Advise on potential EPI for Malamute x GSD

[drogomal02]

Hi axelgrouchy, sorry for the detailed reply - I just checked this forum again today. I hope your pup is doing better now.

Following is an update on Drogo: He is progressing well in his EPI journey and putting on weight. His poos are in the good category for most of the time. Other symptoms such as tummy gurgles, flatulence and lethargy have gone. He seems to be able to heal or regrow fur at a normal healthy rate. During the initial days of his epi when he was not on any medication we noticed that his fur that was trimmed to draw blood grew very slowly.

Sometimes he gets into things and his poos start loosing form (once he had severe diarrhoea). It is followed by flatulence as well. In that case we just continue with his enzyme replacement and it resolves in about 24 - 48 hours. I did try to give him pro-kolin during that time but noticed that it made him nauseated (he would smack his lips through out the night) so I stopped giving him that.

So far the below routine has worked for us:
- we feed him Royal Canine Gastrointestinal Low fat dry food x3 times a day.
- he gets 200 grams of food per meal.
- with each meal he gets x4 capsules of creon 10k.
- he also gets x2 capsules of cabalazorb (Vit B12) supplement per day. The vet said that the excess vitamin will be flushed out of his body.

Since he is a big dog, the vet said ideally we should be feeding him 230grams of dry food per meal. I did try increasing his food to 220grams with increasing the creon vitamin to x5 creon 10k capsules per meal however during that time his poo was loose for a long time. He did get into the cat’s litter box a few times when we were trialing this. So that could be related to it. But we reverted back to 200 grams just until his poo stabilises again.

Apart from that I do weigh him every week just to make sure we are keeping a very close eye on his weight. Once he reaches his goal weight of >=35kg then we will do another vet visit to see if we can change to some other food and if we can start incorporating other treats into his diet. Right now for treat I just give him his dry food as well.

[drogomal02]

Apart from the above message, just wanted to add on how I prepare his food:

We use a kitchen weighing scale to put 200grams of food in his bowl. Then we pour some hot water so that the food will soften. Once it is soften and not hot, I will add in the B12 (if required during that time) and stir the food. Then I will sprinkle the creon on top of the food (No Stirring) and feed it to him.

[jilbert57]

Hi Duaa,
I read your posts from Oct 2023 but I don't see where you posted that Drogo Tli test result was positive for Epi. If so will you post test results?
Thanks for posting your routine. It sounds great!

Jill

[drogomal02]

Hi Jill,

Thanks for your message.

Drogo’s EPI result was 6.1 (I forgot the units). The vet was aware of the new values for EPI and suggested we started treatment as his result was in the highly suggestive of EPI range.

There is one thing to note: Drogo’s test was not done in fasting condition. As his original vet was not very supportive in trying to manage his case, I had to take him to a far off vet that we used to visit before we relocated. That experienced vet was able to diagnose his EPI immediately as he had experience with it before.

Drogo has so far responded well to enzyme replacement treatment which confirms his EPI.

[Eddiespaghetti]

I am not 100 percent sure, but if TLI is anything like other blood testing. If they aren't fasted the results will be higher. All of that aside, if they are responding to enzyme treatment and the vet suspects it's EPI. It's EPI.

[drogomal02]

That is what the vet suspected too - since he was not fasted he said the TLI results would be higher as the body might try to produce some enzymes.
The vet did say that all his symptoms match EPI and so far the enzyme replacement treatment has brought the consistency of his poos and his weight under control.

After a few months we asked the vet if we should re-do the TLI test in fasting condition. The vet said there is no value in redoing the test as he is responding well to treatment so that confirms the EPI diagnosis.

Before we came to this vet, other vets did quite a lot of tests on him (a few blood tests and addison’s test too where they inject him with something and draw blood again to compare the cortisol level). My partner does want to do unnecessary testing on him anymore as that might stress him out.
FYI - his addison’s was negative (Phew!)

[Eddiespaghetti]

I would agree with not retesting TLI, unless you want to check B12 again. Might as well do both at the same time. Personally, I don't see a huge reason to check B12 again. As I just give Eddie B12 and he is responding pretty well.
Though out where I live the cTLI test is 356 dollars, that might make me a little bias on retesting. Well it's like 320 with the rest for the normal vet fee.