Newly diagnosed EPI

[Fepi]

Hi. We are reaching out for advice on best questions to be sure to ask our vet specialist this week when we discuss my dog’s new diagnoses of EPI. And where can we get the pancreatic enzyme my dog’s vet specialist will be prescribing.

Backgroun info: Fistly, let me just say I was so relieved to find this website to learn about EPI after his recent diagnosis. After weeks of our dog having all the problems associated with EPI, we went from his normal vet and got him to a vet specialist that knew to test him for EPI. We just got his results this weekend and the vet specialist said he has EPI and will be talking to us about next steps this week. My small sweet dog is a rescue mix breed (genetic test said he is Amercan village dog, toy poodle and shih tzu). He is likely about 4yrs old. Before getting sick about a month ago, he was 17pds. He is now 14pds. He is currently on Tylosin, Nutramax’s Proviable-Forte, and had a B-12 injection on 10.24 (this date is when he was seen by vet specialist and tested for epi and had an ultrasound). Starting on 10.6 wnen he went to his regular vet because of his stool issues (soft and yellow and often) he was switched to a diet of Royal Canine wet can Gastrointestinal food. He has been on this food since. This Saturday, 10.28 the vet specialist got the test results back and confirmed with us his EPI diagnosis (TLi 1.1 ; cobalamin 293 ng/L. Pancreatic Lipase normal range <30 ; folate normal range 23.7). We will be talking to her this week about what we do next.

I am a bit concerned because in the vet’s email she said she ‘heard the pancreatic enzyme supplement is on back order”. That worries me as my dog really needs to start treatment (He is so hungry all the time and having to poo so often and loosing weight fast. The Gastrointestinal food did turn his stool brown again from bright yellow but most of the time it is soft stool). We are also concerned since he will need to be on enzyme supplement for the rest of his life, where we can affordably buy the supplement.

I wanted to see what any of you think on trying him on a new food soon. I think it will be easier for us to use with the enzyme supplement as it comes in smaller cans so we can open one can for each meal and give it at room temperature (will not need to refrigerate like larger cans). The food is Hills Prescription diet digestive I/D low fat rice, vegetable chicken stew wet can food (My last dog had Crohns disese and IBD and this food worked for his sensitive digestion issues along with his meds). From what I have read on the website it does seem like he may need more good fat then this food may offer and I wonder if that could be done by possibly adding salmon oil or cococut oil?

For my upcoming apt. with the vet specialist I was thinking of asking her about the following. Is there anything else you think I should ask and/or discuss with her for managing this going forward?
-trying New food Hills Prescription diet digestive I/D low fat rice, vegetable chicken stew can food
-and should we add salmon oil or coconut oil (could also order from Wonder lab)
-along with a recommeded probitic? (Currently he is on Nutramax’s Proviable-DC that his reg. Vet put him on 10.6….but I wanted to see if there is one that we could buy ourselves that he should be on since we now know he has EPI).
-Continue with Tylosin (1/8 tsp that i put in a capsule and put in his food)
-Give him weekly B-12 shots at least for next 6 weeks, then every 2 weeks.
-Also Give him Wonder Labs Pet Factor B-12 with Intrinsic Factor 1 capsule a day
-and whatever the enzyme supplement that he is to be prescribed (is there someplace I can direct my vet to be able to get this?)

Anything else I should be doing or asking about. Thank you so much.

[Eddiespaghetti]

Hello,
There is a lot information to give out. I do not want to overwhelm from the get go.
Enzymes- you can get enzymes without a prescription. This forum and website likes enzymediane. I do not know where you live, but enzyme Diane ships to USA and Canada.
Probiotics - you can get a lot of probiotics online. I have had good luck with ones with FoS (I am not going to try to spell what that actually is)
Tylosin - 1/8th of a teaspoon is quite a bit more than what is needed. My dog is 17 pounds and he was on 1/32nd of a teaspoon twice a day. Please confirm this with you vet.
Food- Every dog is different but getting more fat will definitely help put on weight. It will be best to stabilize them before trying a lot of different food. My pup is on taste of the wild Appalachian. It's made for small breeds.

Typical dosage for enzymes is 3/4th teaspoon per 1 cup of wet food and 1 teaspoon for per cup of kibble. A lot of enzymes say per meal, which is wrong.
This is a condensed version of the information, but I don't want to overload you.
I, and many others, are here to assist you and help you get your pup healthy.

[Patsy]

Welcome to you all. Where do you live?
I own a tiny poodle cross too though non-epi. I appreciate how careful you have to be to give them the right amount of food. My epi dog ,a spaniel , took a while to stabilise but regained all weight and long life.
You’ve done brilliant homework and got great advice already . It’s overwhelming at first, but will get easier. Was the epi test done after fasting the dog 12 hours?
You could print out the epi guide for your country and go through it with your vet so that you can clarify what they say.
One tiny dog issue that can be overlooked is that they can get low blood sugar, so licking some honey off your finger or in the food is helpful. Does he ever panic and shiver and shake for no apparent reason? That can be why.
Be warned that many don’t like the enzymes and there are lots of tips on here about disguising the flavour if you do a search.
I’m in the UK , so I used different brands of enzymes, so come back to tell people what your vet recommends. You may be somewhere that can use Enzyme Diane.
All simple or complex questions here are treated seriously.
Hope to hear back soon.
Patsy

[Fepi]

Thank you so much for all the advice. I am in the Northeast in USA. Yes, my dog did fast before the test - the test was done through Texas A & M University.

[Fepi]

It is not clear to me if I am to give our dog both a probiotic and a prebiotic and if so which brands should I buy for him with a diagnosis of EPI??

[Fepi]

My vet specialist was a bit vague on next steps. She did say to give him, tylan powder 1/8tsp 2x day in capsule); , b12 injectables and i can also give the Pet Factor B-12 with Intrinsic Factor pills from Wonder Laboratories .

But It is not clear to me if I am to give our dog both a probiotic and a prebiotic and if so which brands should I buy for him with a diagnosis of EPI?

And with regards to enzyme supplement she did say that the website Enzyme Diane looked legit. But I don’t know which product to order for his 14 pds (normally 17pds).
Should I select the Pancreatin 6x bought off Enzyme Diane the type I should get him? And then just follow the instructions (Approximate dose 1/2-1 tsp per cup of food. Dose will vary pet to pet. Add enzymes to each meal with warm water, mix thoroughly and let sit a minimum of 20 minutes at room temperature before feeding. Pancreatin will vary in potency by batch, adjustments may be needed.).

https://enzymediane.com/product/pancrea ... criptions/

Lastly she said this food would be okay for him: Hills Digestive Care I/D chicken and vegetable stew

Any advice is so appreciated and I will also go back and ask for more clarification from the vet.

[jilbert57]

Since your pup is on Proviable I would just do that. You can order Proviable Forte from Amazon not sure of the price.
There is no need for prescription food unless your pup has another health issue in addition to Epi.
I agree with Eddiespaghetti on the Tylan doseage. It needs to be given 2 times a day for 45 day course. Below in the link to doseage.
https://epi4dogs.com/antibiotics/.
Also as Patsy said was he food fasted at least 8 hrs prior to Tli?
Here are some food selections that have worked for members:
https://epi4dogs.com/dog-food-options/
You are doing good with B12 shots.
Yes the 6x from Diane is great. Porcine.

Jill

[Fepi]

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.

[jilbert57]

Good to hear. Thanks.

Jill

[Eddiespaghetti]

https://a.co/d/7eQyS32
I used something like this. To measure that amount. I mixed the Tylan directly onto the food.
I use the 8x enzymes from enzyme Diane and I also mix it directly onto the food. If you use water just be careful not to add too much, or they might throw it up. I use a wet food topper to give extra calories since he would just throw up when I used water. For 17 pounds you can follow the directions of enzyme Diane. Since they probably won't be getting more than a cup per meal anyway. You can adjust amounts after you see how it goes. I am on the low end and add 1/2 teaspoon per meal. Capsules work as well but my doggie hates pills and it is a lot of work to fill them. They do make capsule filling devices though not sure of the cost.
You should be able to add fish or coconut oil to their meal, I would wait until you get some of the major stuff implemented.