Hello---I will address what I feel confident about.HunnysMom wrote: ↑17 Dec 2022, 15:57 Hi All -
I am back with another set of questions as Hunny continues on her journey
1. When Hunny was tested back in late Oct/early Nov for EPI her levels didn't show EPI but she had ALL of the symptoms. As I have been treating her as if she has EPI she has made progress. She has now officially gained 3 lbs (YAY) and her poop is no longer yellow/diarhea/like cow poop (YAY)
- Her test showed the following:
ALT = on the HIGHER end
Cholesterol = on the lower end
TLI = 4.6 so on the lower end where 5.0 - 35.0 is the range.
B12 = VERY HIGH at 963 where 284-836 is the range
Does it make sense to retest her at any point?
2. She was put on a purina probiotic that she finished about weeks ago. I did not refill it. She seems to be fine without it. Any thoughts on this? Do you think probiotics are a must? And if so, WHY and What brands do you lie and WHY? There is a local probiotic here I do like BUT it does have fiber in it. Can I still use it?
3. I got her Tylisin (spelling?) refilled today. She has one more refill left after this. Do most dogs take this for the rest of their lives? How do you know if they can be taken off of it?
4. I started her on the slippery elm 2 days ago.....so far today she hasn't spit up but yesterday she did a few times and the day I started her. Does it usually take a number of days to work? I have absolutely noted before all of her symptoms she never ever had acid reflux but over the past few weeks it has been bad. I now have 3 official stains on my couch that I never did before.
5. She is on the same pancreatic enzyme (powder) I started her with. It costs over $100 I think like $130 or $140 but she has been on the same one for probably about 6-7 weeks now. Does it make sense just to leave her on this since it seems to be fine for her? How do you know what enzymes are the best?
6. With the onset of all of this I have worked with 2 vets. One of them suspected EPI but then had me put her on The Hills prescription diet which was horrible but he did recommend the enzyme. I don't care for his personality tbh though. Big ego. I saw another vet and she also thought H should be on The Hills (I knew in my heart she should not be on this diet once I saw the ingredients and I do not like Hills anyway) and she is the one that gave me the purina probiotic. She also suggested a sonogram. How do you find a vet you like?
1. Sounds like she has been segueing into EPI, and that she is doing well. Ask your vet if you need to re-test her, as the test is expensive. Most people on the forum do recommend getting a positive EPI test, before feeding enzymes long term. My vet did not want to test, as Tucker had all of the symptoms & responded to treatment. After about a year and a half I sprung for the test that confirmed EPI.
2. Tucker takes Proviable. He was given Flagyl along the way, which I know messed with his gut, so I give it as a preventive. I think probiotics are great for everyone, and since he has been through so much, I just feel like he needs them.
3. Tylosin (Tylan). Not all dogs take it for life, but some need it. NOT at the therapeutic level, though. When Tuck has a flare (gassy, moaning), he takes 1/4 teaspoon twice a day for 45 days. THEN, and this is important, I gradually wean him off it, over about a week. Since I know, after almost four years of trial & error, that the SID will return, I keep him at about 1/32-1/16 teaspoon daily. After you finish Hunny's 45 day treatment, you must be sure to do a gradual weaning, or the symptoms will come right back.
4. I have not had good results using slippery elm.
5. It might make sense to keep her on the same enzymes. How long does $100 worth last you? As with everything else, each dog is different. I buy Enzyme Diane, for about $269/kilo. https://enzymediane.com/ I am embarrassed to say that I have never kept track of how long a kilo lasts. It is necessary for Tucker to receive 4 tsp./day, as he weighs 95 pounds & eats four cups of kibble (he's up from 60 pounds four years ago, before treatment), so I just keep buying it as needed. As far as the best enzymes go, MANY of us use Diane's. They used to be cheaper, but she had to raise her prices earlier in the year, just like everything else in the world today. Her product is wonderful, and so is she. I don't get why one brand would be better than another, as long as the the strength is the same. Some people see a difference, but to me, porcine enzymes are porcine enzymes. Kinda like Walgreens aspirin vs CVS aspirin. Others have had a different experience, so it's totally up to you.
6. A good vet for an EPI dog is one who is willing to be open-minded & eager to learn more. Many members share the forum with their vets. I like a vet who loves my dog & is willing to listen to my observations. I've had my vet, who is mobile, for about 10 years. She was unable to diagnose Tucker's EPI, and when I figured it out, though she sent me to a former colleague of hers for a treatment plan, she has always seemed to resent me. I have five dogs, so we do see her often, and when I make any kind of comment about anything dog-related, she sort of brushes me off. Sorry, but I have an inquisitive nature. Lucky for my Tucker that I do. So, I know what you mean about bedside manner. This page has the names of vets recommended by others on the forum. Maybe a good starting point. https://epi4dogs.com/?s=EPI+vets+recommended .
Hope some of this helps.
Take care---Pam & Tucker