Creon not working (yet?) and other issues

Epi4Dogs Foundation Inc.’s mission is the advancement of science and education relating to EPI (Exocrine Pancreatic Insufficiency), yielding useful insights and positive outcomes in better managing EPI in dogs and cats. Our goals are to support and/or collaborate with veterinary EPI research and researchers, and to promote EPI awareness by educating the general public, pet owners, pet organizations, rescue and shelter organizations, veterinary schools and veterinarians.
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jmeredith19
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Posts: 18
Country: United States
State: New York
Pet name: Sadie
My name: Jennifer

Creon not working (yet?) and other issues

Post by jmeredith19 » 24 Oct 2024, 16:20

Hi all--I'm back looking for advice, and with more details this time--hoping it could help. Apologies if this is long.

My girl is 16.5 yo, 7.5-8 lb dachshund (normal weight is > 8.5). She had pancreatitis twice in the past few months (May and July, admitted in July but recovered). For her whole life, she had presumptive irritable bowel and was on tylan for years, but we stopped it (initially) in July because she refused to take it. We added pepcid then, and her poops were great--solid--2-3x a day. She also has been on the probiotic propectilin twice a day. All was right with the world...and with her poop....

Then in August, out of nowhere--she developed bad diarrhea---which eventually responded somewhat to tylan--> better stools, 2-3 X a day, but gloppy and yellow.

So starting in August, we put her back on tylan, and pepcid, and continued the propectilin. While she initially had 2-3 yellow softish stools on this regimen, eventually it increased to 8-10 stools a day, various forms, and she was losing weight. So we had her tested for EPI, and her tli came back at 3.5---which my vet says IS epi, and recommended pancreatic enzyme.

I tried pancreplus through various ways (on the food---no way, she wont eat it) and self-filling in enteric capsules. We never got too far with the capsules, as she only takes this willingly "sometimes." I cant always guarantee that I can get it into her. So I figured the answer was Creon--no taste or smell---amazing!! I thought we had our answer and solution.

She is really sensitive to all medications so we have been using this medication very carefully. I bought Creon 10,000 and started with 1/4 capsule with all meals. No change. I increased it to 1/3 capsule with all meals--no change. Then I changed the timing of the 1/3 capsule to 5 minutes before eating, and then 10 minutes before--no change. Now we are on 1/2 capsule with all meals (immediately with food), and so far NO CHANGE!! Next step will be to change the time up again, but I'm losing my patience :( My house is all poop all the time, even during the night-time. ALL POOP ALL THE TIME.. (I'm sure you can relate).

I know this medication can be tricky to "get right," but I'm wondering if anyone has anything more to recommend. I've thought about changing up her tylan dosage (now on 1/2 of 1/64 tspn twice a day as hoping to taper off once creon works), or changing her probiotic---but I'm also afraid to do ANYTHING until I can see at least some improvement from the Creon---otherwise I wont know what actually worked. If it's just about being more patient, I can be---but I'm beginning to feel like this wont work for her, and it's a battle all day cleaning up, feeding her multiple decent sized meals so she keeps her weight, and oh--she also has dementia so it's also all peeing all the time. The good news--is she looks pretty happy, waggy, and not too bothered.

Eddiespaghetti
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Country: United States
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Pet name: Eddie
My name: Jeremy

Re: Creon not working (yet?) and other issues

Post by Eddiespaghetti » 24 Oct 2024, 18:00

With the Creon 10k I would try a whole capsule at first. If she starts to stabilize than back off some. I am giving Eddie half of a 25k micrazym. He eats about 3/4th of a cup of food each meal. 1/2cup kibble and 1/4 cup wet, give or take.
I would also stick to 1/64th of a teaspoon twice a day as it might be needed to get the SIDs in line. For at least 45 days. Though she might need to be on a low dose for life. I am different then most people here as I prefer to throw everything at the problem, get it stabilized than adjust.

waz
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Country: Australia
Pet name: Peggy
My name: Waz

Re: Creon not working (yet?) and other issues

Post by waz » 24 Oct 2024, 18:11

Hi
My dog was diagnosed with EPI last week and I'm currently going through the process of figuring out how to optimise creon delivery
This is my experience to date - this is not advice, just a data point
Peggy is 27kg when healthy / 18 months old Australian cattle X
I'm using Creon 10,000 / feeding 2.5cups of low fat kibble twice a day
My plan is to change timing first to identify strongest reaction, then increase the dose to optimise the result

I tried sprinkling and serve immediately with no noticable results for 48h
I then tried whole capsue and serving food immediatly with no noticable results for 48h
I then tried whole capsue 5 mins before serving food with minor improvements (did for 2 days before changing)
I then tried whole capsue 10 mins before serving food with moderate improvements (did for 2 days before changing)
I then tried whole capsue 15 mins before serving food with further improvements

This is where I am currently at - I will probably change to 20 min delay this evening but am expecting effectiveness to strat reducing at some stage

Good luck
Waz

Chance
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Posts: 617
Country: Canada
Pet name: Chance
My name: Andrea

Re: Creon not working (yet?) and other issues

Post by Chance » 24 Oct 2024, 18:39

If you've tried the 1/3rd pill, half etc., the next step would be to try a full capsule.

I've has no problem with giving pills right before the feeding, 5 minutes before and even 10 minutes before feeding.

Although my dog is larger, I do know a few chihuahuas that require a full capsule of Creon 10,000 with meals. I give a Creon 10,000 with treats in the afternoon (when I do treats)!

The only concern would be if it's acute pancreatitis attack now, enzymes might be harder. If it's EPI related, dogs do usually require more enzymes when they are older. So I would try the full capsule with meals. If that doesn't work, then you might need to look into other things.
Chance was my 4 legged soul mate. My mobility assist service dog. Pure yellow Lab, 75 lbs. After struggling with weight all his life, finally dx with EPI. cTLI < 1, folate and B12 very low. Fed Raw. Maintained with Creon, Garden of Life probiotic and intermittent calcium bentonite clay. (Tylosin was a big nightmare for him)!

Rylee is Chance's successor; also pure Yellow/Fox red Lab. Started with symptoms at 8 weeks. At 6 months of age, also prescribed Creon due to suspected EPI (due to passing large amounts of undigested food). Currently suspected of blockages in pancreatic ducts. She is maintained VERY nicely on Creon and probiotics. Also raw fed.

tathancat
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Posts: 1
Country: Austria
State: Georgia
Pet name: Bob

Re: Creon not working (yet?) and other issues

Post by tathancat » 25 Oct 2024, 12:35

waz wrote: 24 Oct 2024, 18:11 Hi
My dog was diagnosed with EPI last week and I'm currently going through the process of figuring out how to optimise creon delivery
This is my experience to date - this is not advice, just a data point
Peggy is 27kg when healthy / 18 months old Australian cattle X
I'm using Creon 10,000 / feeding 2.5cups of low fat kibble twice a day
My plan is to change timing first to identify strongest reaction, then increase the dose to optimise the result

I tried sprinkling and serve immediately with no noticable results for 48h
I then tried whole capsue and serving food immediatly with no noticable results for 48h
I then tried whole capsue 5 mins before serving food with minor improvements (did for 2 days before changinggeometry dashGeometry Dash is a wonderful platform game)
I then tried whole capsue 10 mins before serving food with moderate improvements (did for 2 days before changing)
I then tried whole capsue 15 mins before serving food with further improvements

This is where I am currently at - I will probably change to 20 min delay this evening but am expecting effectiveness to strat reducing at some stage

Good luck
Waz
My sister's puppy was also prescribed pancreplus but I found it difficult for him to take it. He doesn't seem to like it and often spits it out. After about 2 weeks of taking it he is still having diarrhea so I am quite worried if he is not suitable for this medication. Does Pancreplus have any side effects or have there been any cases where it is not suitable for him? Any information would be appreciated.

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Olesia711
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My name: olesia

Re: Creon not working (yet?) and other issues

Post by Olesia711 » 25 Oct 2024, 20:26

Hi Jennifer,

I agree with most of the comments here.... at this point i would definitely try giving CREON 10.
Also.... talk to your vet about slightly increasing the Tylan dose... sometimes that is needed.
And the past point is now that you ahve an EPI diagnosis.... and have to give enzymes..... what kind of food are you feeding, cause that "might" be the underlying issue.

The problem with the enzymes is that fiber can destroy the efficacy of the enzymes from anywhere between 0% and 50%.... but to make it even more difficult to figure out... we have no idea which EPI dog will have this problem and if they do have this problem we have no idea by what %. SOOOooooo this is why we suggest (at least initially ) to start with a "grain-free" (actually just a low fiber content food that does not have grain in it).

SOmetimes going with a low fiber content food does the trick... See if you can buy the smallest bag of something that is made with sweet potato instead of rice (or other grains) and check the fiber content and get something with 4% or less fiber content. It might help or not but worth trying....................
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.........

jmeredith19
Member
Posts: 18
Country: United States
State: New York
Pet name: Sadie
My name: Jennifer

Re: Creon not working (yet?) and other issues

Post by jmeredith19 » 25 Oct 2024, 21:31

Olesia, can you clarify---I am already giving her Creon 10,000 (1/2 capsule with each meal). Would you suggest I go up to the full capsule of Creon 10,000 at this point? Also, I do give her some white potato with every meal---would you suggest we stop that? (the rest of her meal is royal canine I/D and steamed chicken---I feed her about 3 times a day 1/3 -1/2 cup in total for each meal)

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