EPI dog “Johnny”, from Rescue to Service dog
Johnny: a young St. Bernard mix born in El Paso, TX in 2020. There are a lot of words to describe him: fluffy, freckled, goofy, sweet, clever. With his big paws and expressive eyes, he’s very charming and garners “what a pretty dog” comments everywhere we go. Johnny is not just a handsome dog, though – he’s also my best friend, and he saved my life.
I have struggled with chronic illness for most of my life. When I was younger, it was mostly clinical depression and social anxiety. Over the years, I’ve also developed PTSD, OCD, and debilitating chronic migraines and fibromyalgia. I’ve been in therapy for years. I take medications daily. But as of last year I was still seriously struggling, and my disabilities were impacting my ability to function and perform the basics of life day to day.
In 2020, an adoption counselor at an animal shelter in Utah recommended Johnny – at the time known as Scotty – to me based on my living situation and lifestyle. I was uncertain, but made the appointment – a few hours later, a skinny, freckled dog, with the biggest puppy eyes you’ve ever seen and ears and paws too big for his body, was walked out from behind a counter. The leash was handed to me, and it was instantly over for me. This was my dog, and he was going to change my life, and I knew it right then and there.
I had been informed beforehand that Johnny had exocrine pancreatic insufficiency, or EPI, a condition in which a dog’s pancreas is atrophied and unable to produce the digestive enzymes needed to process food and absorb nutrients. EPI requires lifelong treatment – much like my own conditions, it was lifelong, irreversible, and would need to be managed for the rest of his life.
Johnny had been diagnosed with EPI at the shelter but was still in the beginning phases of his treatment, and it showed. He was emaciated, his ribs and all his joints sharp and pointy underneath thin skin; he was ravenous, eating and eating but never satiated; and he was lethargic, unable to go out and walk for more than ten minutes at a time.
We consulted lots of resources – the EPI4dogs website, people who had experience with the condition, Johnny’s veterinarian – and spent the next few months ironing out a treatment regimen that would work for him. Johnny immediately started to blossom – he not only put on all the weight he had lost, but kept growing, and growing, and growing, and it soon became apparent he must have a giant dog breed somewhere in his lineage! (As it turns out, it’s St. Bernard!)
As Johnny became healthy and his temperament began to truly shine through, it quickly became apparent that he had all the qualities that make for a competent service animal. He was laid back, but motivated; even-keeled; friendly to everyone and anyone, but not overly enthusiastic with strangers. I was fortunate to have a background in animal training, and started working with him – he surpassed my greatest expectations, and took to service work like a fish to water.
Nowadays, Johnny is happy and healthy as a dog can be. In fact, when we recently saw a new vet for the first time after moving states, he did not believe Johnny could be an EPI dog until I showed him the paperwork and results from the tests the shelter had performed. He accompanies me on all kinds of adventures – to the grocery store, the bank, medical appointments, restaurants, hikes, you name it and he’s up for doing it together.
Johnny, like all service dogs, is not a pet. He is a partner, one half of a service dog team. He has given me so much of my life and independence back. I take less of the medications that cause me to be slow-thinking and fatigued. My migraines are less frequent, and less severe. I can go out in public, and do things that, for most people, are simple, like picking up groceries, but which have always caused me to have debilitating anxiety attacks.
This time last year, I was struggling with thoughts of suicide. I found no joy in life and didn’t know how much longer I could struggle through trying life to feel some small semblance of comfort or happiness. Today, I accomplished what I never would have been able to a year ago. I went on a hike with Johnny, completed three loads of laundry, went to the grocery store, and, most importantly, woke up looking forward to the day instead of dreading it.
It really is serendipitous, me and Johnny coming together: both of us born in Texas but somehow ending up miles away in Utah at the same time; finding each other at just the right moment, somehow. I truly believe we rescued each other, and that we are able to live day to day happy and healthy because we are two halves of one whole, a team now and forever.
… the dog they thought could not get better…….
This is Maezi in Yoho Park, Canada, owned and very much loved by owner, Wanda.
“There was couple times in her journey when it was suggested to seriously consider putting her down but I just couldn’t do it. Some family & friends didn’t think she would make it & still some who question the cost of her care but they just don’t understand she is the most loved cattle-dog on this continent & she’s mine . Managing EPI is all about finding the right balance…. and yes it CAN be done! And this is our story………..”
I can finally say that I believe we have the right combo/balance for our most loved cattledog.
Maezi was dx july 25 – TLI> 0.6– b12 > 127 weighed only 16.4 kg(36lbs.)
Enzymes -Vet put her on plant based enzymes at 1st with so so results until Aug 17 I went in & asked for porcine ones after advice from here. They worked but they were out of stock when I went to get more so was put on Cotazym(creon) until sept 17 porcine back in stock but Very pricy – Jan 7th got my first order of EnzymeDianes Pancreatic 8x for a huge savings & great results.
Food– She was on Puppy Chow & Beneful 4pups when dx so vet said to keep her on this–tried Acana grain free with poor results. After she was on porcine enzymes we tried 3 more grain free that she had allergy issues with. We are now on 1st mate chicken & blueberry grain free kibble (good 4 dogs w allergy & digestive issues). Nov. 20 we had started grinding it which really helped her poo quality. Also on dec 30 we started adding pumpkin to her diet with more improvement. Jan 20 we no longer grind food. She still can only eat 1 cup at a time mixed w ¾+bit 8x enzymes w ¼ c warm water sit for 45 min. –3 meals a day.
B12– initially vet had said her levels were fine – but apparently learned here that they need to be high normal range & supplemented to maintain.. Sadly her b12 issues were not addressed upon dx and it wasn’t until telling vet sept 16 when we started daily sublingual tablets. Nov 2 we had her re-tested to see how it was working and were happy to be at 739 after only 50 days still on daily tablets.
SIBO – OMG we don’t like SIBO – Again it wasn’t until I told vet about what I learned here that this issue was addressed for Maezi – Sept 12 we put her on 2 week trial of Tylosin with great results so continued for full 6 weeks. She became ill after stopping & had to be put back on for another 2 wks. only to slip again so was put on for 3 wks. and then another 2 wks. During this time we also used Probiotics – nov 12 a 2wk trial of florentero & dec 29 trial of daily 4strain probiotic capsules with ok results. Off tylon since Feb 17 & now on daily Florentero since Feb 18+rexall 4strain Probiotic capsule as needed.
To say its been a roller coaster ride would be an understatement when I look back on all she has been thru. So many ups & downs & setbacks & other issues complicating things.
Now today 8-1/2 months later it has finally become ‘routine’ –3 meals a day with a occasional ‘Mighty wolf” liver treats & moose marrow bone right after a meal to chew on for awhile.
She still has few “issues” when she eats something ‘stupid’ but with extra dose of probiotics she gets thru it.
She was at low of 16.4kg(36lb) and now is at 23.1(50.8lb) her goal weight is/was 23.0 kgs
Maezi is a female Australian cattle dog (blue Heeler) from BC Canada born may 11-2010
Hope’s story… her journey
She was posted by Ft. Worth Animal shelter as an abused boxer that was extremely emaciated and was taken from her owners due to abuse. The owners claim she was 10 years old. Yes, she was a Boxer. I picked her up after seeing her pictures on February 24th and took her straight to the vet. She weighed in at 19 pounds!! She was a petite girl for a Boxer, but she should have weighed at least a good 40 pounds!! They kept her over night. Did an exam and found out that she had a skin tumor, she wasn’t spayed and had heart worms. The vet sent her home with me the next day and said she just had to put on weight before we could try to treat her for anything. So I set out thinking she was just a starving dog. What did I know? The poor thing devoured anything and everything I set in front of her. Still, after a few days….no change in her weight. We kept trying. I even made Satin Balls to try to “fatten” her up. After about 10 days and no changes, I really noticed that she was “pooping” everything out as fast as it went into her. We took her back into the vet and they kept her overnight again to run some tests on her.
The tests came back positive for EPI. I unfortunately do not remember her numbers. They put her on enzymes, and I started to research everything I could about EPI. The vets just didn’t have very much information on it. I found a help group for EPI and joined and sent out an urgent plea for advice and any help and encouraging words. Everyone was very helpful and this group had some of the best information compiled in one place about EPI.
Hope — emaciated from EPI
I put her on a good EPI correct diet and gave her enzymes with each meal.
She was a happy girl. She had the classic “wiggle butt” that all Boxers tend to have. She was my shadow. She was MY girl. She loved me and I loved her. One of her favorite things to do was curl up on my back whenever I lay down on the couch to watch TV .
She also liked to play with our other female Boxer in the sprinklers. They had a great time together. My other female even taught her how to hunt down lizards in the flower beds next to the house. They were an awesome pair.
Hope became my dog after a visit to the vet’s one day when they determined that she would not be adoptable. I talked to the vet and asked if she was in pain or suffering, if she could live out her life in a happy home. They agreed that as long as she was not in pain that she could have a somewhat “quality” life. For how long….no one would know. So…I took her home and “adopted” her. I was going to make sure she knew love and was happy for how ever many days she had left.
Hope started to not feel too well early August last year. I had plans to take her to the vet. The night before she could hardly walk. I had to pick her up and take her outside to go potty and help her get drinks. I slept on the couch and she on her doggie bed right next to me on the floor. I got up several times during the night. One time she had made it over to the window to look out. I brought her back to her bed. When I woke up around 5:30 am to check on her….I found her almost by the back door. She was gone. It really broke my heart.
Thanks for wanting to use Hope’s story in your website. Her life touched mine so deeply and if just seeing her shocking pictures can get the attention of people and make them aware of EPI, then her life was a very full one.
Jodi from Texas
Buddy’s the dog with SID/SIBO but no EPI!
Primary SIBO – Journey to a Healthy Lifestyle
A Story of Our Golden Retriever, Buddy Chosen Friend
Horse, Horse, Zebra, Horse
Buddy presented with diarrhea from the moment we brought him home from a reputable breeder. He was treated for Giardia twice (no other indication of any abnormality). Our vet ordered a highly digestible, low fat, low residue food, but surprisingly to no real avail. We went through several more courses of Flagyl. All follow-up stool specs, along with a complete diarrhea panel were negative (horse). The breeder assured us that no other littermates exhibited these symptoms (horse). All the while negative tests were indicating “horse”, the mom inside of me was screaming, “ZEBRA!!” Because Buddy periodically responded to new probiotics (e.g. ProstoraMax), our vet wanted to take a wait and see attitude, assuring us that Buddy and would most likely grow out of his sensitive stomach by the time he reached 8-10 months of age. At 14 mos, Buddy blew his coat (mid-winter) and dropped to 69 pounds, during another siege of diarrhea. Back on FlagylL While searching the net, I happened upon Epi4dogs. This website was a God-send to me; it gave me a quick, but thorough education on doggy diarrhea (enough to write a thesis!). We discussed with our vet the possibility of Buddy having Epi (Exocrine Pancreatic Insufficiency), a disorder that in the past was predominantly found in GSDs (German Shepherd dogs). Epi is always accompanied by SIBO (small intestinal bacterial overgrowth), [now referred to as SID – small intestinal dysbiosis], leading to diarrhea. In addition, Buddy had blood drawn for B12 and folate levels, along with a complete blood count and full chemistry screen. Buddy tested negative for Epi, and the B12 / folate results were within normal range, but the vet was now convinced Buddy had SIBO. One of our trainers recommended the use of Tylan Powder (a low grade antibiotic that is used in farm animals and is specific to the gut). Tylan can be used in ARD (antibiotic responsive diarrhea) in dogs and does not have the neuro side effects sometimes seen in dogs being treated with long-term Flagyl. Our vet ordered the Tylan, along with VSL-3, a new (refrigerated) probiotic developed for humans with IBS. Buddy is currently being maintained with Tylan powder twice/day (6am and 6pm with his food). Buddy is also receiving two different probiotics: Probiotic Miracle at 12noon and one capsule of VSL-3 at 10pm.
This was the first part of the journey to help Buddy live a normal life.
The second part of the journey begins with:
- Maintenance & prevention,
- Careful observation & immediate intervention at the first sign of trouble.
The goal: to avoid a worsening of infection indicated by adverse physiological signs
(e.g. diarrhea, weight loss, abnormal respirations), along with signs of pain/discomfort.
1. Maintenance & prevention:
- We use a low-fat, low residue diet. Buddy has been on Natural Balance LID (limited ingredient diet) Lamb & Brown Rice dry food for over a year now. He did not do well with chicken; therefore, this worked better than the IAMs veterinary formula. He was also allergic to the Natural Balance Fish (developed cough). NO TABLE SCRAPS. We use his dry food for treats during lessons, but we rarely treat at other times because it is better to give the digestive system a chance to empty between meals (less opportunity for bacteria to proliferate).
- We try to keep outside areas clean, especially from other dogs/animals and changed our other dog to the same food as above, esp. to avoid any change in Buddy’s diet d/t coprophagia (eating poo).
- Buddy is a hunter (moles, mice…); therefore, we use Sentinel Spectrum in order to prevent a recurrence of tapeworms and the need for heavier duty antibiotics.
- We try to stick to a schedule (just like a baby) both for feeding times and “normal” daily activities. We also try to be aware of over-excitement from company. If he gets too excited or if he is “on duty” with strangers (e.g. servicemen) and not taking his usual afternoon nap, he may show signs of softer stool the following day. In winter, we limit playing in the snow to brief periods, reducing over-eating of snow.
- One of the most useful hints is to soak the dry food for 10 to 15 minutes in warm water so it is more easily and more quickly digested, thus reducing the time it is in the portion of the gut where adverse bacteria multiply.
2. Careful observation & immediate intervention at the first sign of trouble:
- First indications of impending problem:
- Whorls become more noticeable (prominent parting of fur)
- Lack of endurance
- Increased “recovery time” after play (excessive panting 20-30 minutes)
- Increased shedding
- Additional symptoms to those listed above, requiring close observation and treatment:*
- Increased thirst
- Passage of very foul flatulence (could clear a room!)
- Partly loose stool (firm ending with softer stool)
- More aggressive play
*At this point, we use Endosorb, an, OTC (over-the-counter) medication that helps absorb toxins in the gut. For our 80 lb dog, we start with 2 tabs twice/day for 3-5 days, depending upon the stool, then we titrate down to 1 tab twice a day for 3 days, then 1 tab once a day for 2 days.
Always check with your vet before giving any medication.
- Symptoms requiring the addition of Flagyl**
- Large, frequent amounts of light-colored “pudding” (no form) and/or liquid diarrhea
- Tenesmus (straining at end of a bowel movement)
- Arching of back upon rising from sleep (due to pain)
- Moaning upon laying down (due to pain)
- “Prayer” position (folding his front paws underneath him)
- Bloodshot eyes
- Reduced salivation (noticed this difference in Pavlov from former dog)
**For Buddy, we begin with 500mg Flagyl twice/day for 3-5 days, depending upon the stool, then 250mg twice/day for 3 days, then 250mg once/day for 2 days (for a total of 7-10 days). Although we initially add the Endosorb, we stop it after 2-3 days once on Flagyl and the stool becomes firm again.
[There are reports of keeping dogs on long-term, low-dose Flagyl, but I prefer to use the Tylan that is specific to the gut and save the Flagyl for flare-ups. Dogs can live normal lives on Tylan and it is relatively inexpensive and has good expiration dating. Because Tylan powder has a bad taste, the best way to administer is to encapsulate it at home. It does not need to be refrigerated. You can make 200-500 capsules at a time and save in a cool place (we keep it next to the wine!).]
At 2 ½ years old, Buddy is now an, 85-pound, well-toned dog. He is also is a Canines4Christ Therapy Dog, exhibiting an extremely gentle disposition with patients. He is basically living a normal life; setbacks happen less frequently and less severely, as we stick to the above plan of prevention and treatment.
Side note: If you were wondering how he got his name, ‘Buddy Chosen Friend’. It came from a song about John 17, where Christ asks His Father to take care of His chosen friends. We didn’t choose Buddy, he chose us. We believe that God had a hand in Buddy choosing us, because Our Good Lord knew we would do our best to take care of Buddy and therefore enable him to bring God’s love to others through the C4C Therapy Dog program.