New member hello

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.
GrimmGSD
Member
Posts: 5
Country: United States
State: Ohio
Pet name: Grimm
My name: Jill

New member hello

Post by GrimmGSD » 13 May 2020, 21:28

Hi
I’m Jill. My dog’s name is Grimm. He is a German Shepherd who is 1 years old. Recently diagnosed with epi and b12 deficiency (Tli was 2.3; b12 was 193). Vet put him on B12 injections weekly (for now), Pancrezyme and Flagyl (he doesn’t tolerate Tylan.) He is currently on RC gastrointestinal, but I will not be keeping him on this because I don’t think it has enough fat.
My poor dog has spent most of the year we have had him with diarrhea. We had tried at least 10 different regular and prescription foods, Tylan, flagyl, and prednisone. It had gotten so bad that he wouldn’t play, go for walks, or do anything except look at me with his sad eyes.

While I am glad to know what is going on, like most, I am overwhelmed with all the things to consider. I’m reading a lot so thanks for all the good information. I have two questions (for now lol):
1. How long can incubated food sit out in room temperature without losing effectiveness? My boy has learned that eating means pain so it takes a lot of coaxing and time to get him to eat.
2. Can I freeze Enzymed food? One of his favorite treats is wet food frozen in a Kong.
Thanks for your help!

Jill

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Madelon
President
Posts: 876
Location: Nashville, TN
Country: United States
State: Tennessee
Pet name: Doc

Re: New member hello

Post by Madelon » 13 May 2020, 21:51

Hi Jill - welcome to you and Grimm. I'm so sorry you have to be here but glad you have a diagnosis - and thank you for posting the numbers. We were all overwhelmed when first diagnosed the same as you, but don't worry we will help guide you through this journey. Can you check what the Folate was? They should have checked that along with TLI and B12. You said Tylan does not do well for your pup - what dose were you giving and how long did you give it for? Tylan is much more gentle than Flagyl, which can have neurological side effects and kills all the gut bacteria - good and bad.

There are four cornerstones to properly managing EPI: Enzymes, B12, Antibiotics and Food

ENZYMES: Most of us use EnzymeDiane Pancreatin 6x - its WAY less expensive than what you get from the vet. Regardless of what you use the recommended starting dose is 1 level teaspoon per cup of kibble, mix in a little luke warm water, then mix in kibble and sit 20-30 minutes before serving.

B12: Your dog's B12 is EXTREMELY low so I'm glad you've started the shots. When you are done with the 6 weeks of injections, PLEASE do not stop supplementing. Most of us switch to WonderLabs Pet Factor B12 pills which have intrinsic factor which helps with B12 absorption. We have seen a lot of dogs have set backs when they stop the injections and wait a month for the next injection. Supplementing is for life with these dogs as they cannot maintain their B12 levels on their own.

ANTIBIOTICS: We recommend a 45 day course of Tylan - you mentioned your dog did not do well on Tylan - what adverse reaction did your dog have? If your dog cannot tolerate Tylan which is uncommon, please be aware of the side effects of flagyl toxicity. With Tylan it does not kill the bacteria but rather inhibits the reproduction of bad bacteria - we recommend a 45 days course and then slowly wean off - if you quit cold turkey you may have a recurrence of SID.

FOOD: We recommend grain free with 4% fiber or less and avoid peas. Feed 150% of the food for the weight your dog should be but in smaller more frequent meals throughout the day. There is no need for prescription food unless there is another underlying condition requiring it.

Until you get the four cornerstones of EPI in proper balance you will not see optimal results. Keep a detailed journal of what you give and what the resulting poops are so you know what works and what doesn't. Ask any and all questions, we've all been there and understand the frustration, desperation and anxiousness.
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

GrimmGSD
Member
Posts: 5
Country: United States
State: Ohio
Pet name: Grimm
My name: Jill

Re: New member hello

Post by GrimmGSD » 14 May 2020, 09:51

Grimm threw up everytime he had food with Tylan; however, perhaps he could tolerate it now that he is on the enzymes. I may also try the slippery elm once we have done the course of metro. He still won't eat very well, but I can tell that he is starting to absorb some of the nutrients because his energy is slightly better than it was (he will play for a few minutes versus not at all). The B12 might be helping with that as well. Fingers crossed that we can see some improvement soon. Thanks for your response and help!

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Montgomery
Member
Posts: 14
Country: Canada
Pet name: Montgomery (I'm a CAT!)
My name: V

Re: New member hello

Post by Montgomery » 14 May 2020, 10:59

I'm glad you found us! There are a lot of wonderful people here. I've asked so many questions here and received excellent advice and a lot of moral support.
Montgomery learned food meant pain, too, because the enzymes gave him mouth ulcers (we put them in capsules now and he's fine). It took about four months of syringe feeding him before he would eat by himself again. You were talking about trying to feed something other than the gastro...Can I make a suggestion? Try something he's never had before. He'll be more likely to eat something he doesn't have a negative association with.
Good luck!
Montgomery was born 20 March 2012. He eats Royal Canin Spayed/Neutered Kitten dry food and Royal Canin Ultra Light wet food. He takes two size zero capsules of Enzyme Diane's Enzymes with each meal, and gets one number four capsule of Tylosin three times a day. He also gets half a millilitre of Ovol twice a day. Montgomery is a fierce, unflappable little guy. Strong, independent and awesome.

GrimmGSD
Member
Posts: 5
Country: United States
State: Ohio
Pet name: Grimm
My name: Jill

Re: New member hello

Post by GrimmGSD » 14 May 2020, 13:46

Good thing there is a lot of different dog foods out there...lol. Syringe feeding....whew, I'm glad we are not there yet. Worse come to worse, I can always put it in a Kong. He loves his kong :D Any specific dog food suggestions? He did well with Z/D wet, but I can't afford $20 a day to feed him. He ironically hated Z/D dry even when we pretended it was a treat. His usual mo is to eat a food for a few days and then refuse it. With the food he is on now (royal canin gastrointestinal), he didn't even eat it at all without persuasion. I also don't like that a serving for him (he is 85lbs.) is 6 cups a day. Even on a good day, we are lucky to get 3 cups in him. I keep telling myself--one day at a time...

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Jean
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Posts: 890
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara
My name: Jean

Re: New member hello

Post by Jean » 17 May 2020, 07:25

Good morning Jill, and Grimm, an unusual name, we are from the UK

You have had excellent advice

Couple of points here, and maybe questions

Tylan is weight dosed, what dose were you giving ?

Sadly I no longer have my EPI friend and partner, but having nearly 9 years of living with it 24/7 I have been around the block a few times

Royal Canin never worked for Kara, too much grain and expensive ,

You mention Grimm is 1 yr old, what was the history of the EPI test ? Has he ever eaten well ? What would his ideal weight be ? Has he lost a lot of weight ? He isnt full grown yet, so I assume he will be bigger at maybe 18 months

Kara would have eaten soil before she was diagnosed, afterwards she wouldnt eat anything , and exactly like you , maybe a few days and then nothing, we started putting toppers on the food e.g. parmesan cheese, or anything smelly like tripe , disgusting !

Enzyme Diane is widely used in US and is cheaper than you get from vets or wherever, she is very approachable which is good

Keep a daily diary or journal and record everything, we also recommend that you feed 50% over and above of the recommended amount of food for the weight that Grimm SHOULD be

Keep in touch

Jean
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 use Panzym enzymes, Tylan and Chemeyes b12 capsules

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


Jeanx

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Olesia711
Founder
Posts: 1134
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy

Re: New member hello

Post by Olesia711 » 17 May 2020, 19:41

Hi Jill and Welcome to you and Grimm,

To answer one of your earlier questions.... how long to leave food out with enzymes in it..... at the most 1 hr.... but not more. The reason is because bacteria can set in and that can bring on even more tummy upsets than what you are dealing with.

My non-EPI dog liked new foods and then went off of them.. Come to find out... it was low B12. Once that came up with B12 treatment (we used pills) she willingly ate everything.... even the same ol same ol food :)

Regarding feeding cold food. Yes you can prepare the food with enzymes and place in the frig, but then you really need to let it get room temp before serving because cold inhibits the enzymes and heat (above 130 degrees) kills the enzymes.

ONe thing you might try is toppers, like mentioned above... OR.... just serve a little bit in the bowl and hold back the rest, until Grimm finishes whatever is in the bowl, wait a few minutes and then ask him/serve him the rest. A silly psychological ploy but sometimes it works............

Regarding food.... maybe "try" the smallest bag possible (just in case it doesn't work) of Taste of the Wild - Pacific Stream (you can order it from Chewey on line).
What i always did, because i just don't like feeding all kibble, is that i gave a combo of food, kibble for the calories & nutritional balance ( in case i didn't get it right) and baked chicken breast pieces, cottage cheese and baked & mashed sweet potato....before my dog developed Diabetes along with the EPI, i also included a little organ meat, like chicken liver..... and she happily lapped all this up. Maybe this will help?
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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Madelon
President
Posts: 876
Location: Nashville, TN
Country: United States
State: Tennessee
Pet name: Doc

Re: New member hello

Post by Madelon » 18 May 2020, 20:38

Just wanted to check back and see how things are going.
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

GrimmGSD
Member
Posts: 5
Country: United States
State: Ohio
Pet name: Grimm
My name: Jill

Re: New member hello

Post by GrimmGSD » 18 May 2020, 22:03

Thanks for checking in. We are seeing some progress. We can pick up most of his poop now (only you guys will understand). He is still reluctant to eat, and we are only getting about 4 cups in him a day instead of the recommended 6. I do add some wet food which probably helps in that respect. He has never particularly eaten well except when he was about 15- 20 weeks old. After that, it has been a battle. Thankfully, although he is thin, he did not get completely malnourished prior to his diagnosis. His parents are both near or over 100lbs. so I’m sure he could gain some weight to meet what he should be since he is only 85lbs. He is probably not going to gain weight with the amount he is currently eating. I’m okay with that as long as he is happy and energetic.

His energy is slowly returning and he no longer paces and whines after eating. He is more restful so I think he is starting to feel better. He got his 2nd B-12 shot today so more of that onboard should help too. I just try to remember that it took months to end up here so it will take time for his body to heal. I am charting everything so that I am able to see if we get off track. The chart on here is super helpful and includes things that I wouldn’t have noticed otherwise.

To answer your question, we were giving 1/2 teaspoon twice per day of the Tylan.

Thanks for the food suggestions. I have tried adding most of that kind of stuff in the past but it only worked for a day or two. Right now I am trying to keep it as simple as possible until we get him stable. If I fed him for 100 lbs, he would need 8 cups a day...no way that is happening :) Maybe over time, he will stop associating food with pain and will start to eat better. Right now, he insists on being fed from a spoon :lol:

I greatly appreciate your advice!

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Jean
Staff
Posts: 890
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara
My name: Jean

Re: New member hello

Post by Jean » 19 May 2020, 06:06

Good morning again

https://epi4dogs.com/antibiotics/

This is the dosing chart for Tylan. Grimm is 85 pounds , therefore, the dose should be 1/4 teaspoon twice daily, rising to 3/8ths teaspoon twice daily when he hits 90 pounds, you also say "were" has this stopped ?

As our foods over here are different in brand, I will l will leave the others to advise

when you say he paces and whines, does he have tummy gurgles ? a warm hot water bottle helps

you could try feeding him more often if it fits into your routine, I had Kara on 5 meals a day,. and a small meal of scrambled eggs, and mashed potato before bed, all enzymed, she loved that, no milk or butter

it took my Kara a long time to improve, she was 39 pounds at age 14 months, so you can imagine she was a mess, I honstly thought we would lose her, but my vet wouldnt have it, she was on b12 injection every day for 12 days, and then 1 weekly for 12 weeks, her b12 Cobalamin was so low, forgive me if you have answered this, what was her b12 result ?

its a roller coaster ride but worth it
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 use Panzym enzymes, Tylan and Chemeyes b12 capsules

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


Jeanx

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