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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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Sandie
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Posts: 7
Country: Portugal
Pet name: Sandie

New member

Post by Sandie » 25 May 2019, 12:32

Hello,

and before anything else, I would like to thank to all who are making this incredible work about this terrible disease.

I really don't know how to start, as I don't seem to have all the information everyone has ... to be honest, I am just confused and angry.

Sandie, who is currently 15 and a half years old, began having some trouble while she was playing and running. Small accidents, a slightly injured muscle, and then pain somewhere on her back to the point she could not move. This went on for about a year, and then suddenly she was much worse. The vets made x-rays, given meds to pain, but could not find out anything. Falls had now become frequent, Finally, on August 2018, a neurosurgeon diagnosed her a herniated disc. By that time, Sandie was very thin, and everyone was telling me it was normal to lose muscle mass due to age. In that appointment, I found out Sandie was a little more than 16 kilograms (her normal weight was 23). The neurosurgeon agreed it was normal, and probably aggravated by not exercising as much as she could before.

He gave her cortisone, a very small dosage, and the result was like a miracle, Sandie was able to run again.
About two weeks later, Sandie had diarrhea. When it seemed to be getting better, she developed fever, showed signs of dehydration and we run to the hospital. She was diagnosed as having a gastroenteritis. I insisted on taking her home as soon as possible, and when I did, even after only 12 hours, she was in pain due to uncomfortable position, very angry, and her back legs had lost strength completely.

She completed her recovery home, regained appetite and started walking again. We even went with her, Maggie (our other dog, who was fighting cancer), and the three cats on vacation.

Some weeks after, she began having stomach noises. She also seemed somewhat thirstier. And had started to poop more often, sometimes while asleep, (and falling back on her poop !) And before I could wonder more about that, her neurological problems became worse – or so I thought. In February, she went to another appointment with a renowned neurosurgeon, who insisted on a tomography scan. It confirmed the herniated disc (which can not be surgically treated). It also revealed she had the lungs of a young dog, no tumors, and no arthroses on legs and hips. The blood tests were also normal. And, yes, she pooped while asleep from the anesthesia in the hospital recovery room – a strange yellowish poop that had started 2/3 days before and that I thought was liver related – and no one paid attention to that …

… and the blood tests, performed that same day, were normal.

She was then given cortisone for a week before returning. Oh, yes, it was devastating. Sandie was a strong dog all her life, and I had never heard her crying in pain. I thought the pain was from her back ! She was up all night, drinking water, walking back and forth, falling on those strange poops. It was horrible. I stopped the cortisone when I realized it was her belly that was hurting and we went to the hospital. She was then very sick. She could hardly stand, her back was arching, she was cold and depressed. I complained, talked about those strange poops, and the vet said she might have a pancreatic insufficiency.

No more cortisone for her, and not much more help from the vet concerning her back problems – maybe acupuncture. They gave me pancreatic enzymes, which also had Vit. B12, and I came home, and found EPI4Dogs, and read the general guidelines about the disease and the diets.

Then Maggie was worse, and I tried to do my best for both of them … It was so, so hard … I had lost faith in veterinarians !
Maggie died on May 2. One week before, I found new veterinarians that were able to help her – I found them too late !!!! – in her last days …

…. So I took Sandie there, and she did all the tests she was supposed to. The EPI diagnose was confirmed, and a Vit.B12 deficiency, and an inflamed liver. The vet told me that is hard to believe how no one noticed how thin she was, even though I kept complaining ! She believes her back problems are worse simply because she is losing muscle mass due to the B12 deficiency – the bones have no support.

Sandie is now in her 5th day of therapy: a special home-made diet with supplements, new enzymes, B12 shots, antibiotic. She is returning to the vet in 3 days. The vet is confident she can help with her legs … (she does not get up anymore from the frequent falls).
I am so sorry for such a long post ! I could not found a better way to shorten this story. I am still so, so sad about Maggie … but I now have hope things can get better for Sandie. She has been suffering so much - and so unnecessarily !

I truly appreciate any thoughts and support. Thank you !

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jilbert57
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Posts: 573
Country: United States
State: Washington

Re: New member

Post by jilbert57 » 25 May 2019, 13:42

Gosh I am so sorry you and your Maggie went through so much then not to have a good outcome. In my experience her symptoms sound like pancreatitis with an acute flare-up at the end that went undiscovered. Just my thoughts.

I am glad your Sandie is on the right track. The 4 cornerstones to getting EPI under control are:
1. Pancreatic enzymes with all food eaten
2. Diet
3. Antibiotics
4. B12

Do you know if the vet drew blood for the Tli test to confirm EPI or is he just treating the symptoms? The Tli is a 12 hour fasting blood test.

Thanks
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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Sandie
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Posts: 7
Country: Portugal
Pet name: Sandie

Re: New member

Post by Sandie » 25 May 2019, 16:06

Hello,

Maggie died of cancer :( :(

As for Sandie, yes, she was tested for TLI, we had the results 6 days ago. It was 3,60 ug/l.

She was also tested for the presence of fat in the feces, and for Leismaniasis - both were negative.

It seems that this vet finally did what others didn't see, all they could tell me was how terrible the herniated disc was, and the fact that she was old :( ...

I have just given her the 5th B12 shot.

She is far from being well, but is no doubt less nervous, and it seems she is somewhat stronger on her legs ...

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jilbert57
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Posts: 573
Country: United States
State: Washington

Re: New member

Post by jilbert57 » 25 May 2019, 17:26

Yes thank you I read she passed of cancer. It just sounded like the pancreatitis might not have been resolved. I am sorry for your loss.

With a Tli of 3.6 Sandie is in the tweener area before EPI. it might be worth a retest in 6 months of the Tli to see if it has gone to 2.5 or less, indicating a non functioning pancreas. Was fat found in the poops?

Glad she is better on her feet.
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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Sandie
Member
Posts: 7
Country: Portugal
Pet name: Sandie

Re: New member

Post by Sandie » 25 May 2019, 17:51

Trypsin-like Immunoreactivity result 3,60 (A) ug/l Ref. 5.7 - 45.2

Those are the reference values, not sure they are the same for every country. And she was taking enzymes already, so I also don't know if it affects the results.

No fat was found in the poops, but I wasn't giving her any fat in the food - she just couldn't stand it.

We are just back from a 20 minute walk (Sandie now walks with a towel around her waist - she was falling every 2 steps ...). Just 2 days ago even 2 minutes was too much ... and now she didn't want to stop walking, and only lost her balance about 2 or 3 times. This is incredible.

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jilbert57
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Posts: 573
Country: United States
State: Washington

Re: New member

Post by jilbert57 » 25 May 2019, 18:42

Yes that is correct. Reference range for normal Tli is 5.7- 45.2.
Tli indicating EPI is <2.5.
You are in the tweener area.
Was she fasted 12 hrs prior to the test?

Here is a good link for you to read:

https://epi4dogs.com/tli-universal-testing/

It explains reference range.

That is so good she could walk so far!
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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Sandie
Member
Posts: 7
Country: Portugal
Pet name: Sandie

Re: New member

Post by Sandie » 25 May 2019, 18:54

Thank you for the very informative link !

No, Sandie wasn't fasted. She had eaten about 6 hours before the blood was taken.

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jilbert57
Staff
Posts: 573
Country: United States
State: Washington

Re: New member

Post by jilbert57 » 25 May 2019, 20:29

You might need a retest. Others should chime in with their thoughts.
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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Madelon
President
Posts: 571
Location: Nashville, TN
Country: United States
State: Tennessee
Pet name: Doc

Re: New member

Post by Madelon » 25 May 2019, 22:45

Hi and welcome to our EPI family. I am so sorry you lost your Maggie - it always so hard when we have to say goodbye.

I'm glad you have found a new vet that you like and trust - you and Sandie sure have been through a lot. With Sandie testing barely above the clinical diagnosis for EPI, we recommend treating as if EPI and then retesting in a few months. Here is a link to our website page regarding SEPI (sub clinical EPI) https://epi4dogs.com/tli-test-not-quite-epi/. What enzymes are you using and how are you preparing them? What food are you feeding and how much?

Sending you cyber hugs!
MADELON and Doc. DX EPI and SIBO: 5/22/2015
Test Results: (1st) 7/2014 = TLI 16.5, B12 894, Folate > 24; (2nd) 5/2015 = TLI < .4, B12 406; Folate >24; (3rd) 10/2015 TLI < .4; B12 >1000; Folate 14.4. Prior to DX: May 2014 (2mos) - DX coccidia/bladder infection; July 2014 (3mos) 1st EPI test = TLI 16.5, B12 894, Folate >24 - Dx SIBO not EPI; Feb 2015 thru May 2015 - weight loss only; May 2015 vomitted several times, diarrhea and eating poop. Regimen: 4 cups Sport Dog Food Elite Herding - Diane 6x 1tsp per cup; 1 WonderLab PetFactor B12 2x day; 1/2tsp Slippery Elm 2xday; Multivitamin; 1 Zyrtec 10mg 2x day; Salmon Oil

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Sandie
Member
Posts: 7
Country: Portugal
Pet name: Sandie

Re: New member

Post by Sandie » 26 May 2019, 07:41

Madelon wrote:
25 May 2019, 22:45
Hi and welcome to our EPI family. I am so sorry you lost your Maggie - it always so hard when we have to say goodbye.

I'm glad you have found a new vet that you like and trust - you and Sandie sure have been through a lot. With Sandie testing barely above the clinical diagnosis for EPI, we recommend treating as if EPI and then retesting in a few months. Here is a link to our website page regarding SEPI (sub clinical EPI) https://epi4dogs.com/tli-test-not-quite-epi/. What enzymes are you using and how are you preparing them? What food are you feeding and how much?

Sending you cyber hugs!
Thank you for your kind words !

Those were the enzymes I was given at the Vet. Hospital when Sandie was first diagnosed (based on the symptoms):

https://wepharm.pt/en/produto/11/

And this is the therapy of the new vet - which she started on May 21st, today is the 6th day.


Creon 25000 : 1 capsule with every meal
- Flagyl 250mg : 1 tablet every 12h for 10 days
- Milk thistle 300 mg : 1 capsule 2 times daily
- Vitamin B12 : 1 shot for 7 days

Home made cooked diet - daily dosage divided in 3 meals:
- Turkey with no fat: 360 gr
- Sweet potatoe: 240 gr
- Beet: 60gr
- Banana: 1
- Egg: 2
Suplements
- Keffir (goat milk): 1 tablespoon with each meal
- Brewer's yeast: 1 tablespoon with each meal

I warm up the food slightly so that it is room temperature and then sprinkle the enzymes on it.

Sandie sends hugs back :)

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