Losing Hope for Xena. Trying Panzquin.

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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Lolly
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Country: United States
State: California
Pet name: Xena

Losing Hope for Xena. Trying Panzquin.

Post by Lolly » 27 Oct 2024, 02:47

Xena is a sweet, gentle, loving, 7 year old Labrador Retriever.

Diagnosed in September. First given Pancreplus. Not much improvement in the few days she was on it.

Then I put Xena on Pantenex which I read was just as good and more affordable. Went through tub and a bit of a second. Not much improvement.

Switched to Enzyme Diane. Seemed everyone was having good luck on that one. Xena hasn't had good luck yet.

Her poop was firm one time I saw. Been like pudding the rest of the time. Which is an improvement over the watery diarrhea.

Bad ascites. Dealing with SID. She is on Tylan and prebiotics/probiotics with FOS. Pet Factor B12 with intrinsic. Slippery Elm Bark although I have cut that back a bit because I think it was bothering her a little.

She has had all the blood work done 3 times now and GI twice and its not improving. Had 2 ultrasounds to rule out something else.

She has very little appetite and is weak.

Just had her back at Vet yesterday. Now he wants me to try Panzquin. I would like to try raw Pancreas. He wants me to try this first. Not sure how much time to give it.

If there is someone out there with a similar story please share...everyone seems to have dogs that improve so quickly.

Spec cPL 77
Trypsan-like Immuno-reactivity (TLI) 1.7
Cobalamin 170
Folate 9.1

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Montgomery
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Pet name: Montgomery (I'm a CAT!)
My name: V

Re: Losing Hope for Xena. Trying Panzquin.

Post by Montgomery » 27 Oct 2024, 11:00

I felt the same as you did. So many animals get better so fast once they begin enzyme treatment. Montgomery didn't. It was still the same old story of trying to find things he could eat, and battling his angry and unpredictable digestive system. Finally, we were able to get in with an wholistic veterinarian. Best thing we ever did. A change in diet and red light therapy was exactly what this little guy needed. We were able to get him off his colic medication, as the agonising trapped gas in his gut was a thing of the past. His digestion stablised. He began urinating exclusively in the litter box, and then deficating there, too. His brain and his gut were finally communicating properly. At ten years old, we could finally say he was house-broken. He's a happy, healthy, strong, and a little chunky twelve year-old. I never thought I'd see the day.
It isn't instantaneous for everyone. Stay strong.
Montgomery was born 20 March 2012. He is SUPPOSED to be eating a home-cooked diet, but refuses. He eats Purina True Instinct Grain-Free Chicken and whatever chicken-based tinned food we can entice him with. Nine pounds of pure stubbornness. He gets two size 0 capsules of Enzyme Diane at each meal and one size 4 capsule of Tylosin three times daily. Sometimes he gets Petromalt. He's our little Spitfire, and when he purrs you KNOW he's got a real Merlin engine. Lately, he's taken to giving hugs. His hobbies include shooting marbles, shredding cardboard, and irritating his sister.

Tuckaboo Pam
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Re: Losing Hope for Xena. Trying Panzquin.

Post by Tuckaboo Pam » 27 Oct 2024, 15:28

I am so, so sorry. Please don't give up.

I don't see how the brand of porcine enzymes would make a difference, but you never know.

I just have a couple of questions---

When you started probiotics, did you introduce them slowly before building up to the recommended amount?

What food do you feed her?

Are you giving the right amount of Tylan? For the longest time, I did not realize that the dosage page gives the amount of Tylan to be given twice a day, and I only gave it once.

I think I would stop the slippery elm for the time being, and just focus on making sure she has the enzymes and a diet that is conducive to enzyme efficiency. I'm not sure why I say this, but I think maybe the correct dose of Tylan is enough for now. I have never used slippery elm & Tylan at the same time. I think others do. Honestly, I have always done well on enzymes, B12, and a focus on SID, which you are doing with Tylan. Some others may have a different opinion, but I would try just the basics for a few days. That fluid can't be comfortable.

Just some reminders---

DIET

------grain free if possible, with potatoes & peas far down the list of ingredients, if at all.
------Some EPI dogs do poorly on chicken & turkey. I feed Taste of the Wild Pacific Stream, have also used High Prairie flavor, with success.
------Remember, you can add good food to the meal: boiled eggs, red meat, sardines, organ meat, for example.

Tucker had no reaction to just the enzymes, and when we added the correct dose of prescription Tylan & Wonderlabs B12, things started turning around.

Sorry for all the questions. I hope we can help you solve this puzzle. ---Pam
Tucker was a shepherd mix--- TLI 1.3, Folate 9.7, Cobalamin 666, Lipase 38. Diane's Enzymes 4 t/day, B12 1 capsule/day, and Tylan 1/16 teaspoon/day. Taste of the Wild High Prairie, 4 c/day. 60 to 85 pounds! Tucker succumbed to hemangiosarcoma Nov. 2023. I will always, always miss my sweet big boy.

Now there's Nina. 5 year old GSD. TLI 1.0 B12 323. We are still tweaking her routine, and getting lots of help from the forum. She is klutzy and goofy, and we love her dearly, too.

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jilbert57
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Re: Losing Hope for Xena. Trying Panzquin.

Post by jilbert57 » 27 Oct 2024, 18:35

Hi. With a B12 of 170 I would get a jumpstart with a plain B12 injection from the vet once a week (you can also give these injections at home if you are comfortable doing so)for 4-6 weeks then daily Pet Factor.
The Tylan needs to be given am and pm for a minimum of 45 days.

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.

Chance
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My name: Andrea

Re: Losing Hope for Xena. Trying Panzquin.

Post by Chance » 27 Oct 2024, 19:02

What foods are you feeding? Is the fiber level decent?

I assume everything was good on the ultrasound and nothing abnormal was seen?

What dose of Tylan are you giving? Is it from the vet?

I second Jill's comment about B12 injections. Wonderlabs does not work for all dogs. It does most, but not all. It did nothing at all for Chance. His levels were critically low while on it. Switched to injections, and overnight improvement. Later levels were checked again, and were in high range normal.
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.

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Lolly
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Pet name: Xena

Re: Losing Hope for Xena. Trying Panzquin.

Post by Lolly » 27 Oct 2024, 20:18

As far as the B12 he doesn't think the injections would make a difference.

The Panzquin has PLUS Inulin - prebiotic fiber Cyanocobalamin (vitamin B12).500 μg the active ingredient in Cobalequin, an oral cobalamin form that is bioavailable and has been shown to increase serum cobalamin concentrations in dogs. So fingers crossed there. I followed the dosing from Vet starting out on the Pancreplus and then moved on to the Pantenex so it seemed gradual to me.

The Tylan is prescribed from Vet and I have been giving twice a day. 1/8 Tsp. (She is 55 lbs)

The Slippery Elm I had already cut back. It seemed to be bothering her.

Neither ultrasound showed anything abnormal and they even drained fluid to see clearly. (Poor Xena)

She gets canned Purina One with Beef and Salmon. The Kibble is Bully Max XL No Grain, no potatoes or peas, 30% Protein 20% Fat 3.8% Max Fiber and 535 calories per cup. Has an "A" rating in Dog Food Advisor. Since I can't get hardly any food down her I wanted to make what I get down her count as far as calories. She also gets scrambled eggs and whatever meat I have to entice her to eat.

Taste of the Wild is what I was feeding, the Beef and the Salmon one. They both had peas, legumes and sweet potatoes listed.

Did I answer all the questions....????

I am trying to do it all right. I read so many posts and try to see what is working, and what is not for other people. And understand its not a one size fits all situation. Just not seeing any improvement. She is so fragile. I am so sad. Thank you for your input and concern!!!! I appreciate it all! Don't stop! There is a solution.

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Olesia711
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Re: Losing Hope for Xena. Trying Panzquin.

Post by Olesia711 » 27 Oct 2024, 20:52

I am so sorry to hear that Xena is not responding as expected.

First.... it sounds like the enzymes are most likely working, but what you are probably dealing with is SID that is out of control.
I strongly suggest you increase the Tylan dose to 1/4 tsp twice a day with meals (just maybe put the Tylan powder in an empty gel cap or something cause it is nasty tasting and can turn some dogs off their food and it sounds like that is the last thing you want Xena to to.

Next.... her B12 is extremely low... and as Andrea mentioned.... not every single EPI dog will respond accordingly to oral B12... even though over all the oral B12 appears to be a winner with most EPI dogs... but since you are not seeing ANY positive improvement.... iwith this too i strongly suggest telling your vet at this point you want Xena to receive the B12 injection.... and since she is so low, you can still give the pills (maybe 1 pill 2 or 3 days a week ) inbetween the B12 shots... once you bring her B12 up... then you can try switching back to the pills.

I know Panzquin has inulin in it, Panzquin is a very good product .....BUT..... depending on the individual, inulin can actually increase inflammation instead of reduce inflammation....... this just came out in very recent research..... so it may or may not be helpful.
https://news.weill.cornell.edu/news/202 ... flammation
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.........

Chance
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My name: Andrea

Re: Losing Hope for Xena. Trying Panzquin.

Post by Chance » 27 Oct 2024, 20:58

The food should be OK in terms of ingredients and fiber...as long as it's something she tolerates OK.

I'm not sure 1/8th tsp is the right dose of Tylan for Xena. I think that's more a maintenance dose, rather than a therapeutic (get things under control dose). Perhaps ask the vet about increasing, if the Panzquin doesn't help.

I'm not sure I fully agree with the comments about B12. Panzquin has the B12, which does indeed work with some. But not all. If Wonderlabs isn't absorbed, it won't be from Panzquin either. I'd at least inquire about Perhaps retesting the B12 levels. If it's OK, then at least you know it has been absorbed, and that's not the source of the problem. If it's still very low, then injections are really about your only option. (When Chance's levels were so bad, I really thought I was losing him. He went from being able to walk miles a day to barely having the energy to get outside to pee within a matter of weeks. He was so frail and depressed looking. Went to the vet, and first thing he said was B12. I disagreed, showing the supplement he was on - Wonderlabs. He said oral isn't good for all dogs. We did blood work; a full panel, including verifying his thyroid meds were still optimal, and B12. $800 worth of blood tests, all to find out there was nothing wrong except the B12 was critically low. He got an injection, and the next morning he woke up soooo happy, he started running around the house with my shoe in his mouth. He was sprinting around the yard, then came back in and stood waiting for breakfast! He was a completely different dog, who the previous day had trouble going out to pee, and make it back to bed to rest before getting back up to eat. Very different dog)! So please at least ask them to recheck to make sure B12 is OK.

I do agree with you on maybe trying the raw pancreas. You can try the Panzquin. You should know within a few days if Xena is doing any better on it. If not, look into pancreas.

Inulin: sometimes it's good. But some dogs with EPI don't do as great on it. It was one thing I tried for Chance; but he didn't cope well with it.

If all of that doesn't help, you might want to try a different probiotic. Every dog is different! It took me 5 attempts to find a probiotic that showed merit! Probiotic #5 did actually help.

And sometimes a probiotic paste is also good for some dogs that are struggling with bad poops. ProMax is sometimes useful too. It's good for probiotic, and also contains calcium bentonite clay. This does help several dogs. Some vets carry this in clinic, but might be cheaper online.

There's also other supplements that some have apparently had decent success with. Every dog is different.

Basically I'm saying you're not out of options yet! There's still hope. Chance was one that I really, really struggled with. For a while, I was certain there was no way I'd be able to get him remotely stable. It took time, and a lot of trial and error; but we did get there. When he did have setbacks, I could get him back on track within days.

There's still a lot of hope.
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.

Tuckaboo Pam
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Posts: 1624
Country: United States
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Pet name: Tucker
My name: Pam H.

Re: Losing Hope for Xena. Trying Panzquin.

Post by Tuckaboo Pam » 28 Oct 2024, 15:49

Hey there. I know we are all coming at you with questions, and it can be sooo hard. The thing is, all dogs are a little bit different, and we are sharing our experiences with you, some with more knowledge than others (I am "others").

Dogs that weigh 60-80 pounds get 1/4 teaspoon Tylan, twice a day for 45 days & then slowly wean off it to see if they can do OK without it. Some dogs take it for life, at a lower dose. With the problems you are having, I'd go with Olesia's suggestion of upping your dose from 1/8 to 1/4 teaspoon. I hope your vet will prescribe enough Tylan for you to do this.

B12 has to be 600 or more, with EPI. Since the Wonderlabs may not be working because of the tiredness, beg your vet to give the injection a try. Share this website with them. This is not just a bunch of pet owners (nothing wrong with pet owners!), but the advice comes from research studies at Texas A&M.

The Taste of the Wild that I use is grain-free, has potatoes & peas but they are way down the list, so not a problem. https://www.chewy.com/taste-wild-pacifi ... /dp/181318

I hope this helps.

Pam
Tucker was a shepherd mix--- TLI 1.3, Folate 9.7, Cobalamin 666, Lipase 38. Diane's Enzymes 4 t/day, B12 1 capsule/day, and Tylan 1/16 teaspoon/day. Taste of the Wild High Prairie, 4 c/day. 60 to 85 pounds! Tucker succumbed to hemangiosarcoma Nov. 2023. I will always, always miss my sweet big boy.

Now there's Nina. 5 year old GSD. TLI 1.0 B12 323. We are still tweaking her routine, and getting lots of help from the forum. She is klutzy and goofy, and we love her dearly, too.

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Lolly
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Pet name: Xena

Re: Losing Hope for Xena. Trying Panzquin.

Post by Lolly » 29 Oct 2024, 03:13

Xena is 53-55 lbs. Used to be much, much more. She was 60 lbs at last visit on Friday because her ascites is so bad. It is all fluid weight. I was actually giving her 1/4 tsp twice a day of Tylan until about a week ago. Realized I was probably giving her too much. I can up it again but it doesn't really seem to be a factor.

Her B12 was 170. I finally got another Vet at the Clinic to approve a injection and I am hoping to have her in there tomorrow. The Vet I have been seeing, and have been seeing for years, has suggested I try to find a Vet that is more well versed in EPI. I have called around and found one that has dealt with them in the past. Not sure how promising that is.

She has basically stopped eating at this point. I got maybe a cup of food down her all day. She will only eat if I hand feed her some days. Today was not at all.

I cancelled the Panzquin he wanted me to try. If she won't eat I can't really try another enzyme anyway. And it isn't like he had any experience with it and I couldn't find anything great about it online other than they have started some marketing system with Vets to sell it through their offices.

I did share the website and he acknowledged that it was legit. It just isn't an avenue he would use for information I think.

Taste of the Wild is what our other dogs eat. it is fine. I just wanted something for her high calorie with no grains, peas, potatoes , etc....trying to go the extra mile since she isn't responding well. At all. At this point I feel I am losing her. The ascites is really bad. I am not sure I am conveying that well. He didn't drain it again when I was there Friday and she looks like an engorged tick. I am worried it will impact her heart at some point and her breathing.

I think she was doing better on the Pantenex and if I can get her to eat again I will go back to that. I kept reading about Enzyme Diane and thought maybe I was shortchanging her. Plus the Pantenex smelled bad and I thought perhaps that was affecting her appetite. Turns out it wasn't.

I will update after tomorrow. Wish there was some directory for Vets that specialize in EPI. Mine tells me not that many dogs have it so they don't get much experience with it. And yet here I have found a whole community.

I appreciate the help and the questions. I am trying everything.

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