Cavalier King Charles spaniel with EPI

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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toblerone617
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Cavalier King Charles spaniel with EPI

Post by toblerone617 » 31 Mar 2019, 12:12

hi,

first time post. and I really thank the people who have set up this forum.

background: 8 year old CKCS with EPI, diagnosed by vet. standard early symptoms...rapid weight loss, disgusting stools, eating stools, etc. placed enzymes about 2 or 3 months ago. Gibbs condition improved but not completely back to what it was before illness appeared. it has now slipped back in the direction of what it was but not quite as bad.

my question: I am going to increase amount of time the enzyme incubates. am also thinking about increasing feeding to 3x per day. but...do I use the same amount of enzyme at each meal? that would mean he was getting 3 tsp per day with an increase of the amount of enzyme by 50%. s

if this helps, his current diet is kibble--Solid Gold/Barking at the Moon, advertised as grain free. he also get dollop of yogurt, canned pumpkin and some green beans. this has been his diet for most of his life.

I would really appreciate any guidance or general information that the members of the forum could give me. he's just the sweetest dog (but then aren't they all?) and I hate to see him slipping back to what he was a couple of months ago.

thanks for any help you can give me.

Margaret Alexander, Newton, MA

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Jean
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Re: Cavalier King Charles spaniel with EPI

Post by Jean » 31 Mar 2019, 12:46

Hello Margaret, and welcome

I wonder, can you give us more information

what enzymes, and ratio of enzymes to weight of food

any b12 supplementation ?

anyantibiotics for samll intestinal bacterial overgrowth

is every morsel of anything being eaten enzymed ?

I am sure we can give you some help here

Jean
My name is Jean we live in Liverpool in Uk

I am the Forum Director which I am very proud of

My Kara born 21 July 2009 diagnosed with EPI by cTLI test August 2010 TLI = <1...folate 14 Cobalamin 408, shot down to 94, b12 injections every other day

Lowest weight 39 pounds

We used Panzym enzymes, Tylan and Chemeyes b12 capsules

Sadly, on 10th May 2019, we lost her to DM


Jeanx

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Olesia711
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Re: Cavalier King Charles spaniel with EPI

Post by Olesia711 » 31 Mar 2019, 14:20

Hi and welcome to our forum.

If you could answer Jean's questions about enzymes/amounts etc. that would be really helpful. Oftentimes... one little tweak can make all the difference.

Years ago i too used Barking at the Moon dog food.... i thought it was a very good food.
I checked on the ingredients and noticed that pea protein is 3rd on the list and then peas are used again as the 7th ingredient... this maybe be jsut fine, or it may be a touch too much peas. Many/most of our dogs have trouble with too many peas/lentils/legumes.... BUT it all depends on the individual EPI dog as to how much (if any) of these ingredients they can tolerate and to what degree.

SO........ if you can answer Jean's questions we can better help you. This may be a slight adjustment needed .. or it could be SID getting out of control and needs addressing.
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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toblerone617
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Re: Cavalier King Charles spaniel with EPI

Post by toblerone617 » 31 Mar 2019, 16:17

okay, here goes. answers to jean's questions,.

"what enzymes, and ratio of enzymes to weight of food"

enzymes viokase-V powder, 1 tsp per meal. kibble 1/3 cup (don't know weight) dollop of pumpkin and yoghurt. a few green beans

"any b12 supplementation ?"

no

"any antibiotics for small intestinal bacterial overgrowth"

he was tested for EPI on 2/11. while waiting for the results to come back he was put on short course of metronidazole

"is every morsel of anything being eaten enzymed ?"

no. he receives 4-6 treats per day. brand "wag more bark less". variety of these. some with peanut butter, some with cheddar. he also get cheerios 4 or so at a time, when we are out walking 2x/day. total cheerios-maybe 20.

I'll look into the questions of too many peas, or pea like foods. he's done so well on this food (previous to EPI diagnosis)I'm loath to start the food research again.

Margaret
My name is Margaret and I live Newton, MA. I have two dogs: Gibbs (age 9 1/2) is the one with EPI. The other one is Sasha (13 1/2). Both are cavalier king charles spaniels.

Gibbs was diagnosed in February 2019 after suffering from a rapid weight loss (16 .5 lbs to 13.5 lbs.) in about 6 weeks. He had all the hallmarks of EPI and was diagnosed with it quickly. He is on Viokase-V, 1 tsp/2x day. He gets about 1 cup of food (grain free kibble mixed with green beans, yoghurt and canned pumpkin) 2x a day.

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Jean
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Re: Cavalier King Charles spaniel with EPI

Post by Jean » 31 Mar 2019, 17:07

thanks for that

firstly, unfortunately, you must not give ANY food without enzymes, enzymes at most last one hour , enough to digest the meal they are with, treats are really only good after stability for at least 3 months

trust me I have been there, and its hard

the rule of thumb is 1 teaspoon enzymes per 1 cup of food(kibble), therefore. 1/3 rd teaspoon per 1/3rd cup, and a bit extra for the yogurt etc.

I would be looking at supplementing b12

https://www.wonderlabs.com/itemleft.php?itemnum=K9688

and is there any rumbling in the tum

and finally keep a journal on everything you do
My name is Jean we live in Liverpool in Uk

I am the Forum Director which I am very proud of

My Kara born 21 July 2009 diagnosed with EPI by cTLI test August 2010 TLI = <1...folate 14 Cobalamin 408, shot down to 94, b12 injections every other day

Lowest weight 39 pounds

We used Panzym enzymes, Tylan and Chemeyes b12 capsules

Sadly, on 10th May 2019, we lost her to DM


Jeanx

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Olesia711
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My name: olesia

Re: Cavalier King Charles spaniel with EPI

Post by Olesia711 » 31 Mar 2019, 19:01

Hi Margaret,

(Please see my revised comments... My apologies.... i read what you wrote but reversed it ... i went about responding to you as if you said you were giving 1/3 tsp of enzymes per 1 cup of food.... my bad! )


Thanks for answering Jeans's questions, and as she explained.... the typical ratio is 1 level tsp of enzymes to 1 cup of kibble, add a little liquid (room temp water will do) to moisten the food with the enzymes, let sit for approx 20 minutes (to help avoid possible mouth sores)... and serve.

When trying to find the right balance of things for an EPI dog..... we first implement everything and then if all is not progressing as it should we try one thing at a time. Based on what you wrote, i suspect that you are now dealing with SID (Small Intestinal Dysbiosis) that is not well managed . THis is nothing alarming, all EPI dogs have SID to one degree or another. THe goal is to keep it in check.

SOOOOOOooooo...

1. increase the enzymes to the 1:1 ratio (i meant to say decrease the enzymes, ratio 1:1)
2. STOP all snacks, treats.
3. For now, stay on the same food.... give the above a chance to improve
4. I too would order the special Wonderlab B2 capsules since over 80 % of all EPI dogs have insufficient B12 levels.

As Jean mentioned everything needs to have enzymes on it... at least in the beginning until the dog becomes stable.... and even then, it is a trial and error to see exactly how much (cheating with treats and no enzymes) if they can have any non-enzymed treats.

Basically between the treats and the most likely too low dose of enzymes... both of these would contribute to promoting SID.... which is probably what you are dealing with . (THis should have read that the treats most likely are contributing to promoting SID) Also.... just a FYI.... with some dogs, when you give too much enzymes that too can trigger loose stools... but i don't think that is what the case is in this situation....


Please 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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Riley's Mom
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Re: Cavalier King Charles spaniel with EPI

Post by Riley's Mom » 31 Mar 2019, 19:45

Hi and welcome to the forum.
EPI really does get easier when things settle in. I know it doesn't seem like that now, but it will.
So am I reading your ratio of enzymes correctly....1 tsp of enzymes to 1/3 cup of food? So that would be too much, not too little enzyme using the 1 tsp per cup of food ratio. Of course you have the additions that you have to also account for (pumpkin etc).
I know it's hard not giving treats, but honestly we have a harder time than they do about it. My girl doesn't even ask anymore and it didn't take long. She used to get a little bit of something from the dinner table. But since EPI she never does, so she doesn't beg. It's actually much nicer :)
After several years, not months, I began to experiment with whether or not I could give Riley small treats or snacks that were not enzymed and not near a meal. I discovered I can give her a small bit of cheese or meat without troubles. But I did wait a LONG time before I was brave enough to try it. If I do stray and give her something, I stick with a protein and avoid anything with grains like crackers or bread because grains are just that much harder for them. Some dehydrate a mush type mixture with ground food and enzymes. The temp is low enough to not destroy the enzymes. But wait a while on treats.....
Try to adjust the enzyme ratio and stop all foods that are not treated, which unfortunately means the treats as well to see if that helps. Keep a good log or journal to see what effect your changes have on your pup.
Elisabeth

Riley is a 10 year old Labradoodle. She was diagnosed with EPI in 2014.
She currently eats Taste of the Wild, I cup in the morning, 2 cups in the evening, each meal with 1 Wonderlabs B12 sprinkled over her dinner. Enzymes are EnzymeDiane, 1 tsp per cup of food, mixed in home made bone broth. No other supplements or meds at this time.
Riley currently weighs about 44 pounds, which is pretty heavy for her.

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toblerone617
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Re: Cavalier King Charles spaniel with EPI

Post by toblerone617 » 31 Mar 2019, 23:24

all,

you've been so responsive to my questions. thank you. to reward you (ha, ha,) I'm going to ask more.

1. before adding B12 (sounds like the one suggested is good) shouldn't I have b12 level checked?

2. I've read other places that I should try to feed three meals a day. that is really hard with two other dogs and a constantly changing schedule. how important do you think this is?

3. any particular recommendations on what antibiotic to use for SIBO?

4. is SID the same as SIBO?

5. is it at all feasible to mix up a little extra kibble enzyme mixture each meal, put it in refrigerator to slow enzymes down, and use that for treats/rewards? my idea was that I could take this "treat mixture" out of refrigerator, let it sit about 30-60 minutes before I wanted to use it (mid-morning and mid-evening)

I think I am pretty close on the ratio of 1 tsp enzyme:1 cup food. By the time you count really heaping 1/3 c kibble and include the add-ons of pumpkin and yoghurt and green beans, it's pretty close to a cup. this is what we started at the beginning of this saga and things were looking good. we'll hope we can get back to that with these changes.

again, thank you all so much for your help.

Margaret
My name is Margaret and I live Newton, MA. I have two dogs: Gibbs (age 9 1/2) is the one with EPI. The other one is Sasha (13 1/2). Both are cavalier king charles spaniels.

Gibbs was diagnosed in February 2019 after suffering from a rapid weight loss (16 .5 lbs to 13.5 lbs.) in about 6 weeks. He had all the hallmarks of EPI and was diagnosed with it quickly. He is on Viokase-V, 1 tsp/2x day. He gets about 1 cup of food (grain free kibble mixed with green beans, yoghurt and canned pumpkin) 2x a day.

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Olesia711
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Posts: 3858
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Cavalier King Charles spaniel with EPI

Post by Olesia711 » 31 Mar 2019, 23:47

oh gosh.... so sorry!!!! ... meant to say increase the food... (not enzymes!) you should start out with a 1:1 ratio
1 tsp of enzymes per 1 cup of food and adjust accordingly "if need be" ... i went back in to my post and revised my comments. I am so sorry for inverting the amount of enzymes per food. My bad!

To answer your new questions.

1. technically yes, you should have the B12 checked. This should have been initially done along with the TLI test. The reason why we are suggesting to just do the pills is because 4 out of every 5 EPI dogs need B12 anyway.... and if a dog does not need B12 supplementation, then they will pee out any excess out.
Also.... many people don't have the money to go test the B12 levels after the TLI testing. If you can afford it, testing the B12 level first is the proper way to go about this.

2. In the beginning of treating an EPI dog, it is recommended to feed smaller portions, but you still want to feed enough food (it is recommended in the beginning to feed approx 150% of what they require until they gain back most or all of their weight).
Since the only way to accomplish this is more meals (smaller in portion) that is why it is suggested to feed 3 or even 4 meals until the Once the dog gains back the weight, then you can go back to feeding twice a day.
This is recommended, but we each can only do the best we can.......

3. We suggest Tylan antibiotic first and if that doesn't work then Metronidazole.....BUT....... the new recommendation is to see if you can get the get flora imbalance (and yes, SID is the current term used for SIBO) under better control via not using antibiotics if possible (which it is not always possible). So the first recommendation is to try prebiotics... see if that is enough to help things get back in order. A lot of vets like to automatically prescribe probiotics.... but that doesn't always work with EPI dogs... simply because the current probiotics available is a "one-size-fits-all" off the shelf.... and different conditions have different flora concentrations or lack there of.... and EPI dogs are already over-loaded with lactobacillacea bacteria.... so standard probiotics may or may not work with EPI dog. (please see the recent EPI and Fecal Microbiome research on the SID/SIBO Microbiome page (https://epi4dogs.com/sid-sibo-microbiome-research/) you will have to expand the font with the plus sign to read it....

4. Your treat idea sounds fine to me..... the only way to tell is to try it and since you will have enzymes in it and then let it get room temp... try it. We also have a treat page here on the website.. Someone once came up with making a meal out of the dog food with enzymes... but putting it in a mushy/squeezable form, filling a squeeze bottle with it and giving the dog a squirt of it as a treat :)

Just don't try giving un-enzymed treats at this time.... you really want your dog to get stable first BEFORE you start trying to "cheat with treats" ...
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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Jean
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Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: Cavalier King Charles spaniel with EPI

Post by Jean » 01 Apr 2019, 06:27

hi

we use SIBO in UK as a rule, but its a case of a rose smelling as sweet by any other name

we werent able to give treats for probably a year

i reckon that its just an imbalance of ratio between food and enzymes

can I introduce you to Enzyme Diane, she does discounted enzymes, widely used in US

https://enzymediane.com/

might help with the costing

so keep your journal and record everything

and ask away

j
My name is Jean we live in Liverpool in Uk

I am the Forum Director which I am very proud of

My Kara born 21 July 2009 diagnosed with EPI by cTLI test August 2010 TLI = <1...folate 14 Cobalamin 408, shot down to 94, b12 injections every other day

Lowest weight 39 pounds

We used Panzym enzymes, Tylan and Chemeyes b12 capsules

Sadly, on 10th May 2019, we lost her to DM


Jeanx

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