Nova and me new to EPI and this forum

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.
nova99
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Country: United States
State: Alabama
Pet name: Nova

Nova and me new to EPI and this forum

Post by nova99 » 12 May 2019, 00:35

Hello everyone,

Nova, my two yr old GSD mix, and us went on an 9 week long roller coaster ride. We thought we were going to lose her; she went from being a solid, energetic pup to a starving, skeleton, pitiful looking one during those 9 weeks. Took us all by surprise, to say the least.

After several trips to the vet - all the while, pound after pound of weight kept dropping - the vet was at a loss. Told us she might survive a month or two at this rate. He did tell us she had what is called malabsoption syndrome, and we needed to find the reason behind it. He recommended having an ultrasound/endoscope done, so referred us to an animal hospital in another city (we live in a rural area). Thank goodness! The vet we met there, after an exam, and discussion of her symptoms, recommended before anything else, to send a blood sample off to Texas A&M. He suspected EPI. Three days later, the results came back.

Cobalamin Fasting - 177 ng/L
Folate Fasting - 9.4 ug/L
Pancreatic Lipase Immunoreactivity Fasting - 107 ug/L
TLI Fasting - <1.0 ug/L

She is currently taking PancrePlus (1 tsp per meal). We are feeding her 3 times a day - 2 to 2 1/2 cups a day. At this time, we are feeding her Hill's Science Diet Digestive Care I/D.

I am aware that the recommended dose is 1 tsp per cup, but my husband insists on going by the directions on the jar (1 to 3/4 tsp per meal). I did finally convince him to move it up to 3/4 per cup, but then Nova got real finicky (always has been actually until she got sick...then wolfed her food down like there was no tomorrow) so he wanted to cut it back. I will admit that she is eating all her meals now, with the lower dose, but I do wonder if when she was getting finicky (like before) she was feeling fuller and therefore, didn't feel the need to eat as much.

She used to weigh approximately 76-78 lbs, dropped down to 56 lbs. We have noticed some weight gain, and she seems a lot happier.

We are all so new at this. So much to learn still, and find the best combination of medicine and diet so that she can maintain a good weight, and have a happy, comfortable life.

I found a website that recommended seeking out an EPI support group, so here I am. I am looking forward to everyone's experience, strength, and hope! We were so freaking scared, and worried!

This post is probably WAY too much, but I am so happy to have found you! Not many folks around me even know or have experience with EPI dogs.

Thank you,
Juanita

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Miss Maddie Moo
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Re: Nova and me new to EPI and this forum

Post by Miss Maddie Moo » 12 May 2019, 13:28

Hello glad you got an answer that it was EPi that was so scary at such a young age to be told your dog may not live but onwards and upwards look forward to getting them on the right track.
Yes we do suggest 1 tsp to 1 cup of food but also you need to look at the poop how many a day , volume and color of the poop there are many variances with EPI not all dogs need to same dose....perhaps you could discuss this with your husband.
What i am also seeing here is low B12 we need the B12 to be up at 600 and maintained there for life are you supplementing ?those levels are really low and for optimum health weight gain and appetite we need to get that area treated as well.
Keep asking questions we have all been in your shoes.
Maddie DX April 2011 along with low B12 she was feed with a low fibre food below 3% , fat was not restricted ( she wasnt good on pea based foods ) She initially had a course of B12 shots weekly over a period of 6 months and then we used the B12 pills from Chemeyes in the UK . We used Panzym and slowly had to increase the dose as she aged when she was first DX she was 23kg but she gained weight quickly and got back to 33 kg .
Maddie gained her angel wings in Jan 2018 at the age of 10 to a condition unrelated to EPI.
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jilbert57
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Re: Nova and me new to EPI and this forum

Post by jilbert57 » 12 May 2019, 18:26

Hi. Ann has given you great advice. Is there an issue that requires the prescription I/D? If not you can eventually change to a grain free diet with fiber 4% or under.
My name is Jill and I live on the Hood Canal in Washington State. I have two dogs: Kiya is an aussie/blue heeler and is 12 yrs young. TJ is a 3 year old Jack Russell. They keep me on my toes.
Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.
6/1999 - 8/2014

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Olesia711
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Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy

Re: Nova and me new to EPI and this forum

Post by Olesia711 » 13 May 2019, 17:19

Hi and welcome to our EPI family! And never feel any post you type is too long..... the more information, the better!

First i would like to HIGHLY commend the vet that suggested to do the TLI blood test before doing the scope. I wish more vets were like this vet and if you continue to see him, please thank him profusely from the EPI community!

Next, the more likely reason why Nova didn't want to eat with as much vigor once you increased the enzymes is most likely cause she didn't like the taste of the increased enzymes..... it happens.... and they jsut have to get used to it....so we do have a variety of tricks to get them to eat food with enzymes...... :)

Ann (Maddie's mom) gave a great response. Yes, we typically recommend 1 tsp enzymes per 1 cup of food, add enough liquid to help spread the enzymes around in the food, let it incubate for 20/+ minutes... then serve. HOWEVER... some dogs need a pinch more enzymes and some dogs need a pinch less enzymes...DO NOT go by what is on the jar/bottle.... some enzymes companies give the correct dosing instructions, others do not. The best thing is to start with 1 tsp per cup of food- -watch the poos for 3 to 5 days..... what you want are tootsie roll poos (#2 on the poo chart) chocolate brown in color and frequency anywhere between 1 to 3 times a day. every dog is different so this is why we start with a standard 1 tsp per cup of food and then observe and adjust as needed.

Once the dog is stable (delivering normal poos for about a month) it IS recommend to try and reduce the amount of enzymes to the lowest dose possible to maintain the dog's EPI condition.......so watch the poos and eventually ascertain if Nova can be maintained with a lower dose of enzymes...........

Next... the B12 is LOW! Nova will not fully recover until you bring up the B12. Please review our B12 section. They used to only recommend B12 shots... but we at Epi4Dogs have been telling the researchers for years that high dose B12 pills with the intrinsic factor works... FINALLY the vet researchers did some testing and found that high dose B12 pills can work vs. B12 shots. We highly recommend Wonderlabs Pet Factor B12. https://www.wonderlabs.com/itemleft.php?itemnum=K9688 They are cheap, effective with most EPI dogs and have the intrinsic factor in them where other B12 products do not.
Olesia, owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.3, Doing great 12+ years later! Once stable at 3+ months, was able to reduce enzymes to only 1/2 tsp of Enzymes (use EnzymeDiane's 6x) with each cup of food, but as she aged- -had to go back 1 tsp enzymes per cup of food. Fed various grain-free kibble+real meat, 6x pancreatin enzymes from EnzymeDiane., gave 1 tsp of coconut oil / fish oil daily .... until she developed Diabetes and she now cannot tolerate higher fat foods. Currently feed an 80% home-made diet of sweet potato, a lean meat/fish, 1/3 of a raw egg, fat free cottage cheese, fish oil+vitamins and bone meal with 20% Annamaet Lean & Grain Free kibble. This combo has regulated her Diabetes (takes Vetsulin) and EPI and is very well managed. In Feb 2013, Izzy developed a very serious condition called IMHA which she (thankfully) beat and is now in remission. This is when we discovered that she also developed Diabetes & Low Thyroid. Izzy was able to receive excellent care because of the generosity of folks on Epi4dogs! Izzy continues to wake up every day full of joy. I am not a vet. All of my suggestions/recommendations are based on personal experiences, observations, information gleaned from EPI researchers & pet parents alike, and EPI research. Please share with your vet everything we suggest.

Barb
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Posts: 270
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State: New Jersey

Re: Nova and me new to EPI and this forum

Post by Barb » 14 May 2019, 14:27

A warm welcome to you, Juanita! Three cheers for the vet who recommended the cTLI test, so Nova did not have to go through other invasive tests. And we are glad you reached out to us. We have all been where you are and know what it is like to see your pup losing weight right before your eyes. Our Kolby was down to 54 pounds when he was diagnosed 9 years ago and for a tall German Shepherd, this weight made him look awful. He has been at his target weight of 86 pounds for many years.

I highly recommend the Wonderlabs B12 pills, "Pet Factor" that have the intrinsic factor necessary for absorption. Kolby did not really gain weight until we got his B12 level up. Now we use the pills to maintain his weight and health.

If you need a source for reasonable enzymes, many of us use enzyme Diane's enzymes. She is a member here, she provides an excellent product for much less than the commercial brands. She has saved us so much $$. You can go to her website or talk to her in person.....she publishes her phone number on her site. She is wonderful to work with.

Finally, I heartily endorse using a log/journal. It saved our sanity. You can download a blank log form from our site or just use a notebook. Record everything you give Nova each day, including medication, the amounts, and the resulting poos. This will help you to see what works and what doesn't and it gives you information you might miss if you hadn't written it down. It also helps if you have questions to ask here or at your vet's.

Try not to feel too overwhelmed .....although you will at times. Ask any questions that you have. You are doing a great job already. Nove is lucky to have you.

Barb

nova99
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Posts: 3
Country: United States
State: Alabama
Pet name: Nova

Re: Nova and me new to EPI and this forum

Post by nova99 » 16 May 2019, 01:01

I have been working out of town the last several days, and am finally home! Read all your replies. Thank you for the feedback!

Current dog kibbles - Vet who chose to do a TLI blood test first recommended the Hill's Science Diet. He sent us home with a bag, along with several doses of enzymes. When he called to tell me she was positive for EPI, he asked us to keep her on the Hill's kibbles until she gained weight. I believe there is a page at EPI4dogs website with a list of dog food used by other EPI owners that I'll be looking through.

We are working on week 3 of her enzyme regiment, and on the 'poop chart' she is scoring a 5 at this time. Question: Should she already be scoring a #2? (if we'd been giving her a tsp per cup, and given the time factor)

Thanks for the link for Wonderlabs! Will be making a purchase for B12 as soon as possible. Also, since we were getting low on the enzymes we'd purchased from the our local vet, I had already decided to try Diane's enzymes. Came in the mail today!

A little funny: Recently, while I was working out of town, my husband text me a picture of one of Nova's poops. This is about the time she started moving up the scale to a 5. I text him back "Awww! They pretty though!", his next reply "Only an EPI dog owner would say that" ;)

Juanita

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jilbert57
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Re: Nova and me new to EPI and this forum

Post by jilbert57 » 16 May 2019, 09:37

Thank you for the update. Sounds like you are on the right track. You are right . The I/D is either the really low fat and the regular I/D is lower fat than normal food. The foods on the EPI page would be higher in fat and calories to help gain weight.
The poop will get better when all 4 parts of the regimen are implemented including higher B12
levels, diet that suits your pup, enzymes with all foods including treats, and antibiotic for SID if present.
My name is Jill and I live on the Hood Canal in Washington State. I have two dogs: Kiya is an aussie/blue heeler and is 12 yrs young. TJ is a 3 year old Jack Russell. They keep me on my toes.
Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.
6/1999 - 8/2014

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Riley's Mom
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State: Virginia

Re: Nova and me new to EPI and this forum

Post by Riley's Mom » 17 May 2019, 07:55

Hi and welcome to the forum!
We have all been where you are, scared and worried. But EPI is totally manageable! We are here to help you!
You have already been given good advice, I wanted to jump in and also welcome you.
You asked if the poops would be better by now if the correct dose of enzymes were given, the answer is probably yes. I say probably because these EPI dogs are all different and Nova might need some "tweaking" to her routine to get things balanced just right for her. But I believe as long as the enzyme dose is so low, she will struggle. I see you got some enzymes from Diane...good! Those directions will be correct and maybe your husband will feel more comfortable increasing the dose. Then hopefully you will see better poops.
Glad you are addressing the B12 as well. That is so important to help them really get on the right track. With B12 that low, she will certainly need supplementation. And they need that B12 supplement for life too...
You crack me up with the pictures of the poop, yes we are all pretty poop obsessed, lol. We think nothing of talking about it and taking pictures of it. Goes with the territory. Welcome to the poopologist club :lol:
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.

Barb
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Posts: 270
Country: United States
State: New Jersey

Re: Nova and me new to EPI and this forum

Post by Barb » 17 May 2019, 13:18

Thank you for the update. It sounds like you and Nova are moving in the right direction. Glad your hubby has a good sense of humor. Yep, we all get excited about good poos! Keep up the good work.

Barb

nova99
Member
Posts: 3
Country: United States
State: Alabama
Pet name: Nova

Re: Nova and me new to EPI and this forum

Post by nova99 » 18 May 2019, 00:20

Hey everyone! Hope all are doing well.

Every day is a step forward. We are all slowly getting accustomed to our new routine. She knows her feeding time means "wait"...so she'll lay down right by the counter where we keep her food...those long 20 minutes! As soon as the timer "dings"...her head tilts, and ears turn to the sound, sits up, watching as we stir her food once last time before placing her dish on the floor.

Our other two non-EPI puppers, also look on in anticipation. I read in someone else's post, they have divided up their non-EPI's meals so they wouldn't feel left out. We've had to do the same. My pups just don't understand ("why does the brat get so many meals? What are we? Chopped liver?") Unfortunately, during those hellish weeks, they put on some pounds while Nova lost them. So the new no treats rule is a house rule; hopefully, they'll drop those pounds. Back to walks, and am thinking of putting the other two on low fat diets for a while. I digress...back to the original reason for my post.

Reading other posts here, brings to mind a few questions/thoughts...

*So, the fat content isn't really something to be too concerned about...? It's the fiber that needs to be as low as possible (at least around 4% or so)

*Grain-free is suggested, since it tends to be low in fiber...or at least until the pup is stabilized?

* Did I read correctly that chicken should be off their menu?

*I'm trying to do this slowly...or at least introduce one new item before many. The main things I think right now are the enzymes and b12. I realize I should do some more research, but have read some that salmon or coconut oil is also good for them, and vitamins...?

I am still so grateful to have found you all. I plan on letting our vet know about EPI4dogs, and want to stop at all the clinics around the area, so they can a) refer other EPI parents here, b) possibly gain some more knowledge about EPI, and be able to spot the symptoms a lot quicker, and save more fur-babies!

Oh! She's moving up again on the poop scale. We're definitely a #4 now! We used to wash her poop away...looks like a shovel may be needed now!

Have a great weekend everyone! :)

Juanita

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