New to EPI and need some guidance

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.
Mandy
Member
Posts: 12
Country: United States
State: Arizona
Pet name: Shazam
My name: Mandy

New to EPI and need some guidance

Post by Mandy » 08 Feb 2020, 07:56

Hello,.

I am new to all of this and am desperate for some guidance. I've only gotten the diagnosis about 2 weeks ago and finally got him started on the enzymes about a week ago. (THANK YOU enzymediane.com, they really are cost effective!) I called my vet due to some concerns about the B12 injections, and we got to talking about how he was doing, I told her that he was started on the enzymes and hes doing so good but i have concerns about how wet his poops can be, she said to increase his enzymes to about 1 1/4 to 1 1/2 tsp per 1 cup of food, and along comes a new problem......Nothing will get a dog owner out of bed faster than the sound of a sick dog and poop....... He pooped almost black diarrhea all over his kennel. Is he getting too much enzymes now?

Tuckaboo.
Member
Posts: 310
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: New to EPI and need some guidance

Post by Tuckaboo. » 08 Feb 2020, 11:19

Mandy, HI! I'm going back to read your post, but I feel your anxiety & wanted to respond immediately. ALL WILL BE WELL!!! You've come to the right place. I'll tell you what I know shortly, and then some staff members will really break it down for you.---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.

Tuckaboo.
Member
Posts: 310
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: New to EPI and need some guidance

Post by Tuckaboo. » 08 Feb 2020, 11:24

I haven't read anything about giving additional enzymes, but the directions do say 1 teaspoon per cup of food, more or less. BUT----it looks like you are not using Tylan, an antibiotic that combats SID. Some dog people can get away with using slippery elm, instead, but my impulse would be to get your vet to address the small intestinal dysbiosis, which most (all) EPI dogs seem to suffer from. Maybe you can call this morning, before they close? Forgive me if you are already doing this...my speed reading ain't what it used to be.---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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jilbert57
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Posts: 994
Country: United States
State: Washington

Re: New to EPI and need some guidance

Post by jilbert57 » 08 Feb 2020, 12:10

Mandy, too much enzyme can be as bad as too little. Is the strength on the enzymes 6x strength? If so the 1 level teaspoon enzyme per 1 cup kibble is the ratio. Put a little room temperature water in and stir the two and let set 20 to 30 minutes. Stir again and serve.
There are 4 cornerstones to EPI:
ENZYMES
DIET
ANTIBIOTICS
B12

These 4 things need to be applied. What food are you feeding? It should be a grain free food with 4% or less fiber. Please keep peas, lentils/legumes at the low end of ingredients.

B12 needs to be at 600 or higher.

Most dogs have SID/SIBO at diagnosis in the gut and need to be on a 45 day course of antibiotics 2 times a day. Tylan is first choice as it doesn't kill the good bacteria.

Will you please post your test results this will help us better help you.
Thanks

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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Jean
Staff
Posts: 1046
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: New to EPI and need some guidance

Post by Jean » 08 Feb 2020, 12:24

Welcome from the UK

Ok

What food are you giving ? And how much per meal

Are you giving ANYTHING without enzymes

What breed is your dog

When you say wet poops exactly what do you mean,

As Jill says too much enzyme is as bad as too little

What strength of Dianes enzymes are you giving

Have you been prescribed B12 and antibiotics

What was the time line up to the diagnosis

I am so sorry about the questions it will give us a base line to work from

Keep a journal on everything you do
My name is Jean we live in Liverpool in Uk

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

Mandy
Member
Posts: 12
Country: United States
State: Arizona
Pet name: Shazam
My name: Mandy

Re: New to EPI and need some guidance

Post by Mandy » 09 Feb 2020, 09:45

Thank you all for the help, and i do appreciate it so much!!! .

Pam,
Thank you! I did call my vet just a couple of days ago and told her what was going on and asked if i should start some Tylan, she was not ready to do this yet. (one would think the Dr would do SOME research into a patients diagnosis if they are not familiar with it) I asked a couple of times in that conversation. They are not open on the weekends either..... (frustration sets in easily with those hours)


Jill,
I do remeber reading something about too much and too little being issues and its all a "right proportions" game for the individual dog. Yes, he is on 6x strength, and i do follow the directions with about 3 Tbsp of room temp water and let it sit for about 20+ minutes and stir again, which leads me to my second problem, his appetite has decreased since starting the enzymes. He was eating 1 cup two times a day and 2 cups once a day, now im lucky if i can get him to eat 3 total cups a day. Looking at the 4 cornerstones it seems the only thing i am lacking is the antibiotics. (i have only had Shazam for 4 months now) I have had him on grain free foods for about 3 months and that was also a lot of mistakes made there, he has been on Pure Balance, grass fed beef and boar for about 2 & 1/2 months now and i thought i had it all figured out. The (now diagnosed) EPI went away completely for about 3 weeks and i thought the problm was solved until he went through an 11 pound bag a week and didnt gain any real weight. (sorry rambeling) it has a fiber content of 4%. (the vet told me to add pumpkin and berries to his food to increase his appetite and help with his stools) he is also on B12 injections every week, i am changing this to the 500mg pills/tablets though.
I just read the ingredients list on the bag i bought this morning, peas and chickpeas are the 4th and 5th ingredients on the bag........
I have no clue what his blood levels of B12 are at, the ONLY test ran was the TLI which came back @ <1. There has been no other testing done.

Jean,
Answers to your questions, and hopefully for me too.

What food are you giving ? And how much per meal
Pure Balance grass fed beef and boar. 1 cup twice a day(morning and night) and 2 cups once a day(afternoon feeding)with 1 tsp of enzymes per 1 cup of food about 3TBSP of room temp water stirred in set aside for 20+ minutes, stirred again and served.

Are you giving ANYTHING without enzymes
No only Pure Balance with enzymes

What breed is your dog
2 yr old male boxer (I've had him for about 4 months now,adopted from the local pound)

When you say wet poops exactly what do you mean,
Poops/stools look like they are glossy/shiny, not diarrhea but wet and slightly lose today

As Jill says too much enzyme is as bad as too little
I am learning this one quick!

What strength of Dianes enzymes are you giving
6x

Have you been prescribed B12 and antibiotics
Just B12, i asked for antibiotics, the Dr is not willing to give them just yet and want to wait the 6-8 weeks for his check up to do it. She said its too soon for them.?

What was the time line up to the diagnosis
Not sure what your asking for here, but ill give it a go.

We adopted him the last couple days in September 2019 from the local pound. I do remember seeing yellow diarrhea in his cage there and thinking it was just from lack of nutrition. He was turned in as a stray by a good samaritan. (I believe his prior owner turned him in because they were at a lose as to what was wrong with him. His paws are soft and silky feeling. no road or desert wear at all, he had a family. I live in Arizona dry and hot. His pads were not worn like any dogs normally are for here, he also walked right into the house and made himself at home on the couch.) He weighed 32 pounds when he was taken into the pound and 37 pounds a week later when we adopted him. Free fed puppy food like i would any other underweight dog. He went through 25 pounds of puppy food in 2 weeks without any real noticeable weight gain. I tried the boiled rice and beef diet, (this was a literal nightmare) to calm his tummy and also in the hopes of some weight gain. That lasted 2 days and only made him worse. Then i tried the adult food thinking maybe he just needed the adult foods to help his tummy. He became so hungry he would wait for us to leave the house even for a minute or two and sneak into the pantry are and steal the loaves of bread, i figured out a grain intolerance when i gave him a hot dog bun i had left over and thought to feed him instead of throwing it away and maybe it would help with is weight issues as well, wrong. He pooped out more than he took in all the time. When i brought him home from the pound he came home on doxycycline because they said he had kennel cough they discovered the same day. This did not help his stools at all. I stopped this med about 3 days into the course of it. He continued to have yellow stools no matter what i fed him, but once on the Pure Balance his stools seemed to become solid but not what they really should be. I finally had had enough. I called around for an affordable vet and took him in. In the 4 months I've him hes only had somewhat normal stools but never had a real dog poop. Every time i thought i was on the right track because he would get a little better it would blow up in my face with other symptoms and signs. It feels like its been a year that ive been trying to figure this one out and at least now i know. Hes also almost always had "bubble gut". Some days are really bad other you hear nothing.

I am so sorry about the questions it will give us a base line to work from
I just hope ive answered them with enough info, and don't worry about the questions. How else are we supposed to get through this and start really living!

Keep a journal on everything you do
I will be starting this this weekend for him and hopefully it will also help at the vets office too. There is so much to put into one for him, i just dont want to miss anything. I'm learning every little detail is super important with EPI.

Thank you all for the assistance in this. A little update for the day, i cut the enzymes back down to the normal dose and the stools have turned from black to brown. They still look wet and now he just seems to be a little constipated also. (I'm giving this my best shot here, he deserves the best.)

Mandy
Member
Posts: 12
Country: United States
State: Arizona
Pet name: Shazam
My name: Mandy

Re: New to EPI and need some guidance

Post by Mandy » 09 Feb 2020, 10:58

I'm not real sure if the response i posted went thru, it kept telling to resubmit my response. if you cant find my response to questions post please let me know. Thank you.

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jilbert57
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Posts: 994
Country: United States
State: Washington

Re: New to EPI and need some guidance

Post by jilbert57 » 09 Feb 2020, 11:30

Yep, your post came through.
So did your pup get over kennel cough?

The fiber in the Pure Balance is Max 5% and dried ground pea is 3rd, might be too much fiber. Just a thought.

I would ask the vet again for a 45 day course of Tylan.

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

Mandy
Member
Posts: 12
Country: United States
State: Arizona
Pet name: Shazam
My name: Mandy

Re: New to EPI and need some guidance

Post by Mandy » 09 Feb 2020, 12:12

Yes, but im not sure he really ever had kennel cough. It seems to be standard practice out here for them to treat for it even thought there may not be any real symptoms or tell tale signs. Thank you, i will try again to get the Tylan for him.
**UPDATE**
This morning his stools are much better, I actually reduced his enzymes by about 1/8 tsp total for the day (a tny pinch per feeding) and his stools have improved! Again, thank you all for the help and i will be using a lot of the info from here to give to my vet as well as good jounal about his daily habits. THANK YOU!!

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Ehellriegel
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Posts: 41
Country: United States
State: Georgia
Pet name: Fi
My name: Eleanor

Re: New to EPI and need some guidance

Post by Ehellriegel » 11 Feb 2020, 09:14

Hi Mandy!
I am certainly no expert, but I have learned a lot over the past couple weeks since my German Shepherd (11 months) was diagnosed on the 1st! First things first, stop the pumpkin!! It is essentially entirely fiber and that's not helping the poops at all since EPI dogs can't handle nearly as much fiber as normal dogs, which is why they need such low fiber percentages in their food. We started a journal for our pup (Fi is her name) and I realized that every time her poop got worse and turned to watery diarrhea, is was following a meal with pumpkin on it since I was alternating it in and out. Once we stopped giving her pumpkin, her poops improved dramatically! If you need something to make him more interested in his food, try adding bone broth for some flavor, most dogs love it.

I understand vet frustration, my vet was dead-set on not giving Fi any B12 to see if her body could naturally replenish it, which from research, I knew it couldn't (her levels were <150 when we got her TLI test done, the machine couldn't read any lower). I waited about a week and she was only becoming more lethargic, so we started her on the WonderLabs B12 with Intrinsic Factor and the difference in her mood, energy, and tummy issues were night and day! Many people on here swear by the WonderLabs and believe it works better than injections.

As for food, one that is highly recommended on here and that I have started to switch Fi over to is Sport Dog Elite Buffalo and Sweet Potato. It has a low fiber percentage (3.3%) and has no grains, pea, chickpeas, legumes, etc. While it is fairly pricey, they need a bit less of it since it is so calorically dense! And you can save by setting and Autoship up through Chewy. And with Fi's poops, they have already improved dramatically after starting to transition her to this food from one that had chicken and rice in it. We are actually getting solid poop at this point!

I hope this information helps, we are all in this together!!

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