Hi All,
We are just starting on this journey with our day-blind dog, Dot. She is 3 1/2. Received results of her TLI test last Friday, 2 Feb.
TLI = 2.2
Cobalamin = 382
Folate = 12.4
EPI diagnosed and recommendation of Purina HA, low fat, low fiber diet, omeprazole 2x day
Pancreatic enzymes: viokase or pancreazyme 1tsp / 10 kg / meal
BACKSTORY (not really necessary to read -skip to questions if you want):
In October I started complaining to our retired vet who does difficult grooming chores (clipping nails, anal glands, etc) for us that Dot had lost a lot of weight since July/August. We sorta wrote it off to the new energetic rescue playmate we acquired in August.
In November Dot had lost noticeably more weight. We had also noticed 'emoji poop' that was quite orange.
Finally got initial bloodwork done in December. Along with regular fecal and urinalysis. Most interesting thing to us was low cholesterol. This vet thought Addison's or atypical Cushings. Our observed symptoms and clinical symptoms for those did not really match up.
After doing research on low cholesterol we found there were basically 4 conditions indicated: those mentioned above, malabsorption and EPI.
We went to another vet who we've known for 20+ years to consult with her. She was also unimpressed with low cholesterol (which, btw, was very low). She did agree symptomatically Dot did not line up with Addison's or Cushings. It was decided there were 3 tests we could do: complete fecal, Digestive Panel which included TLI, and OncoK9 a predictive cancer test.
We did fecal test first - took forever to get results. Nothing there to explain weight loss.
TLI test came back with results noted above.
OncoK9 is not scheduled for now.
In the meantime, Dot has been to the emergency vet twice for severe gastric problems. She has lost 10+lbs over the last 5 weeks. (57lbs to 46lbs)
END BACKSTORY.
Current meds: omeprozole 2x/day, visbiome probiotic 2x/day.
Recently discontinued sucralfate (stomach med) because Dot absolutely refuses it after being on it 2x/day for 2weeks.
B12 and Slippery Elm are on order from Wonderlabs - should arrive tomorrow.
Enzymes: we tried human ones to get her started - ended up at the emergency vet due to severe vomiting. Got fluids, B12 shot, and Cerenia injection(anti-nausea).
Pan-tenex arrived - gave her very small dose with 2 meals. After second meal she seemed to have upset stomach. Would not eat 3rd meal with enzymes. Gave her small amount of can food before bed. Threw up 3 hours later.
Food:
Royal Canin Gastrointestinal low fat- canned
Hill's Sensitive Stomach and Skin-dry.
Dot has done the best on the Royal Canin GI. She felt the best we've seen in 6 weeks yesterday - even with some stomach upset from the enzymes
We incubated enzymes per recommendations prior to feeding.
QUESTION 1: Could Dot have porcine enzyme allergy but NOT be allergic to pork? Her GI food has pork in it.
QUESTION 2: Are there other ways we can give powdered enzymes and keep nausea down?
QUESTION 3: Are Enteric coated enzyme capsules really tolerated better than the powder.
QUESTION 4: Is fresh beef pancreas mixed in with food tolerated better than powder and/or enteric capsules.
Question 5: what seems to be the best way to give enteric enzyme capsule to keep her from chewing it. She is not keen on Pill Pockets. How big are the capsules. We cannot 'pill' her like you would a regular dog. Nothing about Dot is easy....
Thank you in advance for insights, help, your experience and wisdom.
Intolerance of Enzymez
Intolerance of Enzymez
Dot is our day blind 3 1/2 year old half Idaho Shag half Australian Cattle Dog. She was diagnosed with EPI in late January 2024. We continue to try to figure out her best protocol.....
-
Olesia711
- Founder & Research Director
- Posts: 3933
- Location: North Carolina
- Country: United States
- State: North Carolina
- Pet name: Izzy
- My name: olesia
Re: Intolerance of Enzymez
HI Greydon and thanks for writing in about Dot.
So so SO sorry she is having trouble with her EPI treatment.
First.... please share with your vet what i am going to suggest to you.
i can send you some CREON to try .... it is very rare for a dog to have a true pork allergy wo where they cannot tolerate the porcine enzymes that is the typical treatment to manage EPI.
Plant enzymes and powdered beef enzymes do not seem to work long term on these dogs that do have a true pork allergy.... however.... what we have discovered it that enteric coated enzymes do work. the only think i can think of is that maybe because the enteric coated enzymes might work because the potency is so low since they are enteric coated... that it might not be enough to upset the dog's system. Of course i am just guessing here, i really don't know why they work, but they do with pig allergies.
HOWEVER, that being said.....since a pork allergy is rare, something other than a pork allergy might be going on ,.....
it is possible that your dog is struggling with a very bad case of SID/SIBO/Dysbiosis that accompanies all EPI cases. THis might be why the gastro food is helping cause they are usually are loaded with prebiotics and this helps dysbiosis/SID/SIBO.
The other thing that comes to mind is that she might very well be dealing with EPI + IBD... so every time she eats, her tummy really hurts........ and this is another reason why the gastro prescription food might be helping..... Also.... a lower fat often helps curtail dysbiosis... so this may be another reason why this is helping.
Although normal amounts of fat in the diet is actually advised for EPI dogs, unless the fat is bothering them, like in Dot's situation.
In any case..... sorry for the long winded story.... BUT my two suggestions are to:
1. ask your vet if they would consider a course of Tylan antibiotic powder to see if this is indeed raging dysbiois/SID/SIBO.... and not a pork allergy... here is the instructions and research supporting the use of Tylan
https://epi4dogs.com/antibiotics/
2. ask your vet if they do think this might be a pork sensitivity.... and if so, i can send you some donated CREON to try... .... typically you open the capsule and sprinkle the contents on top of the food (wet food) and serve immediately ... so you don't have to worry about shoving an capsules down their throat.
So so SO sorry she is having trouble with her EPI treatment.
First.... please share with your vet what i am going to suggest to you.
i can send you some CREON to try .... it is very rare for a dog to have a true pork allergy wo where they cannot tolerate the porcine enzymes that is the typical treatment to manage EPI.
Plant enzymes and powdered beef enzymes do not seem to work long term on these dogs that do have a true pork allergy.... however.... what we have discovered it that enteric coated enzymes do work. the only think i can think of is that maybe because the enteric coated enzymes might work because the potency is so low since they are enteric coated... that it might not be enough to upset the dog's system. Of course i am just guessing here, i really don't know why they work, but they do with pig allergies.
HOWEVER, that being said.....since a pork allergy is rare, something other than a pork allergy might be going on ,.....
it is possible that your dog is struggling with a very bad case of SID/SIBO/Dysbiosis that accompanies all EPI cases. THis might be why the gastro food is helping cause they are usually are loaded with prebiotics and this helps dysbiosis/SID/SIBO.
The other thing that comes to mind is that she might very well be dealing with EPI + IBD... so every time she eats, her tummy really hurts........ and this is another reason why the gastro prescription food might be helping..... Also.... a lower fat often helps curtail dysbiosis... so this may be another reason why this is helping.
Although normal amounts of fat in the diet is actually advised for EPI dogs, unless the fat is bothering them, like in Dot's situation.
In any case..... sorry for the long winded story.... BUT my two suggestions are to:
1. ask your vet if they would consider a course of Tylan antibiotic powder to see if this is indeed raging dysbiois/SID/SIBO.... and not a pork allergy... here is the instructions and research supporting the use of Tylan
https://epi4dogs.com/antibiotics/
2. ask your vet if they do think this might be a pork sensitivity.... and if so, i can send you some donated CREON to try... .... typically you open the capsule and sprinkle the contents on top of the food (wet food) and serve immediately ... so you don't have to worry about shoving an capsules down their throat.
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........
-
Eddiespaghetti
- Member
- Posts: 296
- Country: United States
- State: California
- Pet name: Eddie
- My name: Jeremy
Re: Intolerance of Enzymez
Hello,
You have come to the right place.
First thing; enzymes should not be calculated by weight of the dog. It should be done by the amount of food. Typically, 1 teaspoon for one cup of kibble and 3/4th teaspoon for cup of wet food. It's not perfect but it's a good starting point. You can adjust later. They might be throwing up because not enough enzymes is being given. It happened with my dog when we first started seeing symptoms of EPI. The body can't break down the food and it sleeps inside the stomach. I think once you get the correct amount of enzymes in them, you will see a huge difference.
As Olesia mentioned, they are also battling SIDs. The slippery elm should help, if not, tylosin will as well.
I do think you might be giving too much probiotics and Omeprazole, but neither will really hurt while you get Dot stable. Hopefully, we can start tapering some off once the enzymes and slippery elm start working.
QUESTION 1: Could Dot have porcine enzyme allergy but NOT be allergic to pork? Her GI food has pork in it.
Yes, but mostly no. It is different parts of the piggie, but if anything, it might be the anti-caking ingredient in the enzymes.
QUESTION 2: Are there other ways we can give powdered enzymes and keep nausea down?
There are, you can get empty capsules. It will take a bunch of them but it can be done.
QUESTION 3: Are Enteric coated enzyme capsules really tolerated better than the powder.
QUESTION 4: Is fresh beef pancreas mixed in with food tolerated better than powder and/or enteric capsules.
These are really based of the induvial dog. It is also dependent on where you live. Getting raw pancreas beef or pork can be damn near impossible in some places.
Question 5: what seems to be the best way to give enteric enzyme capsule to keep her from chewing it. She is not keen on Pill Pockets. How big are the capsules. We cannot 'pill' her like you would a regular dog. Nothing about Dot is easy....
I completely understand this. My Eddie has had a rough life in regards to medication. He will bite the hands that feed a lot of the time when it comes to medication. I take wet food add a little water and make a smoothie and add the powdered enzymes and other supplements he needs. I have to change the wet food a lot or he starts to catch on.
You have come to the right place.
First thing; enzymes should not be calculated by weight of the dog. It should be done by the amount of food. Typically, 1 teaspoon for one cup of kibble and 3/4th teaspoon for cup of wet food. It's not perfect but it's a good starting point. You can adjust later. They might be throwing up because not enough enzymes is being given. It happened with my dog when we first started seeing symptoms of EPI. The body can't break down the food and it sleeps inside the stomach. I think once you get the correct amount of enzymes in them, you will see a huge difference.
As Olesia mentioned, they are also battling SIDs. The slippery elm should help, if not, tylosin will as well.
I do think you might be giving too much probiotics and Omeprazole, but neither will really hurt while you get Dot stable. Hopefully, we can start tapering some off once the enzymes and slippery elm start working.
QUESTION 1: Could Dot have porcine enzyme allergy but NOT be allergic to pork? Her GI food has pork in it.
Yes, but mostly no. It is different parts of the piggie, but if anything, it might be the anti-caking ingredient in the enzymes.
QUESTION 2: Are there other ways we can give powdered enzymes and keep nausea down?
There are, you can get empty capsules. It will take a bunch of them but it can be done.
QUESTION 3: Are Enteric coated enzyme capsules really tolerated better than the powder.
QUESTION 4: Is fresh beef pancreas mixed in with food tolerated better than powder and/or enteric capsules.
These are really based of the induvial dog. It is also dependent on where you live. Getting raw pancreas beef or pork can be damn near impossible in some places.
Question 5: what seems to be the best way to give enteric enzyme capsule to keep her from chewing it. She is not keen on Pill Pockets. How big are the capsules. We cannot 'pill' her like you would a regular dog. Nothing about Dot is easy....
I completely understand this. My Eddie has had a rough life in regards to medication. He will bite the hands that feed a lot of the time when it comes to medication. I take wet food add a little water and make a smoothie and add the powdered enzymes and other supplements he needs. I have to change the wet food a lot or he starts to catch on.
Re: Intolerance of Enzymez
Hi, you are being given great advice.
Question 5: you don't give the Creon or enteric coated capsule whole. You do not incubate it. You open the capsule and sprinkle on the food right before feeding.
Hope this helps
Jill
Question 5: you don't give the Creon or enteric coated capsule whole. You do not incubate it. You open the capsule and sprinkle on the food right before feeding.
Hope this helps
Jill
My name is Jill and we live on the Hood Canal in Washington State. We currently have 2 Jack russells, TJ is 8 and Sadie is 2.
Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014
Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.
Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014
Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.
Re: Intolerance of Enzymez
Hi Jill,
Thanks for the info about the enteric coated capsules. I guess I don’t understand the reasoning for opening the capsule?
The capsule breaks down in the acid stomach and the enteric coating on the enzyme pellets breaks down in the basic environment of the small intestine to release the enzymes. Correct?
I get that we aren’t dogs but humans take the capsules whole at mealtime.
Is there a worry that dogs will chew the capsule and break the enteric coating on some of the little pellets? But my brain says that’s a risk with just sprinkling the pellets on the food as well.
Is it for ease of administration? Or is there some other reason I am missing?
My preference would be to try to give the capsule whole so I’m just trying to understand if there is something different about the way it works in dogs?
Thank you again for your help. We are so grateful for all the information.
Thanks for the info about the enteric coated capsules. I guess I don’t understand the reasoning for opening the capsule?
The capsule breaks down in the acid stomach and the enteric coating on the enzyme pellets breaks down in the basic environment of the small intestine to release the enzymes. Correct?
I get that we aren’t dogs but humans take the capsules whole at mealtime.
Is there a worry that dogs will chew the capsule and break the enteric coating on some of the little pellets? But my brain says that’s a risk with just sprinkling the pellets on the food as well.
Is it for ease of administration? Or is there some other reason I am missing?
My preference would be to try to give the capsule whole so I’m just trying to understand if there is something different about the way it works in dogs?
Thank you again for your help. We are so grateful for all the information.
Dot is our day blind 3 1/2 year old half Idaho Shag half Australian Cattle Dog. She was diagnosed with EPI in late January 2024. We continue to try to figure out her best protocol.....
Re: Intolerance of Enzymez
Excuse me all to pieces! I have never used it just read to open the capsule and sprinkle on the food. So here is an excerpt on Creon from our site. It does say you can feed whole. Sorry!
"CREON (available world-wide!!!!)
CREON is enteric coated microspheres of enzymes encased in capsules. These capsules may be given whole or sprinkled on food if served immediately. Alternately, some people find that after giving Creon waiting for approximately 5 minutes before feeding is more effective. Every dog is different and experimentation is required to find the most effective method. Please note: if you are going to sprinkle the contents ensure that the dog eats the entire meal so that all of the Creon is ingested. If in doubt, give the capsule whole before trying the sprinkling method.
CREON is commonly used in many places outside the U.S. Existing CREON enzyme capsule products vary from region to region with not all strengths available in all regions. They can come in 5 , 6, 10, 12, 25, 40 strengths and new strengths approved as of 2009 of 6, 12, strengths are becoming more readily available mainly in the US. Because the enzymes in CREON is enteric coated- -the recommended enzyme potency to treat EPI is dramatically different from pancreatin powder or pills! When initially treating an EPI dog, it is recommended to start with CREON 12 or CREON 10 which has 10,000 USP of Lipase, 37,500 USP of Protease, 33,200 USP of Amylase. There is some latitude using Creon as its effectiveness is dependent on the dog’s pH level (you do not need to test for this) so getting the exact strength is not strictly necessary.
The CREON the potency measurement comparison is as follows:
CREON 10 Composition : 150 mg Pancreatin
Amylase 8,000 PhEur units (BP Units) also equals 33,400 USP units
Lipase 10,000 PhEur units (BP Units) also equals 10,000 USP units
Protease 600 Ph Eur units (BP units) also equal 37,500 USP units
CREON 25 Composition : 300 mg Pancreatin
Amylase 18,000 PhEur units (BP Units) also equals 74,700 USP units
Lipase 25,000 PhEur units (BP Units) also equals 25,000 USP units
Protease 1,000 Ph Eur units (BP units) also equal 62,500 USP units
SINCE CREON is a human EPI drug…PLEASE SCROLL TO THE BOTTOM OF THIS PAGE TO READ MORE ABOUT CREON AND “HOW-TO” ADMINISTER. CREON can be used for both dogs and cats. With dogs, start with CREON 10 or 12. With cats, start with CREON 5 or 6"
Jill
"CREON (available world-wide!!!!)
CREON is enteric coated microspheres of enzymes encased in capsules. These capsules may be given whole or sprinkled on food if served immediately. Alternately, some people find that after giving Creon waiting for approximately 5 minutes before feeding is more effective. Every dog is different and experimentation is required to find the most effective method. Please note: if you are going to sprinkle the contents ensure that the dog eats the entire meal so that all of the Creon is ingested. If in doubt, give the capsule whole before trying the sprinkling method.
CREON is commonly used in many places outside the U.S. Existing CREON enzyme capsule products vary from region to region with not all strengths available in all regions. They can come in 5 , 6, 10, 12, 25, 40 strengths and new strengths approved as of 2009 of 6, 12, strengths are becoming more readily available mainly in the US. Because the enzymes in CREON is enteric coated- -the recommended enzyme potency to treat EPI is dramatically different from pancreatin powder or pills! When initially treating an EPI dog, it is recommended to start with CREON 12 or CREON 10 which has 10,000 USP of Lipase, 37,500 USP of Protease, 33,200 USP of Amylase. There is some latitude using Creon as its effectiveness is dependent on the dog’s pH level (you do not need to test for this) so getting the exact strength is not strictly necessary.
The CREON the potency measurement comparison is as follows:
CREON 10 Composition : 150 mg Pancreatin
Amylase 8,000 PhEur units (BP Units) also equals 33,400 USP units
Lipase 10,000 PhEur units (BP Units) also equals 10,000 USP units
Protease 600 Ph Eur units (BP units) also equal 37,500 USP units
CREON 25 Composition : 300 mg Pancreatin
Amylase 18,000 PhEur units (BP Units) also equals 74,700 USP units
Lipase 25,000 PhEur units (BP Units) also equals 25,000 USP units
Protease 1,000 Ph Eur units (BP units) also equal 62,500 USP units
SINCE CREON is a human EPI drug…PLEASE SCROLL TO THE BOTTOM OF THIS PAGE TO READ MORE ABOUT CREON AND “HOW-TO” ADMINISTER. CREON can be used for both dogs and cats. With dogs, start with CREON 10 or 12. With cats, start with CREON 5 or 6"
Jill
My name is Jill and we live on the Hood Canal in Washington State. We currently have 2 Jack russells, TJ is 8 and Sadie is 2.
Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014
Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.
Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014
Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.
Re: Intolerance of Enzymez
Lol! No problem! I am just one of those annoying ‘why’ people.
Thanks for the excerpt on CREON.
Thanks for the excerpt on CREON.
Dot is our day blind 3 1/2 year old half Idaho Shag half Australian Cattle Dog. She was diagnosed with EPI in late January 2024. We continue to try to figure out her best protocol.....
Re: Intolerance of Enzymez
Well I learned something for sure! I like why people. I am one who takes a topic and picks it to its end when maybe I could have stopped a long time ago lol!
Jill
Jill
My name is Jill and we live on the Hood Canal in Washington State. We currently have 2 Jack russells, TJ is 8 and Sadie is 2.
Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014
Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.
Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014
Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.
Re: Intolerance of Enzymez
Hi Olesia and Jeremy
I spent quite a while last night writing a reply to your posts. Alas, it must not have gotten it submitted correctly as it is not to be found this morning. Geez - what could be so hard about clicking ‘submit’.
LOL!
Thank you, thank you, thank you for your responses.
Yes, Dot has SID/SIBO. It is actually more pronounced today than it has been for the last few weeks. She had an acute episode of vomiting and bloody diarrhea in early Jan (pre diagnosis). Did 7 day course of amoxicillin which was very successful. However, she is beginning to show worsening signs again. B12 and Slippery Elm from Wonderlabs hopefully arrive today. Would prefer not to do antibx again so soon. Will try to check with vet today.
The GI food has been so good for Dot. Olesia, your comments about why that could be are appreciated. We do believe it has to do with her current inability to break down fats without enzyme support
Her symptoms don’t seem to line up with IBD. But …..
Her intolerance to enzyme powder is in her stomach. You can see it happening after the second meal with enzymes. She refuses subsequent meals containing enzymes and throws up about 3 hrs after the last meal - totally undigested food.
We would welcome a sample of the enteric coated enzymes. Just think if we can get the enzymes passed her stomach she will be ok. Fingers crossed!
We do have a source for fresh pancreas but it is only available on Wednesdays. Going to try it next week. We have no idea if Dot will eat it. If you can point us in the direction of how to feed it?
I am sure there is more from y’all’s post that I should respond to but my brain is full.
Thank you both SO much again and again and again.
I spent quite a while last night writing a reply to your posts. Alas, it must not have gotten it submitted correctly as it is not to be found this morning. Geez - what could be so hard about clicking ‘submit’.
LOL!
Thank you, thank you, thank you for your responses.
Yes, Dot has SID/SIBO. It is actually more pronounced today than it has been for the last few weeks. She had an acute episode of vomiting and bloody diarrhea in early Jan (pre diagnosis). Did 7 day course of amoxicillin which was very successful. However, she is beginning to show worsening signs again. B12 and Slippery Elm from Wonderlabs hopefully arrive today. Would prefer not to do antibx again so soon. Will try to check with vet today.
The GI food has been so good for Dot. Olesia, your comments about why that could be are appreciated. We do believe it has to do with her current inability to break down fats without enzyme support
Her symptoms don’t seem to line up with IBD. But …..
Her intolerance to enzyme powder is in her stomach. You can see it happening after the second meal with enzymes. She refuses subsequent meals containing enzymes and throws up about 3 hrs after the last meal - totally undigested food.
We would welcome a sample of the enteric coated enzymes. Just think if we can get the enzymes passed her stomach she will be ok. Fingers crossed!
We do have a source for fresh pancreas but it is only available on Wednesdays. Going to try it next week. We have no idea if Dot will eat it. If you can point us in the direction of how to feed it?
I am sure there is more from y’all’s post that I should respond to but my brain is full.
Thank you both SO much again and again and again.
Dot is our day blind 3 1/2 year old half Idaho Shag half Australian Cattle Dog. She was diagnosed with EPI in late January 2024. We continue to try to figure out her best protocol.....
-
Olesia711
- Founder & Research Director
- Posts: 3933
- Location: North Carolina
- Country: United States
- State: North Carolina
- Pet name: Izzy
- My name: olesia
Re: Intolerance of Enzymez
HI Greyden,
Thanks for your response..... please email me privately at:
[email protected]
and give me your mailing address so i can send you some CREON capsules to try.
IN the meantime.... this could be more SID related than Enzyme sensitivity.... so... do try the SLippery Elm and see if that helps, even a tiny bit and keep us posted. Just don't over due on the slippery elm as too much can trigger loose stools and upset tummy... just give the right amount as noted on the SLippery Elm page.... and keep us posted
Thanks for your response..... please email me privately at:
[email protected]
and give me your mailing address so i can send you some CREON capsules to try.
IN the meantime.... this could be more SID related than Enzyme sensitivity.... so... do try the SLippery Elm and see if that helps, even a tiny bit and keep us posted. Just don't over due on the slippery elm as too much can trigger loose stools and upset tummy... just give the right amount as noted on the SLippery Elm page.... and keep us posted
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........
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