EPI and Addison's - weight struggle

[ursh]

Our girl Misha, now two years old, has been diagnosed with Addison's disease in September 2021 and 6 months later also with EPI. In that time she lost 15% of her weight. Her vet says her Addison's is well regulated, while, although we think we are doing everything by the book regarding EPI, Misha still struggles with her weight. We believe we have found the right ratio of food vs. enzymes (her stools are mostly ideal), we are overfeeding her by 100%, we are giving shots of B12 and are supplementing folates. Every few months she gets meds against potential parasites. No matter what we do, Misha is stuck on the same weight she was at when diagnosed.
That being said, we now became suspicios of her Addison's and the amount of her meds. The latter is causing Misha's Potassium to be on the lower side and her Sodium on the upper - but both more or less still within normal range. Is it possible that this slight imbalance is preventing Misha from gaining weight?
Any insight on the matter would be greatly appriciated.

[Olesia711]

i honestly do not know if low potassium levels and elevated sodium levels via Addisons can trigger lack of weight gain...... HOWEVER..... to address Misha's lack of weight gain with diet from the EPI angle.......... there are a couple of things you can consider.

1. Many EPI dogs forever need to eat a LOT more food to maintain their weight/gain weight. I can give you a personal example. I had 3 Spanish Water Dogs. My female (EPI) who weighed 35lbs ate 2+1/2 times as much as my male (non-EPI) who weighed 60lbs. And this was just so that she could maintain her weight.
so........... you just might need to feed more, We typically suggest 150% of what is typical suggested, but some dogs may need even more.

2. Sometimes you just have to switch to a higher calorie food.... what works with a LOT of EPI dogs is a food called SPORT "Elite" it is grain free, but has like 500 calories per cup.... i am just using this as an example. I realize you live outside the USA, so you have different brands of dog foods.

3. Sometimes with some of these EPI dogs, that have trouble gaining weight, it can be that the B12 is not optimal - -even when receiving B12 supplementation...... sometimes the type of B12 being given needs to be changed. Have you rechecked the B12 levels to make sure they are in the upper mid range?

4. And sometimes with some EPI dogs that are really slow gaining weigh, we recommend to "try" adding organic, or cold-pressed, coconut oil. The good stuff. This is a medium chain triglyceride and usually very well tolerated by EPI dogs and it is high in calories and a nice way to add good fat to a diet.. Start with 1/2 tsp, watch the poos to make sure they don't go sloppy, and if okay... then try giving 1 tsp per meal. Of course this is if it is okay to give coconut oil to a dog with Addisons.

[ursh]

Olesia, thank you for your insight.
Is seems I have not expressed myself correctly - by overfeeding her by 100% I meant we are feeding her 100% more than she would require if she was healthy - so basically 200%, sometimes even more. And that I am talking about kibble only. On top of kibble she is regularly given wet food, treats, peanut butter, fruits, etc. So it really could be close to 250%. We have tried switching foods a few times since diagnosis in search of the best one, and the one she's at right now seems to be the best so far - her digestion and stools wise.
We will most definetely try coconut oil. However based on the abnormal large amount of food she gets and still not gain weight, my gut tells me there is something else going on.
Regarding B12 we don't really know her current values. The last time we measured it was in October 2022 and it was in the lower-middle range, so we started first with 6 weekly shots and then with one monthly. We were planing to check again in a month or two.

[Olesia711]

Ahhhhh..... low normal and they reduced the B12 to monthly.... hmmmmmmmmmmmmmmmmm........this might be a contributor.

Ask your vet if they are giving Cyanocobalamin shots.... if yes.... ask them to switch to hydroxycobalamin and to give one every two weeks..... see if that helps..............

if not (at least it won't hurt)..... then i agree with you, something else might be going on.

[Olesia711]

i wish i had answers regarding the Addisons and if the Addison's medication can interfere with weight gain, but i don't know.... maybe if you join and Addisons' facebook group.... and ask the Addisons' community if anyone every had issues with lack of weight gain due to Addisons's meds.... that might give you some answers.............. and of course ask your vet. However, i have learned that sometimes you find more answers to "unusual" happening on forums where lots of people are dealing with the same health condition vs. typical known adverse effects .

[jilbert57]

Are you treating the apples, peanut butter and other treats with enzyme also before feeding?

Jill

[ursh]

Ahhhhh..... low normal and they reduced the B12 to monthly.... hmmmmmmmmmmmmmmmmm........this might be a contributor.

It seems I have not correctly expressed myself again. English tenses are not my biggest strenght. In the testing in October her levels were low-normal for the first time. Before that at each testing her B12 levels had been high-normal to normal (slowly dropping) so the vet hadn't recommened supplementing just yet. When met with the October values then the vet basically recommended to follow the epi4dogs protocol, which is 6 weekly shots at first and then continuing with monthly shots, which we are now doing. She is getting hydroxycobalamin.
Maybe a hypotetical question regarding B12 shots - if it were the low levels that are causing not gaining weight (disregarding all other factors), how soon should I notice any improvement?

[ursh]

i wish i had answers regarding the Addisons and if the Addison's medication can interfere with weight gain, but i don't know.... maybe if you join and Addisons' facebook group.... and ask the Addisons' community if anyone every had issues with lack of weight gain due to Addisons's meds.... that might give you some answers.............. and of course ask your vet. However, i have learned that sometimes you find more answers to "unusual" happening on forums where lots of people are dealing with the same health condition vs. typical known adverse effects .

Thank you. Of course blaming Addison's and slight electrolyte imbalance is only a wild guess - there could be factors or even tiny detailes about EPI that we're still unfamiliar with and are causing the weight struggle so any insight or debate is greatly appreciated. (:

[ursh]

Are you treating the apples, peanut butter and other treats with enzyme also before feeding?

Jill

Yes, she is usually given those at meal time anyway so even if the treat itself is not directly treated with enzymes, it is consumed basically simultaneously with the food that is. Only occasionally while on walks she rewards herself with a snack in a form of wildlife poo that goes untreated.

[Olesia711]

ahh... so you ARE using Hydroxycobalamin B12 ... this is better than Cyanocobalmin B......but if it dropped.... my suggestion would be to ask the vet to increase the B12 shots to every other week....or even every week for now.

. if insufficient B12 is the underlying problem.... then with the increased B12 supplementation... you should start to see an improvement within 3 weeks...