Advise on potential EPI for Malamute x GSD

[drogomal02]

Hi Everyone,

I am looking for advise for my malamute x GSD male dog (Drogo) who might have potential EPI. He is 2.5 yrs old and is not de-sexed yet.
Since September his weight has been gradually decreasing (31.5kg -> 28.5kg -> 28kg -> 27.6kg -> 26.9kg (As of Monday))
He is very hungry all the time (scavenging when unmonitored) and is having intermittent diarrhoea. He has low energy.
We have done the initial blood test (Partial report which shows low levels of Amalyse and Lipase attached)
Currently waiting for poo test and TLI test results to come through.
The vet has verbally told us that he suspects Drogo has EPI. Before starting any treatment he wants to wait for the results to come.
In the interim what do I feed him so that his weight does not decline further?
Currently he is on HILLS PRESCRIPTION DIET Gastrointestinal Biome Digestive Fibre Care With Chicken Dry Dog Food.
Along with this, we are giving him boiled white rice and chicken.
We also sometimes give him chicken broth (chicken breast + water boiled and blended together)so that he is sufficient fluids.
I am very worried that his weight will decline further until the results come in and the treatment starts.

Any help would be greatly appreciated! we are in Australia.

[jilbert57]

I am sorry you are having trouble with your pup.
Here is a link. Scroll down to Australia and download the Quick start guide brochure for Australia. It might help.
https://epi4dogs.com/epi-quick-guides-outside-usa/
Low lipase and amylase could indicate pancreatitis. It usually takes a test for the specific enzyme, pancrealipase, to show pancreatis. It is specifically emitted by the pancreas. Good thing you had the Tli test done. Hopefully your pup was food fasted 12 hrs before the test.
4 things are implemented for getting a Epi dog on track:
1. Enzymes. Porcine enzymes must be used on all food from here on out.
2. Diet. Grain free diet with 4% or less fiber. Chicken can be a problem for some animals. Please try to find a food without peas, lentils or legumes, no pea flour, .
3. Antibiotics Most animals with Epi have a disbalance of gut microbiome with an overgrowth of bad bacteria. A 45 day course of 2 times a day Tylan is prescribed. First you aan try a prebiotic, then a probiotic and see if that helps.
4. B12 Almost all have low B12. This must be in the mid high to high range. It can be daily supplementation with Wonderlabs B12 with Intrinsic Factor or weekly B12 shots forb6 weeks.

This is alot of information I realize. Look and read up all the links on the Home page tab

In US we can get capsules at the health food store with low dose pancreatin enzyme in them. Maybe ask your vet if you could try those while waiting?

Jill

[Eddiespaghetti]

Based on the test results and what you are saying, both diabetes and EPI are possible. The low ALP is probable of malnutrition which can be caused by both EPI and diabetes.
Possible things to try; get some enzymes and see if they respond. I am unsure how it is in AU, but you should be able to find enzymes without a prescription. This is if you don't want to what for the cTLI results.
Try a low fat food. This will help a little with pancreatitis and diabetes. The downside to this is, if it is EPI you don't want to give low-fat food.
Give fluids. It will probably have to be subdural fluids though. The elevated ALT means the liver is working hard. Fluids should help flush it out. This is a little harder since you will need a vet prescription and/or they will do it. You said your vet wants to wait for the results of the cTLI test before starting treatment.
It is devastating watching them lose weight, but luckily, if it is EPI after the initial trial and error phase they can easily put the weight back on and will bounce back to be super happy pups.

[drogomal02]

Hi,

Thank you very much for your help.
I am looking into the enzymes whilst waiting for the results.
I will give an update as soon as I can.

[drogomal02]

Update and further advice needed:
Vets were not able to find anything from the blood test and the poo test.

We took him to another vet for a second opinion who thinks that he might have EPI as he has all the following signs:
1- gradual weight loss
2- increased appetite (he is always hungry and will scavenge when unmonitored)
3- rumbling from stomach/abdomen
4- flatulence
5- goopy poop most of the time. When it is solid it is has a weird Grey outer coating.

This vet did a TLI result last week. We are still waiting for the result. The vet called me just now and said he would like to try giving him the enzyme supplement as it won’t cause any problems for him. We are hoping the results will either come in today or tomorrow.

Initially Drogo was on the Hill’s biome fibre care food. But now we are transitioning him to Royal Canin gastrointestinal low fat food as it has a reduced fibre and fat content which might be more suitable for EPI dogs.

The vet recommended to give him either enzyplex or viokase. However he has said that enzyplex is discontinued and viokase is not available in Australia.

I read on EPI4Dogs forum that CREON 10,000 tablets can also be used. I think I am able to find these from chemist warehouse but wanted to check what other owners in Australia are giving their dogs?

If I am to give him CREON 10,000 tablets what dosage should I start off with ?

[Eddiespaghetti]

Trying to convert it over to American measurements. Then comparing it to what I use. Based on the information I could find on Creon 10,000. I would say 1-2 tablets per cup of food? Someone will help you along, who probably knows more than me.
You don't want to give reduced fat foods to EPI dogs as they already struggle to get nutrients, and if they have lost weight , they need the fat. That being said, you definitely want to stabilize them first. You can always switch food later.

[drogomal02]

Thank you very much for replying! It is definitely helpful. Apparently in Australia many people are using Creon as other enzyme supplements are not available

Yes, our plan is to stabilize him first. He continued to have goopy poop, stomach rumbling and flatulence throughout the week. So that is why we are switching him to a easily digestible diet. Hopefully tomorrow I can get an update from the vet so we can start his medication quickly.

[Tuckaboo Pam]

Duaa---I have recently used Creon, and I will share what Olesia told me. Open the capsule, sprinkle on moist food, and serve. Do NOT stir & do not let sit. Hope this helps. ---Pam & Tucker

[axelgrouchy]

Thank you very much for replying! It is definitely helpful. Apparently in Australia many people are using Creon as other enzymecoreball supplements are not available

Yes, our plan is to stabilize him first. He continued to have goopy poop, stomach rumbling and flatulence throughout the week. So that is why we are switching him to a easily digestible diet. Hopefully tomorrow I can get an update from the vet so we can start his medication quickly.

Hello. Has his condition improved? My dog is having the same problem as him. I saw a veterinarian and used medication as directed, but the situation was still not improving.

[jilbert57]

Hi axelgrouchy, maybe you could start a new thread and introduce Haki?

Thank you

Jill