Newly diagnosed EPI

[Fepi]

Thx for the link to the measurement spoons, I just added it to my amazon order

[Tuckaboo Pam]

Thank you Jill!! Yes he was fasted well over 8hrs before test.

Thank you Eddiespagetti, reg. Tylan forgive my ignorance on this but how do I accurately measure 1/32 tsp. And does anyone have a place they buy the capsules from and tips on filling them. I was so shaky doing it, it took forever lol.

Also is it best to follow the instructions on Enzyme Diane and incubate on food rather then give in a pill? What if he can’t tolerate it on his food? Do you just put it in a capsule and give it to him with his food- can that be effective or is it just trial and error as each dog is different.
I have a lot to learn for sure.

Regarding food. My dog has always been fussy with kibble. Is there a can diet that works well for epi that any of you have had success with with your dog? I will go look through that helpful link too, thank you so much.

Thank you Patsy for advice with small dog. And yes he does shake sometimes for no apparent response. Mostly in the morning.

Hi there and WELCOME. We have ALL been in your position, and we know how overwhelming it seems, at first.

ENZYMES---I prefer enzymediane.com 6X, because the measurement is easy to remember---1 teaspoon per 1 cup of food. I have heard nothing about her enzymes being on back order, so you can order them now & have them in a couple of days.

TYLAN---the chart says a 20 pound dog gets 1/16 teaspoon, so I would take my 1/4 teaspoon measuring spoon from the kitchen, fill it level with sugar, place it on a plate, separate it into fourths, put a little less than 1/4 back into the measuring spoon, and see what that looks like. Aim for that amount of Tylan each time. I believe I have read here, that Tylan is forgiving, if you are not completely accurate.

Food---grain-free & less than 4% fiber. No peas or white potatoes, unless they are far down the list of ingredients. AND----Feed her 150% the amount you'd feed if she weighed what she should weigh. Separate the food into three or four meals a day, if you can.

Enzymes can be tricky to feed, if your dog doesn't like the taste. You will want to mix them in with the kibble & some liquid, then let it sit for 20 minutes before you feed it. If she refuses to eat, place some parmesan cheese or tuna fish on top, to get her excited.

Proviable---start with way less than the recommended amount, and build up to full strength over a few days.

You are so right to be happy you've found this wonderful group. Over the past 4 1/2 years these people have saved Tucker & me, over & over again. Ask every question you have, that's why we're here!

---Pam & Tucker

[Eddiespaghetti]

Since our dogs should weigh about the same, I can comfortably tell you the regimen that has worked for Eddie.
https://www.chewy.com/taste-wild-appala ... u8EALw_wcB
Thie kibble. We started off with 1/2 cup per meal and as he put on weight and wasn't starving we have slowly scaled it back to 1/4th cup now.
https://www.chewy.com/wellness-core-gra ... vnEALw_wcB
We top each meal with one of these to hide the flavor of the medications. He gets a whole pouch for each meal.
When we started off with Tylosin we used the 1/32 measuring spoon and put in a rounded spoon. They are on the cusp of the weight dosage. It is pretty forgiving a little more or less won't hurt.
We feed three meals and use 1/2 teaspoon of 8x enzymes each meal. The topper adds moisture and flavor and helps soften some of the kibble. No need to add water to it.
Side notes, the Appalachian formula has peas in it, some EPI dogs have trouble with peas or any legumes for that matter. I like this one because the kibble is tiny and very easy for Eddie to eat. When we were feeding a half of cup of kibble we did increase the amount of enzymes to 3/4th teaspoon.
I am not sure if this will help you or not, since every EPI dog is different. I will hopefully help you cut down some trial and error.
Now, to answer your incubation question. You do not HAVE to incubate the enzymes. What you do have to do is make sure you aren't giving dry enzymes to your puppo. This can cause mouth sores. Capsules are fine, if you don't mind filling them. A lot of people say incubation helps their dogs with tummy issues. For efficacy purposes, it does not make a difference. Incubation also doesn't cause any issues, so I do it as well. I usually mix up the food every couple minutes throughout the 15 minutes to make sure everything is mixed correctly.

[Fepi]

Pam & Tucker & EddieSpaghetti, you are so kind to take the time to layout so clearly your routine. Such great advice.

Thanks to all the responses I have received since my initial contact with this forum. I was able to discuss next steps with my very busy vet specialist and bring up some of the recommendations that I have read and learned about from this fantastic website and forum group of caring individuals. I have ordered the Pancreatin 6x from enzyme diane (my vet had never heard of it and was such a help as her go to source had a back order) and all the other meds and supplements. Fingers crossed in a couple days when we start putting the new plan in action with our pup he will start to feel better (will we see changes within a week or does it take longer?). It is comforting to know I can come here for advice as we go through the trial and errors until hopefully we find the sweet spot that works for him. Happy dog, happy dog parents as the saying goes

[jilbert57]

Please feel free to copy and print out any information on our website to give to your vet or friends.
Keep in touch. I am so glad your vet is open to learning with you!

Jill

[Fepi]

Will do.

[Fepi]

Happy Valentines Day!
Just a shout out to thank everyone for all the advice you have given me on this journey. It has been a while so I thought I would provide an update on Fin. He is managing pretty well. He has gained back weight staying at just about 15 pds. which is a good weight for his size and build. He is a very active small dog (mix poodle, shih tzu, american village dog according to genetic test).

This is what we have been doing to manage his EPI if it is helpful for any new comers:

Food:
-Hills Prescription diet z/d canned food and small bite kibble (highly hydrolyzed protein).
-Enzme Diane Pancreatin 6x usp powder. (1/8 tsp with every 1/4 cup food). I use part can and part kibble for each feeding to make up 1/4 cup total serving). I Mix with water and incubate for 20 minutes. He gets (1/2 cup in morning: 1/2 cup at lunch; 1/2 cup at dinner; and 1/4 cup for dessert). (We split the 1/2 cup servings into two and give a few minutes in between because he eats it fast).
-Noteworthy: I take care To make sure water used to mix food with is room temperature. And wet food from refrigerator is taken out to get closer to room temperature. (I do not use hot water in food mixture as can ruin enzymes). Also, Enzymes stored in air tight bag and containers. I Take out smaller amount from larger bag and store in airtight bag and container to use for a few weeks and keep the larger bag of enzymes stored away air tight in good room temps).
-No treats (use toys instead for rewards~ he loves fetch).

Meds:
-Tylasin 325mg (2.7grams) , 1/8 tsp powder 2xday (I put into a gel dissolvable capsule that I get from a compound center pharmacist because this medication is very bitter tasting).
-WonderLabs B-12 with Intrinsic factor (sprinkled on top of food once a day) (started after 8 weeks of weekly B-12 shots). (Started pills Jan. 2024. Will retest B-12 levels to see if his level is okay). (I don’t mix into to the food).
-Probiotic Proviable Forte 1 capsule sprinkled on top of food once a day. (prescribed by vet). ( i don’t mix into the food).

His stool has been consistently good .

Then just the usual (along with vaccines)
Preventatives:
-Inceptor
-Bravecto

Fin isnt totally without some slight regurgitation (not to the point of of spitting up but sometimes burping up some food for sure, but not really sure what else we can do for thatbother then keep on Tylasin and spread his feedings into smaller portions etc).

Most recent issues is he seems to have allegies (likely environmental vet says rather then food since he has been on z/d for a while now). He has been getting ear infections (ears and paws yeast issue) that the vet is treating. I now also make sure groomer uses hypo allergenic shampoo and conditionare and makes sure no water gets into his esrs). We live in Maine so winter now. He is an active outdoor dog (hiking, ball chasing, walking near coast and woods). I bought an air purifier for our house in case that will help.

He does have alot of reverse sneezing. I read on another thread that someone said their dog sneezes more now. Not sure why he is doing this now as it was very rare before EDI that he did this and now it is very often.

[Eddiespaghetti]

Let me start by saying I am very glad our advice worked and that Fin is doing well. What I am about to recommend is only something to think about. It is tough to change a routine when it works.
That amount of Tylan is a little on the high side. Eddie is on a maintenance dose of 1/64th of a teaspoon. You might want to see if you can cut it back, slowly. It won't hurt Fin if you don't, but it might be easier to give, if you are giving less.
I also use a mix of kibble and wet food. I typically add hot water to the cold wet food and mix it up before adding the enzymes. Sometimes, i microwave the wet food for 10 seconds then add the kibble and enzymes. I am not sure if this is easier for you, but was just mentioning it.
If you have been giving B12 every day and have given the shots. You can possibly cut it back to one capsule every couple days, or a half capsule every day. Might make it cheaper overall, if that is a concern. If you are going to retest the B12, it is best to stop giving B12 5-7 days before the retest.
You are doing an incredible job and I am not saying you need to change anything. I am just offering some advice to maybe cut down cost or amount given. If their stool is stable you might be able to introduce treats. I typically give treats after he eats his whole meal, like a good boi. I can also give 1-2 milkbone minis throughout the day and not have issues. There are treat recipes you can try, if you want to go down this route.

[Fepi]

Hi. Thanks so much for the feedback. Always appreciate hearing suggestions and feedback, One of the many ressons to post
I originally thought I would be able to wean him off the Tylosin (that is what vet had told me originally)after his stool had improved and became normal for a long time. But since he still seems to regurgitate some, I assume he still needs to stay on it. Should he not have any regurgitation by now being on all of these meds and new food or is it normal to have some even if stool is fine? If I reduce Tylosin from 1/8 tsp 2x day (which is what the vet prescribed) how does that help with the slight regurgitation issues he has now? Is there something else I should be doing to manage that? Also, for retesting B12 levels, what is the reasoning for stopping giving him the B-12 pill 5-6 days beforehand— what does that do? Thank you so much for any and all insights.

[Eddiespaghetti]

He might need to be on the Tylan for life. Some dogs do, you will just want to find the lowest dose that works. The throwing up might not be from the SIDs and the Tylan may not help with it. There is also a chance, albeit small, that the regurgitating is from the Tylan. He might need famotidine, Omeprazole, or slippery elm instead. If you don't mind keeping him on the Tylan that is fine too. This was more of a cost/ease of use thing.
You want to stop the B12 5-7 days before because otherwise it will be high when retesting. You want to see what their levels are, otherwise you are basically just checking the B12 capsules. Think of it kind of like checking your oil. If you are adding oil while you are checking it, of course it will be higher. I, personally, don't see a reason to recheck the B12 levels. As long as you are giving them B12 often and they are otherwise healthy. It doesn't matter to me if it's 600 or 1200.