New to Epi and very stressed

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.
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Candicexq8
Member
Posts: 2
Country: United States
State: Texas
Pet name: Cochon
My name: Candice

New to Epi and very stressed

Post by Candicexq8 » 02 Mar 2023, 11:50

Hello

I have a 8 years old diabetic dog who has epi- it started in January - spent over 1200$ with the vet in one month to run 2 full blood panels , 2 fecal tests , multiple blood sugar tests- changed food - gave antibiotics and anti diarrhea - all tests came back normal except for elevated liver enzymes and fat in the urine ( I don’t think my vet tested specifically for epi )nothing worked until I begged my vet to prescribe enzymes 2.5 weeks ago.
I diagnosed the dog ´with epi thanks to your website and multiple research as he had all the symptoms ( the vet wanted to run more tests - meanwhile my dog was not getting better ). My dog used to have 2 bowels movements a day when no EPI and he went up to 6 and lost ton of weight. The first 10 days of using enzymes were great - 70% of his poops looked normal and he was going 4 times a day.
However / the last week has been a set back with poops looking bad again ( yellowish and soft )- gas and we are back to 4-6 poops a day - I have done more research and ordered b12 and sliperry elm supplements - do you think it could help with the poop issues ? These have yet to Come in the mail.
The vet also prescribed probiotics 2times a week but I have not seen any effects of those.
I am just at a loss what to do and not sure why enzymes helped first week and not anymore - I tried to up the dose slightly , incubate longer… no change …
My vet is obviously not well versed in epi management ( when he prescribed enzymes he said just use once a day but I use it with every meal) so I am pretty much one my own to manage my dog - any help/ advice would be greatly appreciated
Thanks so much/ Candice

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

Re: New to Epi and very stressed

Post by Barb » 02 Mar 2023, 17:07

Hello, Candace. A warm welcome to you and your pup. I am so sorry he is having difficulties.

I know you said you have spent quite a bit of money on tests, but if you can possibily swing it I heartily recommend your pup be tested for EPI with the cTli test. It will tell you if your pup has EPI or not and then you can proceed with the correct treatment that will help him. The reason I am saying this is without the Tli test, other things can mimic EPI but may be something else and you could miss valuable time not treating the actual condition.

Your pup will need to be fasted and it is best if he can be tested at the beginning of the week rather than the end or over a week-end. I know how hard it is to see your pup struggling. That is why it is so important to get an accurate diagnosis. Let us know if you can see clear to get the test for EPI. We can give you some suggestions on what to do in the meantime. What enzymes are you using and how much at each meal? What B12 did you order? If your pup does have EPI he probably has low B12, so that will help. Also, if you get him tested, give us the resulting numbers when you get them.

Hang in there.

Barb

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

Re: New to Epi and very stressed

Post by Olesia711 » 02 Mar 2023, 22:20

Hi Candice,

I too STRONGLY recommend having your dog tested for EPI with the TLI blood test as Barb suggested. There are too many other conditions that mimic EPI and unintended consequences can happen if you assume that this is EPI and it is not.

With regards to EPI + Diabetes..... my dog Izzy had both ... and the Diabetes became a real challenge... HOWEVER... what you are describing, without confirmation of EPI is possible SID (small intestinal dysbiosis) which happens not only with EPI, but also with IBD, IBS, and many other gastrointestinal conditions.

Typically we suggest FIRST trying to treat SID with a prebiotic..... here we often suggest trying some slippery elm powder to see if that is good enough to help (and Slippery ELm powder is cheap)
instructions are here:.
https://epi4dogs.com/slippery-elm/
If the Slippery Elm doesn't work, save it, as it may help in the future.... but the next thing to try is a probiotic. Currently we suggest trying either Visboime, Proviable, Mercola COmplete Probiotics or VetriScience Mega Probiotics. Give the probiotics a few weeks to see if they are helping... and ALWAYS start off with less than 1/2 the recommended dose and work your way up to a full dose over the course of a week or so.
If the probiotic also fails.... THEN talk to your vet and ask them to prescribe a course of Tylan antibiotic powder, twice a day for 45 days. DO NOT let the vet prescribe Metronidazole (Flagyl) because Metronidazole will kill ALL the bacteria in the gut where as TYlan will only inhibit the bacteria in the gut from reproducing. SOmetimes the only way to take care of SID is with an antibiotic, and Tylan is usually very good at addressing this issue in the small intestine, whereas Metro doesn't always work well........... Also, Tylan is safe for Diabetic dogs.

But PLEASE do try to run the TLI test to confirm your dog has EPI............

I hope this helps a little!
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.........

Candicexq8
Member
Posts: 2
Country: United States
State: Texas
Pet name: Cochon
My name: Candice

Re: New to Epi and very stressed

Post by Candicexq8 » 08 Mar 2023, 21:45

Thank you so much to you and Barb- I am sorry I just saw this response today- I had asked for notifications when a reply is posted but did not receive any.
I have ordered the slippery elm and the b12 supplement ( both from wonderlabs) as well as a soiled based probiotics. I did not see your recommendation until,now so the probiotics I have is called rover four leaf. The slippery elm helped right away with having brown coloured poops ( not all the time but about 40% of the time- which had not happened for the last 3 months)and since he has been on all 3 supplements he is going only twice a day- which is a big improvement from 6 times a day without any treatment and 4 times with enzymes only. He seems to have gained a little weight and is more active- all in the last week -he defintely had digestive issues with gas and girlging sounds in his stomach before and I do think the probiotic- prebiotic have been helping with this.
Until today where he had some gas again and he did go 5 times to poop and last time was just 3hours after eating ( brown coloured poop but a bit softer) so maybe I should ease up on the slippery elm ( I was giving it once a day - 1/4 teaspoon since my dog is 15 pounds ) as I read it can cause softer stools ….?? Not sure while after 6 perfecr days we are back to more numerous bowel movements???? I had also reduced the enzymes in the last 48h ( he eats 2/3 cup kibble and a teaspon wet food- i was giving him a teaspoon of enzymes until now and reduced it to 6/8 of a teaspoon- we bought pancreplus) please can advise if the up and down is normal with epi/ sibo?
Yes, I guess I should get him tested ( the vet never suggested it though- he just prescribed the enzymes after I begged him since nothing he was doing was helping- he did ran two full blood panels and fecal tests but I guess did not diagnose anything) but I dont think it is IBS as my dog never had diarrhea or constipation and he has all the synptoms of epi and sibo…
However can he be accuratly diagnosed if he is tested whilst he takes enzymes and supplements?

Thank you so much for all your help and again so sorry i did not see your and Barb’s response earlier

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

Re: New to Epi and very stressed

Post by Olesia711 » 10 Mar 2023, 19:35

HI Candace,

First let me apologize for not responding yesterday..... also, thanks for letting me know that you are not getting notifications.... i stopped getting them too.... *sigh*.... something is going on cause ever since the website update, we had notification issues, web master fixed it, it worked for a little while and now it appears to not be working again.... i'll report it.

Yes, if at all possible, please do have the standard EPI blood test done... it is called the TLI test.. you will have to food fast the dog for 12 hours.... BUT.... you can still give the enzymes, as they will not interfere with the test... and neither will any supplements :)

What you cannot do is when you are running the B12 blood test (Cobalamin) then you cannot give the dog any B12 shots 30 days prior to the blood test and if giving B12 pills, you cannot give a b12 pill 1 week prior to the blood test.

SID (that tummy gurgling, etc. can happen with other health conditions, no just EPI.... so you really want to make sure this is EPI, hence test).
From your post, it doesn't sound like Slippery Elm all of a sudden triggered softer poos, more frequent poos... i would suspect the lessening of the enzymes in the past 48 hrs might have triggered the looser stools. SO.... i would up the enzymes to where they were before and leave the slippery elm as is.... see if this improves things over the next couple of days. If not, THEN i would try reducing the slippery elm. However, i am also wondering if he got into something that maybe he shouldn't have.

Yes, you can have what i call "iffy" stools with SID.........

And this time MY apologies for not getting back to you sooner!
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
Olesia711
Founder & Research Director
Posts: 3858
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: New to Epi and very stressed

Post by Olesia711 » 10 Mar 2023, 19:42

HI Candace,

First let me apologize for not responding yesterday..... also, thanks for letting me know that you are not getting notifications.... i stopped getting them too.... *sigh*.... something is going on cause ever since the website update, we had notification issues, web master fixed it, it worked for a little while and now it appears to not be working again.... i'll report it.

Yes, if at all possible, please do have the standard EPI blood test done... it is called the TLI test.. you will have to food fast the dog for 12 hours.... BUT.... you can still give the enzymes, as they will not interfere with the test... and neither will any supplements :)

What you cannot do is when you are running the B12 blood test (Cobalamin) then you cannot give the dog any B12 shots 30 days prior to the blood test and if giving B12 pills, you cannot give a b12 pill 1 week prior to the blood test.

SID (that tummy gurgling, etc. can happen with other health conditions, no just EPI.... so you really want to make sure this is EPI, hence test).
From your post, it doesn't sound like Slippery Elm all of a sudden triggered softer poos, more frequent poos... i would suspect the lessening of the enzymes in the past 48 hrs might have triggered the looser stools. SO.... i would up the enzymes to where they were before and leave the slippery elm as is.... see if this improves things over the next couple of days. If not, THEN i would try reducing the slippery elm. However, i am also wondering if he got into something that maybe he shouldn't have.

Yes, you can have what i call "iffy" stools with SID.........

And this time MY apologies for not getting back to you sooner!
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.........

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