Possible EPI diagnose? Please Help

[Eddiespaghetti]

My vet also gave me the whole bottle of B12. The entire 100ml bottle.
It's tough changing vets. While it might be worth it, you also will have to start over with some of this stuff. I honestly have two vets for my dogs. One for day to day stuff, which is close by. The other handles the bigger stuff, like EPI treatment or the congested heart failure in my other dog. Of course, if you change vets and they actually listen to you, it will be worth it.

[Olesia711]

you can order B12 on line from WOnderlabs "Pet Factor B12" it's about $16 for 90 pills. I like this B12 best for our dogs cuz it is made with Methylcobalamin + INtrinsic factor rather than just Cyanocobalamin.
https://wonderlabs.com/PET-FACTOR-B-12

[lylzzf3841]

Yep! I do have the B12 pills from wonderlabs (with intrinsic factor), but the doctor said his b12 level was too low to use oral supplement, so we started the injections. Meanwhile i’m also giving him one pill per day now cuz I guess it won’t hurt. But since he’ll be overdue for his injection this week, I’m bumping it to 2 pills today

[lylzzf3841]

My vet also gave me the whole bottle of B12. The entire 100ml bottle.
It's tough changing vets. While it might be worth it, you also will have to start over with some of this stuff. I honestly have two vets for my dogs. One for day to day stuff, which is close by. The other handles the bigger stuff, like EPI treatment or the congested heart failure in my other dog. Of course, if you change vets and they actually listen to you, it will be worth it.

I think having 2 vets is a great idea. I’ve been wanting to get a second opinion for this. So is your vet for EPI stuff an internal medicine specialist, or a regular vet?

[Eddiespaghetti]

Regular vet. It is a place that has 5 different vets. I am unsure if they are specialized or not. I just like going there for the big stuff because he will bring the medical publications out and we go over them together.

[lylzzf3841]

Regular vet. It is a place that has 5 different vets. I am unsure if they are specialized or not. I just like going there for the big stuff because he will bring the medical publications out and we go over them together.

I see. I think some of the regular vet doesn't have too much experience treating EPI. I talked to my vet this morning and we decided to bring in an internist for consultation (while she's still very hesitant to start on enzymes...)

So my dog has been on enzymes Diane 6x for one and half day now. I have to say I'm not seeing big improvements yet. He's stool is still solid at the beginning and goes soft at the end Maybe enzyme is not enough? or too much? I'm giving about 1 1/2 tsp per 2cups of home made food.. but I don't know if I should increase or decrease the dose at this point...

I'm also planning to stop Proviable DC since I don't know if it's helping him. I wanted to try out slippery elm. How is it usually administered? It look like it forms mucilage so does it impact enzyme's efficacy?

[Eddiespaghetti]

You can try increasing the enzymes. The safe bet is to increase by 1/8th of a teaspoon at a time. Before I got everything dialed in I would increase by 1/4th of a teaspoon. I, personally, like to start high and scale back when things are improving. While too much enzymes can be a problem, it's usually when it's way too much. It's a little tough to dose based off homemade food because it's not necessarily a sum of all it's part. At the same time, you may not be seeing a difference because the SIDs is still rearing it's ugly head.
The slippery elm is in fact a mucilage, but it doesn't effect the enzymes because they do not need to be absorbed. They only need to break down the food. You do need to be careful if they are on medication that is administered orally because the slippery elm can impact that efficacy.
I would try the slippery elm before increasing the enzymes, unless your upper is losing a lot of weight.

[lylzzf3841]

Oh I forgot to mention, he did have a Schebo test about 3 months ago and it was negative… I was just browsing through the forums and read it could 100% rule out EPI?

[Eddiespaghetti]

Yes and no. While the Schebo test can help rule out EPI, the cTLI is more accurate. However, that was three months ago. They just may not have had the markers for the test at that time.

[lylzzf3841]

Yes and no. While the Schebo test can help rule out EPI, the cTLI is more accurate. However, that was three months ago. They just may not have had the markers for the test at that time.

I see. Yeah I somehow also got the feeling that this is progressing really fast. But at the same time I don't know if he's responding to enzyme treatment