Is EPI Sudden Onset?

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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Madelon
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Re: Is EPI Sudden Onset?

Post by Madelon » 26 Jun 2020, 22:26

Hi there and welcome to our EPI family. FIRST and FOREMOST that B12 is EXTREMELY low!! Glad you got a B12 injection. Please know that B12 is critical to properly managing EPI and supplementing is for life with these dogs. If you are going to do the six weeks of shots, when that is done please consider switching to WonderLabs Pet Factor B12 pills - most of us use these pills as they are inexpensive, easy to administer and work for most EPI dogs. As far as food, definitely try to stick to lower fiber 4% or less and try to avoid or limit peas and legumes as they can interfere with the efficacy of enzymes.

As for retesting, with the TLI being as low as it is your dog is probably towards EPI, however it takes time for the pancreas to atrophy. So, if you retest in a month the TLI might not change much but if you retest in 3 months or 6 months it could be significantly different or it may never change. My dog was tested at 3months old and his TLI was 16 - he was retested at 13months old and the TLI was less than .4. If I were you, I would treat as if EPI and see how things go and retest in 3 months.

Please keep us posted - we are here to help in any way we can :)
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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sierra2020
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Re: Is EPI Sudden Onset?

Post by sierra2020 » 01 Jul 2020, 22:41

Thanks For the Feedback. Sirra is taking well to the enzymes. The 150% of dog food bag reccomendation is given out over 4 meals daily. Still no solid poo, but it's looking a lot better. Before starting on enzymes it looked like pureed kibble. Now it looks like there is some digestion and absorption going on. Next weigh in is on Friday with a B12 shot. Hopefully the weight loss will have stopped and she's on the right track.

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Shirl D.
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Re: Is EPI Sudden Onset?

Post by Shirl D. » 02 Jul 2020, 21:22

Hi Ben,
I'm glad you've seen some improvement, although some more improvement would be nice! I just want to make sure that Sierra is getting enzymes with every meal. Also, no treats between meals, because without enzymes they won't be absorbed. We recommend not giving treats until she's been stable for 3 months or so.
Let us know how the weigh in goes tomorrow. She should continue to make improvements as the B12 increases. If there isn't more improvement in the poop consistency within 5-7 days of having enzymes with all meals, you might need to make some changes. Let us know how things go and we can help you figure out how to get better poops.

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sierra2020
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Re: Is EPI Sudden Onset?

Post by sierra2020 » 03 Jul 2020, 12:08

Stool slowly improving. Still losing weight. We are increasing the food + enzymes. She still eats everything that we put in front of her right away.

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Olesia711
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Re: Is EPI Sudden Onset?

Post by Olesia711 » 03 Jul 2020, 14:57

Hi Ben,

I would like to 2nd Madelon's suggestion about re-testing. Although your vet is correct in suggesting a re-test in about a month.... (that is what is technically recommended).... in all practicality, you will be better served to re-test after a little longer time-frame.... my suggestion would be to wait 3 months. BUT your vet is 110% on the mark with wanting to treat this as EPI. I applaud his decision, as after having thousands of dog owners write in to this site over the course of 12 years, when borderline, it truly serve the dog best to treat as EPI but... do retest at a later date to confirm.

Regarding the weight... if this is EPI, the first thing you address is the loose stools, once you get that under good control, the next thing you focus on is weight gain. This all is a process... trying to find the right balance of each of the 4 aspects to managing EPI (Enzymes, Diet, B12, and keeping SID under control either with prebiotics/diet and or antibiotics).

Be sure to keep a log as recommended... https://epi4dogs.com/epi-log/ .
As Shirl reiterated... not cheating with treats or snacks in-between meals with no enzymes (at least not in the beginning...)

And as Jean mentioned, now that you are using enzymes, initially try foods low in fiber content.
When a dog has EPI and is not on enzymes, it is the fat that give them the worst stools, but once they go on enzymes, then you have to be careful about too much fiber cause fiber can destroy the enzyme efficacy from anywhere of 0% to 50%.... problem is we just don't know how much from one dog to another. .. so to start with limit the fiber content to 4% or even less is better. Once the dog is stable if you want, you can "try" foods with grain/rice... and your dog "might" be able to handle it, but many continue to have issues with too much grain.

Peas/legumes... UGH.. too much in a food and this really wrecks the poo production..... once of the worst fibers for EPI dogs.......

Ahh chicken... some dogs do fine on chicken others do not.... you just have to figure out what protein sources agree with your dog... so.... what we like to suggest (so as not to waste too much money) is when trying different foods, buy the smallest package available just to "try" first. If it works well, then go on to buying big bags or multiple cans..........

And definitely continue B12 supplementation.... although shots were the gold standard, they are now discovering that special B12 pills works as well or better. We are not sure, but suspect it is because the pills use Methyocobalamin vs. cynaocobalmin that is in the injectibles... but we cannot be sure yet if this is the reason why.
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
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Re: Is EPI Sudden Onset?

Post by Madelon » 08 Jul 2020, 19:16

Hi Ben. Just wanted to check in to see how the poops are going. If you're still not seeing a big improvement and the food meets our recommendations, then you might want to try Slippery Elm Bark powder. It's a prebiotic mucilage that coats the gastrointestinal tract and work well for a lot of EPI dogs in dealing with SID (small intestinal dysbiosis), however, if after a few days on Slippery Elm you're still not seeing good results, then you'll need to talk to your vet about getting a prescription for Tylan antibiotics. Here are the links for dosing, etc for both
https://epi4dogs.com/slippery-elm/
https://epi4dogs.com/antibiotics/

Paws and fingers crossed for firm poops.
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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sierra2020
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Re: Is EPI Sudden Onset?

Post by sierra2020 » 14 Jul 2020, 15:37

Update:
Encouraging News. After more than 3 Weeks straight of losing wight, Sierra had gained 1`.3 Kg from the 3rd of July to the 10th while using the Bovine Enzymes that we purchased while waiting for the testing to come in. We were hoping for stable weight or at least the rate of weight loss to decrease so it was a big relief to see her weight go up. It is still early in this condition for us and her stools are still pretty soft looking but we are encouraged. Over the weekend we switched to Pank-aid provided by our Vet, as the store bought Bovine enzymes had run out. She seems to not like the food as much with this Enzyme. We Notice a real difference in the texture and smell of the Pank-Aid Product.

The Bovine Stuff had a strong "Beefy" smell to it that would drive both of our dogs wild. There was no issue in feeding Sierra food with this enzyme because she could not get enough of it and would clean her bowl. With the Pank-Aid it seems she's not quite as hungry and has gone back to her old eating habits of eating a bit and then leaving food sit around till later. The problem with that is the other NON-EPI dog will then raid her Bowl. I guess we will have to try smaller portions and more frequent feeding or take the bowl away when she stops eating to prevent the other dog from eating her treated food.

The ultimate goal is to get on Diane Enzymes once the vet provided stuff runs out. From what I gather, Enzyme Diane's Product will be similar to Pank-Aid, so I expect Feeding may be a challenge. Small Adjustments and hopefully we get her feeding and weight sorted out.

A few questions raised:
How long can food keep once treated with Enzymes, if she doesn't eat it all at once? Is it OK to give it back an hour or 2 later?
I know the recommended feeding is 150% of bag guidelines. Do we eventually taper this down to 100% once she achieves her Ideal Weight, which in her case is around 36-38KG?
How bad is it for a Non-EPI dog to eat a bit of Enzyme Treated Dogfood? We have always taken a Laissez-faire attitude towards the dogs feeding, but I guess we will have to up the discipline here.

all the best.
Ben

Barb
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Re: Is EPI Sudden Onset?

Post by Barb » 14 Jul 2020, 16:33

Congratulations on the weight gain! We had a slow gainer, but over the course of his first year and a half on enzymes he eventually got to his target weight. So you are on the right track.....and once she gets the hang of it, she might gain faster. We were happy with slow and steady.

Your non-EPI dog won't be adversely affected by enzymed food....i think it's hilarious that he wants it....the worse scenario would be Sierra getting into the non-enzymed food. But you should probably take the food up or feed separately, so your other dog doesn't make a habit of stealing it. You can refrigerate the uneaten portion, but when you give it back, you will need to raise it to room temperature as the enzymes go dormant when they are cold. Putting the bowl in warm water works as long as you don't spill the contents of the bowl into the water.....obviously I am speaking from experience LOL. And yes, when she gets to her target weight, you can taper her food down or she could end up joining the "Chunky Monkey" club....which many dogs have done to the shock of their owners.....

It sounds like she is definitely going in the right direction. Keep the good news coming.

Barb

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