First time poster in need of help.

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

Re: First time poster in need of help.

Post by Tuckaboo Pam » 17 Dec 2022, 19:13

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?
Hello---I will address what I feel confident about.

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
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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Olesia711
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Re: First time poster in need of help.

Post by Olesia711 » 17 Dec 2022, 23:13

I too will address some of your questions as best i can... my answers will be in caps:
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?
YES... BUT TEST IN MAYBE 3 OR 6 MONTHS FROM NOW, IT DOES "SOUND" LIKE SHE IS SEGUEING INTO EPI.

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? YES, I PERSONALLY WOULD TRY A PRE+PROBIOTIC, AS IT HELPS STRAIGHTEN OUT THE GUT FLORA, AND WHETHER THIS IS EPI, IBD, IBS OR SOME OTHER GASTRO ISSUE, MOST LIKELY HER GUT FLORA IS NOT DOING THAT WELL AND THAT COULD BE WY HER ALT IS HIGH. FIDING THE RIGHT PROBIOTIC DEPENDS ON WHICH PRODUCT THE INDIVIDUAL DOG'S GUT BEST RESPONDS TO. SOME OF THE ONES WE FAVOR ARE: VISBIOME, PROVIABLE, MERCOLA COMPLETE PROBIOTICS, VETRISCEINCE MEGA PROBIOTICS... AND THERE ARE MORE, BUT THOSE ARE THE MOST COMMON ONES....

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? IT'S TYLOSIN.... AND IF THIS IS EPI, SOME DOGS NEED TO BE ON A MAINTENANCE DOSE FOR LIFE, BUT MOST DON'T AND JUST NEED A COURSE OR TWO OF IT AND THEN LET THE PRE+PROBIOTICS DO THE LONG TERM JOB OF STRAIGHTENING OUT THE GUT FLORA.

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. SO SORRY ABOUT THE STAINS. SOMETIMES IT DOES TAKE A COUPLE OF DAYS, BUT USUALLY SE IS PRETTY FAST ACTING....I'D KEEP HER ON IT FOR A BIT MORE. IF THE ACID REFLUX CONTINUES, EITHER ASK THE VET TO LET YOU TRY OMEPRAZOLE OR THE OTHER THING YOU CAN DO IS TO TRY REDUCING THE ENZYMES BY A TINY PINCH... MAYBE REDUCE BY 1/16 TSP PER CUP OF FOOD.

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? LEAVE HER ON IT FOR NOW, BUT IF THIS IS EPI, YOU MIGHT WANT TO CHECK INTO ENZYMEDIANE'S 6X... How do you know what enzymes are the best? AS LONG AS THE PRODUCT IS PORCINE ENZYMES AND THE POTENCY IS CORRECT (CHECK OUT THIS PAGE https://epi4dogs.com/enzymes-in-brief/ AND THE ENZYME SECTION) THEY ALL ARE GOOD. WE DO HAVE AN ENZYME LIST TOO: https://epi4dogs.com/enzyme-list/

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? YOU DON'T NEED A VET WHO IS FAMILIAR WITH EPI, BUT RATHER, CHECK WITH NEIGHBORS AND FRIENDS WHO THEY LIKE AS A LOCAL VET. WHAT YOU WANT IS ONE THAT WILL WORK "WITH" YOU, IS WILLING TO THINK OUTSIDE THE BOX, TRY THINGS AND IS SO EXCITED TO HAVE AN EPI PATIENT THAT THEY WILL DO MORE RESEARCH ABOUT THE CONDITION ON THEIR OWN TOO.

HOPE SOME OF THESE ANSWERS HELP :)
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.........

HunnysMom
Member
Posts: 57
Country: United States
State: Texas
Pet name: Hunny
My name: Jen

Re: First time poster in need of help.

Post by HunnysMom » 28 Dec 2022, 01:02

Hi everyone

Been reading through your helpful info.

Biggest issue right now is Hunnys constant regurgitation/spitting up.

It seemed like the slippery elm was working a little bit but it’s really not.

I have so many stains on my couch and just cleaned a big one tonight on the carpet.

She does it outside, in the car…everywhere.

What I have noticed many times but not all is especially when she drinks water it will
Happen faster. She also eats very fast and I have noticed she drinks way more water
Now than before.

How I’m the world can I get her to stop spitting up?

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jilbert57
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Re: First time poster in need of help.

Post by jilbert57 » 28 Dec 2022, 09:01

Good morning is her B12 level high and being supplemented daily?

I would look into slowing her down eating. Either get a slow feeder bowl from Amazon or try a Likimat. For water just put down small amounts at a time so she doesn't gulp it with air.
Here is an article that might be helpful.

https://www.dogsnaturallymagazine.com/d ... sted-food/

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.

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

Re: First time poster in need of help.

Post by Tuckaboo Pam » 28 Dec 2022, 10:20

And make sure you are not feeding too much at a time. Some dogs need their food split into as many as four meals a day, the last one coming close to bedtime if the work day is a problem.

Apologies if you are already doing this. --- 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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Olesia711
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Posts: 3857
Location: North Carolina
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Pet name: Izzy
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Re: First time poster in need of help.

Post by Olesia711 » 28 Dec 2022, 11:49

since the slippery elm appeared to help a little and then not.......... my next suggestion was to talk to the vet about trying some omeprazole.

However.... i do have a question fo you.. when you regurgitate.... is it yellow foam, or white foam or liquid with food mixed in?

Here is a good article on constant regurgitation that might be helpful... just in case this is not easily remedied by slowing down the eating/drinking and or the addition of an acid med, like Omeprazole..... as this might be something else entirely......(see article)..... and the first thing i would ask the vet to check into would be possible Addisons... especially with the increased water intake.........

https://www.petmd.com/dog/symptoms/dog-regurgitation
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.........

HunnysMom
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Posts: 57
Country: United States
State: Texas
Pet name: Hunny
My name: Jen

Re: First time poster in need of help.

Post by HunnysMom » 28 Dec 2022, 12:11

Thank you everyone!

Here is some more details to support:

Hunny is eating a total of 3.5 cups a day of taste of the wild. Sucks this isn’t a high calorie food and I’m working on her weight gain I’m trying to give her as much food as possible. I could go to 4 cups…

I am absolutely splitting her food up 4 times a day. For ex: in the am I mix up 1.5 cups and feed her about half. Then an hour or two later I give her the rest. Then she gets 2 more cups and she gets those cups soemtimes split up into smaller and sometimes not. she does eats out of a maze bowl to slow her down.

Before her epi symptoms I stopped feeding her from that bowl Because she eats SO fast so I started putting her kibble into one of those bobble looking things where she has to knock it around to get the food. This worked perfect because it took her a long time to eat. We had zero issues.

BUT now that she needs her food mixed with the enzyme, slippery elm, and tylison sprinkled on top I can’t feed her in the bobble because of the liquid and the food gets a bit mushy If you have any ideas on how I can do let me know!

Her b12 levels were actually high when she was tested but I continue to give her a b12 supplement anyway.

When she spits up it is clear with some of her food. It is not foamy or white. Soemtimes it seems like she is going to spit up but she doesn’t. You can see something is coming up inside of her and hear it and then she’s just licking her lips and it passes.

I do feel the water plays a role and some movement. She will be fine for hours and then all of a sudden she will move or maybe lay on top of me and it comes up.

It happens so fast too. I keep wanting to note that before her symptoms this never ever happened. I did monitor her water but now she’s so much more thirsty than before!

Lastly, I work from home so I am happy to make any adjustments needed.

Thanks all!

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

Re: First time poster in need of help.

Post by Olesia711 » 28 Dec 2022, 13:18

Thanks for giving us the details..... now i have a better understanding of what has been happening and where is appears to put the focus on.
Based on what you wrote, it does indeed sound like she is eating/drinking WAYYyyyyy to fast. however.... the increased water intake may be something else..........

there are two options that i can come up with, maybe others will come up with more:
1. for each meal.... maybe just put 2 tablespoons of food down at a time... wait a minute after it is finished before putting the next 2 tablespoons of food down and repeat until meal is done. See if this helps...
2.mix the enzymes, tylan, slippery elm in a little bit (maybe 20% of the meal) of mushy food... let sit for the 15-20 minutes.... and serve. Then give the rest of the kibble dry in the special slow eating feeder you have.... see if this helps.

I personally would try #1 first....

regarding the increased water intake..... sometimes when enzymes are first introduced they start drinking a lot more water (for a few weeks/month) but then it subsides..... HOWEVER... with Hunny, she has been on the enzymes for a month and this increased water intake is just happening now???? If so... i'd have it checked out.... Addisons, Diabetes, etc.

hopefully someone else might have more suggestions...................
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.........

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

Re: First time poster in need of help.

Post by Tuckaboo Pam » 28 Dec 2022, 13:33

To reiterate---TOTW may not be an extra high calorie food, but neither is it a low calorie one. Someone early on referred to it as low calorie, and that is incorrect. I just wanted to repeat that for you. Tucker gained 35 pounds eating regular calorie kibble, and TOTW was one of them.

Olesia, I love your description of feeding the enzymes first in some of the food, and then feeding dry kibble in the slow feeder. That is brilliant.

--- 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.

HunnysMom
Member
Posts: 57
Country: United States
State: Texas
Pet name: Hunny
My name: Jen

Re: First time poster in need of help.

Post by HunnysMom » 29 Dec 2022, 13:10

My gut has been feeling that the increased water intake has been due to all of the "powders" she is taking in. I should add it isn't "just now." I have noticed it over the last few weeks or so. It could have started a month ago...not fully sure.

I had researched addison's but I highly doubt this is it.

I will monitor this for sure though.

The intensity of how she eats is wild. She will finish a full cup of food in less than 60 seconds. It is as if she is worried about something and if sh doesn't eat so fast something will happen. I have seen this behavior in her in the past and with the change in how I feed her/what I feed her (due to the EPI) it has increased.

I will try what you suggested.

All of this is so exhausting. It is so weird to have seen my girl perfectly healthy with NO issues....I mean ZERO to now all of this special feeding and treatments and it seemingly happened overnight!

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