new to 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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carrie_m
Member
Posts: 10
Country: United States
State: Oregon
Pet name: Josephine (aka Josie)
My name: Carrie

new to EPI

Post by carrie_m » 13 Jan 2020, 14:41

Hello my name is Carrie we have a wonderful almost 2 yr old German Shepard she started losing weight in November, by December we had a diagnosis of EPI. We have started her on enzymes and b12 she is also on antibiotics.. The diarrhea goes away with the antibiotics but within 5 days it comes back. She has lost 4 more pounds since last appointment.. any words on about how long it may take to get her weight up. any words of advise on how we can get her to gain weight. our vet has put her on Hills Diet gastrointestinal Biome Digestive fiber care dog food 2 cups along with 2 tablets of Pancre Plus 3 times a day. We give her a B12 shot once a week. We are still in the learning phase of this so is there any foods we should avoid or any we should be giving her more of.. we don't give her human food except blue berries, green beans, never table scraps.
I have seen some of you are using Pro Biotics, what kind is helping do we add to food any help will be appreciated. Thank you in advance

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jilbert57
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Posts: 951
Country: United States
State: Washington

Re: new to EPI

Post by jilbert57 » 13 Jan 2020, 15:08

Hi Carrie, welcome to you and your pup.
There are 4 cornerstones to getting an Epi animal back on track:

Enzymes- 1 level teaspoon of powdered enzyme per cup of kibble. Add room temperature water, stir and let set 15- 20 minutes. Stir and serve. In your case you would crush the tablets up, put in with food and water and incubate as above. I would use 2 tabs per cup of kibble.
https://epi4dogs.com/enzymes-in-brief/

Diet- unless your pup has a concurrent condition along with Epi you do not need a prescription food. Low fat is not needed
Grain free diets of 4.0% fiber or less and try to limit legumes, peas and potatoes .
https://epi4dogs.com/diet-in-brief/

Antibiotic- looks like you have that covered
https://epi4dogs.com/sidsibo-in-brief/

B12- the Epi pup B12 levels need to be 600 or greater. Here is information:
https://epi4dogs.com/b12-in-brief-2/

Personally I would hold off on the Probiotic to see if once you have all things implemented above, your dogs poop improves.

Jill
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 13, TJ is a 4 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

Tuckaboo.
Member
Posts: 255
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: new to EPI

Post by Tuckaboo. » 13 Jan 2020, 19:07

Carrie, is Tylan the antibiotic your pup is taking? Mine has been on Tylan since last summer, and when I've tried to take him off, his poo has gone runny again.---Pam
Tucker is a shepherd/lab mix, adopted on craigslist; he has tested positive on the ScheBo test for EPI. Currently taking Diane's Enzymes 3 teaspoons/day, Wonderlab B12 capsules 1/day, and Tylan 1/5 teaspoon/day. Thriving on Sport Dog Food Elite/Herding Dog. No more coprophagia, his weight is steady, and he is a happy member of the family, if a bit of a bully with his four siblings from time to time. Tucker is my boyfriend, and my husband is OK with that.

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carrie_m
Member
Posts: 10
Country: United States
State: Oregon
Pet name: Josephine (aka Josie)
My name: Carrie

Re: new to EPI

Post by carrie_m » 14 Jan 2020, 15:21

Thank you for you advice. Husband is having a very hard time being patient for treatment to start working. Josie is his mental support dog and to watch her lose weight is really hard for him.
we are not on Tylan we are on Metronidazole 250mg every 12 hours works while she is taking it but when she is off it it takes about 7 days for diarrhea to come back

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jilbert57
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Posts: 951
Country: United States
State: Washington

Re: new to EPI

Post by jilbert57 » 14 Jan 2020, 17:36

The treatment for SID is a 45 day course of antobiotic. I would either ask the vet for a 45 day course of Metro or Tylan(preferred antibiotic). Here is some information:


https://epi4dogs.com/sidsibo-in-brief/

https://epi4dogs.com/antibiotics/

Jill
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 13, TJ is a 4 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
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Posts: 938
Location: Nashville, TN
Country: United States
State: Tennessee
Pet name: Doc

Re: new to EPI

Post by Madelon » 15 Jan 2020, 14:02

Hi Carrie - welcome to our EPI family. It's so hard watching these pups lose weight and feel so poorly but I can't imagine having a support dog go through this.

The reason the diarrhea is coming back is because your pup has SID (small intestinal dysbiosis - formerly called SIBO) - we now know all EPI dogs have SID in their system but it's a matter of properly managing the cornerstones of EPI to keep it from flaring up.

First, with the enzyme tablets the recommended dose is 1 tablet per cup of food PLUS 1 for the bowl - so if you are feeding 2cups of food you would use 3 tablets - crush them and mix in with food - wait about 10 minutes and serve. Have you looked into using the powder enzymes from EnzymeDiane? They are a lot less expensive than the vet prescription enzymes and the dosing is a lot more accurate than using the tablets. Most of us use Diane's Pancreatin 6x enzyme (the preparation and dosing is a little different so if you decide to try them we'll help you with it) https://enzymediane.com/.

As for the antibiotics - we do not recommend using metronidazole unless Tylan does not work. The reason is metronidazole kills ALL the bacteria in the gut - good and bad whereas Tylan does not kill any bacteria but rather prohibits the reproduction of bad bacteria. Also, metronidazole can have serious neurological side effects. HOWEVER, before you try Tylan, you might try Slippery Elm Bark Powder - it's a prebiotic mucilage that coats the gastrointestinal tract and recent research has shown in some cases it works better than antibiotics at treating SID. https://epi4dogs.com/slippery-elm/ this link has the dosing information - be sure to mix with 1-2 Tablespoons water and put directly on the food. If you do not see immediate improvement in the poop, then ask your vet for a prescription for Tylan - use for 45 days and slowly wean off.

Are you feeding 150% of the food for the weight your dog should be but in smaller meals? We recommend doing this until you reach the goal weight.

Be sure you do not stop supplementing B12 - once you finish the 6 weeks of the shots you can switch to WonderLabs Pet Factor B12 pills - they are very inexpensive and have intrinsic factor which helps with B12 absorption.

As for probiotics - we do not recommend giving probiotics until your dog is stable - good poops and weight gain for a month or two. The reason being recent research has shown that EPI dogs have too much of the most common strain which is in most probiotics and too much of a good thing can be a bad thing.

Don't worry, we'll get you and your pup on track,
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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carrie_m
Member
Posts: 10
Country: United States
State: Oregon
Pet name: Josephine (aka Josie)
My name: Carrie

Re: new to EPI

Post by carrie_m » 16 Jan 2020, 13:51

thank you for your reply we will take what we learn here to our vet and see if we can find a plan that works for Josie.. we appreciate all the helpful advice.

Tuckaboo.
Member
Posts: 255
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: new to EPI

Post by Tuckaboo. » 16 Jan 2020, 16:41

Hi, Carrie. I wonder, has anyone mentioned a low fiber diet for your Josie? That is what you will normally read, here, and I'm thinking your fruits & veggies may be tipping the scales. Could you use meat, instead, when you are feeding her the other stuff? Just a thought, and I feel so bad for your husband...he must feel anxious seeing Josie suffering. So, follow the advice you will get on this forum, and tell your husband that one of these days you'll look at Josie and say, hmmmm, she's gettin' a little chubby. Last month I had to reduce Tucker's kibble by 25% , and he has maintained! We just started in May. Take care---Pam
Tucker is a shepherd/lab mix, adopted on craigslist; he has tested positive on the ScheBo test for EPI. Currently taking Diane's Enzymes 3 teaspoons/day, Wonderlab B12 capsules 1/day, and Tylan 1/5 teaspoon/day. Thriving on Sport Dog Food Elite/Herding Dog. No more coprophagia, his weight is steady, and he is a happy member of the family, if a bit of a bully with his four siblings from time to time. Tucker is my boyfriend, and my husband is OK with that.

User avatar
carrie_m
Member
Posts: 10
Country: United States
State: Oregon
Pet name: Josephine (aka Josie)
My name: Carrie

Re: new to EPI

Post by carrie_m » 17 Jan 2020, 02:37

Thank you we have already Eliminated the fruit and veggies we are currently looking for a dry kibble and possibly a wet food to give her.. once we find one that is easily available to us we will make a switch and of course price is an issue the hills diet is expensive along with everything else

User avatar
carrie_m
Member
Posts: 10
Country: United States
State: Oregon
Pet name: Josephine (aka Josie)
My name: Carrie

Re: new to EPI

Post by carrie_m » 17 Jan 2020, 02:46

I do have another question! So EPI has not slowed Josie down at all she begs to go out and catch the frisbee doesn’t want to stop. They usually go out for 10-15 minutes every couple hours to chase the BB (frisbee) husband worries that too much exercise will make it harder for her to gain weight. Should we let her continue to play as normal or should we not let her work as hard as she wants.. thank you all for the insight and advice

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