so much :)
Felina is a 2 yr old Mexican Street Dog (she's all the breeds) Diagnosed with EPI via TLI blood test 10/2022. B12 was 356, Folate >24, TLI 0.2
She has not lost weight, does not have stool issues, but has crazy gurgly stomach issues and an intense need to eat grass in these times.
She's on prescription diet for now: 1 1/2 C Royal Canin GI low-fat kibble, 1/2 can Hill ID low-fat wet food and 1 1/2 tsp of Enzyme Diane (just switched from EpiZyme at 1 Tbsp) per meal. 2 meals/day
SHE HATES THE ENZYMES!! Does NOT want to eat them, and currently figuring out our delivery method to get her to eat them

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Fuzzysmom
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Posts: 15
Country: United States
State: Texas
Pet name: Fuzzy
My name: Melanie

Re: New EPI diagnosis, Felina does not like the enzymes

Post by Fuzzysmom » 10 Nov 2022, 19:46

Fuzzy is a jerk. He loved to give me nervous breakdowns at the start because he didn't want dog food (he had previously been fed raw) his ideal weight is 175lbs. So you can imagine how he looks when he decides not to eat and how much he HAS to eat.

Many tips given to me helped for awhile: the flat plate, the mixing in with canned or raw, letting him think he's stealing another dog's food, and letting him eat the kibble and then the enzymes with some canned. After a month or so he's right back to "No thanks to your enzymes lady!! :roll: " No sibo, B12 was fine etc he just hates the enzymes. After a few months of this, I adopted a strategy of food's going in one way or another. So I used a food processor to grind his kibble. Then added some canned or raw, a bit of water (enough to make a course pasty meal to form into "meatballs") and the enzymes. Wear vinyl gloves while making the "balls" and feeding them . Enzymes eat skin (guess how I know) Then I tossed the balls down his throat 1 at a time while saying ""eat it or wear it ". He needed 10 cups a day to gain his weight back so I just split the amount.

After 2 months he decided he no longer wanted to eat by "meatball" and began eating them off the plate. He still gives me the stink eye and wanders away from his plate sometimes but if I say "eat it or wear it" he comes back and eats lol

It seems like extra work or stressing but I found it way less stressing than wondering if and when he's eat or worrying about his health bc of weight loss.
Fuzzy is a Boerboel dob 8/29/19 diagnosed by TLI 1/5/22 Ideal weight 175lbs + Still growing so he's fed to lean body condition for growth. After regulation enzyme amt. went from 1 tsp a cup>1 1/2 tsp per meal> NOW 1/2 tsp per meal!

1st meal: 2 cups Inukshuk Marine 25 2 cup raw blend(tripe,organs,beef) 1/2 tsp Pantennex 2 B12,
2nd : 1 cup Inukshuk Marine 25 , 1cup raw 1/2 tsp Pantennex

He is completely off the slippery elm maintenance amt (1/8 tsp)although I keep on hand in case of sibo. 2 Prescript Assist Soil based probiotics every 4 days

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sue_annie
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Posts: 6
Country: United States
State: Oregon
Pet name: Felina
My name: Sue

Re: New EPI diagnosis, Felina does not like the enzymes

Post by sue_annie » 11 Nov 2022, 01:25

Fuzzy is cracking me up! :lol:
I can so relate to all of the delivery method trials. Another forum user suggested hand feeding and plate feeding, and that does work pretty well. I can't be hand-feeding my dog on a daily basis though, so I'm hoping the plate will work for now. I switched to Enzyme Diane 8x since you have to use less of them. They do seem to smell more potently, so that is not working out too well thus far. I mean, they DON'T smell good, so I can't blame her!

She's not lost any weight, or had any loose stools, she just has the crazy gurgles going on in that belly of hers. She's currently getting a Pepcid at night to help with that as it seems that's when it's the worst- and without that leads to urgent needs to get us up at 4am, again at 5 or 6 to go eat grass. She does not throw up the grass, which seems odd. She just poops it out.

I'm hoping she isn't a stinker about these damn enzymes for as long as Fuzzy! I love the meatball story, lol. We've been discussing doing something just like that in hopes it'll work. We'll probably try that next, so thanks for the suggestion- and the warning about wearing gloves! My husband noticed his finger that he's always grabbing the teaspoon out of the jar of enzymes with is now sensitive. Felina also seems pretty dumpy and bummed after she eats them- did you ever notice that with Fuzzy? If they do that to your skin, I would guess there's a good chance of them messing with their belly.

Thanks so much for the response! It gave me a chuckle AND some insight :-)
Felina is a 2 yr old Mexican Street Dog (she's all the breeds) Diagnosed with EPI via TLI blood test 10/2022. B12 was 356, Folate >24, TLI 0.2
She has not lost weight, does not have stool issues, but has crazy gurgly stomach issues and an intense need to eat grass in these times.
She's on prescription diet for now: 1 1/2 C Royal Canin GI low-fat kibble, 1/2 can Hill ID low-fat wet food and 1 1/2 tsp of Enzyme Diane (just switched from EpiZyme at 1 Tbsp) per meal. 2 meals/day
SHE HATES THE ENZYMES!! Does NOT want to eat them, and currently figuring out our delivery method to get her to eat them

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Fuzzysmom
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Posts: 15
Country: United States
State: Texas
Pet name: Fuzzy
My name: Melanie

Re: New EPI diagnosis, Felina does not like the enzymes

Post by Fuzzysmom » 11 Nov 2022, 03:39

" Felina also seems pretty dumpy and bummed after she eats them- did you ever notice that with Fuzzy?"

He does actually but I can't be sure if it's the enzymes or the fact I outwitted him. :lol: I noticed less of "dumpy & bummed" if I add the enzymes to the canned let it sit about 5 minutes then smush that into the ground dry food. I think the enzymes do irritate their stomach some and I think the moisture in the canned or raw helps or even the water in dry food "meatballs" He also used to burp right after eating when there was less liquid going in with the enzymes.

By the way: the kibble he eats breaks down fast in the food processor because it's not extruded. When I do rotation food with a different protein that's extruded I soak it in some water then grind after it puffs. If you are doing just "deconstructed" kibble balls : take about a 1/2 cup moistened ground kibble add enzymes let sit about 5-10 min then add that back to the rest of the ground kibble and make your balls. If you leave the enzymes too long on the kibble they will start breaking it down and you get sludge.

One other trick that worked for him for awhile until he realized I was "doping" his meat. I'd put the enzyme dose in a little ball of ground meat. Basically squashed the ball flat enzyme in middle of patty and folded the patty back into a ball with the enzyme in the middle. Let sit for 5 min then I'd give him the ball and then his kibble. His poops were good on this method since the amount of meat was so small it digested along with the kibble. I can fool him with it still as long as he doesn't think it's his treat ball. Green tripe is good for this but the smell will make you want to hurl so don't inhale. Tripett canned tripe has a distinct odor but not as bad and hides things pretty well.

The problem with Fuzzy the jerk is he hates enzymes and dog food but since his diagnosis he doesn't do well on only raw anymore.
Fuzzy is a Boerboel dob 8/29/19 diagnosed by TLI 1/5/22 Ideal weight 175lbs + Still growing so he's fed to lean body condition for growth. After regulation enzyme amt. went from 1 tsp a cup>1 1/2 tsp per meal> NOW 1/2 tsp per meal!

1st meal: 2 cups Inukshuk Marine 25 2 cup raw blend(tripe,organs,beef) 1/2 tsp Pantennex 2 B12,
2nd : 1 cup Inukshuk Marine 25 , 1cup raw 1/2 tsp Pantennex

He is completely off the slippery elm maintenance amt (1/8 tsp)although I keep on hand in case of sibo. 2 Prescript Assist Soil based probiotics every 4 days

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

Re: New EPI diagnosis, Felina does not like the enzymes

Post by Tuckaboo Pam » 11 Nov 2022, 17:54

Sue, have you tried adding a nice plop of something yummy, right on top, to get her juices flowing so she'll just keep eating.?

We are 3 1/2 years on the forum, and I have heard/used cottage cheese, yogurt, sardines, parmesan cheese, shredded cheddar, tuna fish, cooked beef, canned food, on & on. As long as you count the dollop when you measure the enzymes, it is fine to add a good amount of yummy stuff on top. I am currently giving Tucker a few tablespoons of Fresh Pet & some canned pumpkin. Good fiber is OK. You may also use bone broth, room temperature, instead of water. All these things help mask the taste of the enzymes. They are horrible. I tasted them by accident once.

If this is redundant, I apologize. I know you've read a lot already. --- 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.

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