Need help how to feed our EPI dog.

[Emma@MTK]

Hello EPI forum,

We have a 14 month blue heeler, Emma.
She has had EPI since she was 10 months and her weight has gone down from 43 lbs to 30 lbs.

We have been giving her enzymes since mid Nov 2023 but so far she only gained back 1 lb.

For food, we give her home cooked beef, sweet potatoes and carrot, plus Pancreplus 2.5 tables, and also WonderLabs B12 (only in the morning).
We incubated all (food, Pancreplus and B12) for 10 minutes. 3 times daily, each time 1.5 cups. However, she is still constantly ravenous.

So far, her stool is more firm, but is still bulky and a lot for a 30 lbs dog.

My questions are:
1. Do we feed her the appropriate way food and medicine?
2. What should we change or add to help her gain weight faster?
3. What type of kibble is good for EPI?
We have tried the kibbles below they all made her stool soft/diarrhea.
-Simply Nourish grain free (Salmon and sweet potatoes)
-Diamond grain free (beef and sweet potatoes)
-Acana grain free (pumpkin/beef)
-Natural Balance grain free (sweet potatoes/duck)

We appreciate your advice.

Thank you
Emma@MTK

[Kissy1921]

Sorry to hear your girl is still losing weight.

I would start with adding 50% extra food per day, divided over however many meals you feed.

I would also wonder if you are giving enough enzymes.

You will have to add extra enzymes as well to compensate for the extra food .I have no idea how much as every dog is different. I am sure somebody with more experience in the enzyme department will come along and help you soon.

I also feed homecooked and never kibble as if makes my girl poo massive amounts, basically as a lot of kibbles are full of filler.

I also wouldnt swap about and keep trying other foods until your girl is stable. The slightest change in diet can upset them.

Fingers crossed that somebody can help you further. This is a wonderful forum
.
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[Olesia711]

Hi MTK,

Thanks for writing in about Emma.... and thank you for providing some details, however, i need a little more info to discern whether the lack of optimal results are due to enzymes, dysbiosis or the diet.

1. the enzyme tablets that you are giving,.... does it say 425 mg on the bottle? if so... you are under-dosing and most likely not giving so that it is most effective. Each pill only has 9,000 USP units of Lipase. We typically give approximately 71,400 USP units of Lipase (powder)per 1 cup of food . Of course there is a lot of leeway with this, but not this much .

~Giving 1+1/2 cups of food would suggest giving approx 12 crushed pills of 425mg of Lipase pancreatic pills... (i suspect you could probably do fine with less than 12 pills, maybe 8 pills..... but i am sure you can see the disparity ?)
~Giving 1+1/2 cups of food would suggest giving aprox 107,000 USP units of Lipase with powdered pancreatic enzymes. (1+1/2 tsp of powder)

2. Next... when giving pills, they often don't work UNLESS they are crushed into a powder and then add an extra or more pill to the mix. IN the end. the pills appear less expensive, but by the time you use and crush and incubate as many pills as needed.... you'd be much better off buying the powdered version. BTW. PancrePlus is an excellent product- - just go with the powder, not the pills.

3. another possibility is that Emma has SID/SIBO (dysbiosis) which ALL dogs with EPI have. https://epi4dogs.com/possible-alternati ... tibiotics/
The latest trend is to try and get it under good control with pre+probiotics in the beginning.... BUT... if the poos don't improve after a couple of weeks, then tell your vet you want Emma on a 45 /twice a day course of Tylan (Tylosin Tartrate soluble antibiotic powder).. about halfway thru the Tylan regimen.... slowly introduce a pre+probiotic (start with less the 1/2 the recommended dose and work your way up to a full dose over the course of a week or two) SOme of the pre+probiotics that we recommend are: Visbiome, Proviable, VetriScience Mega Probiotics, Mercola COmplete, etc. etc. The problem is that all of these are one-size-fits all and every dog has their own unique gut flora composition, so there are no guarantees that this will work or which one will work (the probiotic part) however, the prebiotics will definitely work on all dogs.
https://epi4dogs.com/prebiotics-and-probiotics/

4. DO NOT let your vet prescribe Metronidazole.... Metro kills ALL bacterium... whereas Tylan only stops the bacterium from reproducing.....and EPI dogs don't have enough gut flora (bacteria) nor do they have enough variety of bacteria either.... so avoid Metro (Flagyl) and ask for Tylan.

5. First try all of the above.... as the above is most likely the problem.... however... if none of the above works, then we move on to the diet.
Typically we suggest grain free food (food that has 4% or less fiber content and food that doesn't have grain in it (to begin with) simply because once a dog is place on enzymes, because grain/fiber may reduce the efficacy of the enzymes from anywhere between 0% to 50%... and we have no idea which dog is affect (if affected) by what %. Since this issue appears to happen very often with EPI dogs, we tell everyone when "starting" with the enzymes, start with a low fiber content food.... once things settle out... if you want then try a food with grain in it. preferably start with a food with rice... or just try adding a little bit of your own cooked white rice to the their diet and see how it goes.

The confusion with this is when you look at the whole dog, the EPI dog, on one hand too much fiber can reduce the efficacy of the enzymes and all EPI dogs need enzymes.
but on the other hand it is fiber that helps get or keep SID/SIBO/dysbiosis under good control... and all EPI dogs have SID. SO.... you kind of have to walk a fine line with this. This is why we suggest a low fiber diet (grain free) and then suggest Slippery Elm powder as the prebiotic (controlled amount of proper fiber + mucilage) https://epi4dogs.com/slippery-elm/

I know this is a lot of conflicting information, but there have been a small minority of EPI dogs that nothing worked UNTIL some fiber was actually added to their diet, via regular dog food... not grain free. SO, trying a food with grain in it may be another possible option... or not
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[Eddiespaghetti]

Olesia has covered a lot of the technical information. It does sound like you might need to up the enzymes.
What I had to do with my Eddie boi was just ramping up the amount of food I was giving him. Every meal add maybe 1/4th cup more? I used 1/8th, but Eddie weighs less. I did it this way to easily add more enzymes. 1/8th cup means 1/8th teaspoon of enzymes. I also added toppers to further increase calories and moisture to his meals. Eventually he wasn't starving and started eating less and less.
I had a lot of success with:
https://www.chewy.com/taste-wild-high-p ... e/dp/30075
https://www.chewy.com/wellness-core-min ... /dp/182073
At least you are on the right track and Emma isn't losing more weight. Sometimes putting on weight on a slow process.

[Montgomery]

Are you adding a balancer to her food to make sure she's getting everything she needs? I feed a home-cooked diet, too, and this is crucial.

[wandaMaeZi]

Hello
Emma a blue heeler
Mine Maezi is a blue heeler ..

You’ve gotten some great advice already

Tis can be a slow process finding
Right balance
Hopefully will be upping enzymes ratio

I feed Maezi now fresh senior recipe


Wanda & Maezi

[Emma@MTK]

Thank you for the informative responses, especially from Olesia.
We are reviewing all the information to see what we can do to help Emma better.
We are also looking at buying pancreas directly from slaughter house but their responses so far is we have to buy the whole animal.

[Emma@MTK]

Update from us,

We got pancreas from stomach region and thymus gland from neck of cow. Both are called sweetbread. Which one is supposed to work better for our EPI dog? How long before we can see the improvement? Thank you in advance.

[Olesia711]

the one from the stomach region

BUt since you are in California..... and If you want to do raw pancreas, check out:
https://www.greentripe.com/

They have raw green tripe and excellent sources of raw pancreas. Their products are excellent. i have ordered from them in the past... however....the products are very inexpensive... HOWEVER... to ship elsewhere (outside Calif) the shipping costs are outrageous.....


https://www.greentripe.com/pages/our-products
Beef Pancreas (Medicinal Use Only)
Freshly frozen beef pancreas is offered as an alternative to treating dogs with pancreatic health issues, such as Exocrine Pancreatic Insufficiency (EPI).

**Please note that we do not offer this on our online store. Please email or call us to order**
[email protected] . You can call us at 669-205-7222 or our toll-free number at (833-468-8747)

Mailing Address: 7238 Alexander St., Gilroy, CA 95020

This comes in a 2lb roll size only.

The other fantastic product they carry (IMHO ) is Xkaliber..... if i only lived closer i would be purchasing this product!

[Emma@MTK]

Thank you for the info, Olesia.
I called greentripe and a very nice lady answered the phone.
She told me green tripe product is available at our local store.

From our research, beef pancreas also available at Wild Fork food stores.
https://wildforkfoods.com/search/?query=sweetbread