Newbie 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.
Posts: 3
Country: United States
State: Illinois
Pet name: Thunder
My name: Meredith

Newbie to EPI

Post by Thundersmom » 14 May 2022, 08:58

Hello and thank you for this forum.

I am currently at the beginning of what might possibly be an EPI journey with my 17 month old Belgian Shepherd.
We've been battling weight and diarrhea for months and I finally found a vet to listen to my concerns (previous vet diagnosed him with anxiety and suggested CBD oil to calm him down).

After learning about EPI, and reading article after article and finding this forum, I feel both relieved that I might have an answer as to why my little guy is failing to thrive but also so broken hearted that he has been slowly starving and no one believed me when I asked about his weight and eating and eliminating habits.

Thunder is currently on an antibiotic, a steroid, and a probiotic. Once he finishes this course of treatment, he'll go to the vet for an overnight to fast and then be tested for EPI.

I have so many questions about why, what to do, what not to do. My emotions are erratic. This is my first dog - the two other dogs we had technically belonged to our children but I inherited my son's dog when he left for college- and is supposed to be my empty nest companion and adventure partner. I feel like I've failed him on so many levels.

I'm heartbroken for both of us. We just lost our other canine companion (5 weeks ago) and we are still mourning the loss of him. The other dog was 15yo and Thunder came into our lives and gave the Old Man a new vim and vigor and helped make his final year more joyful. It was actually the passing of the other dog that triggered a 4 pound weight loss in Thunder. That was a big weight loss (10%) for an already underweight dog and not just due to mourning. I cannot believe that I am back at the vet for repeat visits, tests, and medications. I expected that with a 15yo but not my young dog.

I am angry with the breeder even though I know they probably couldn't have done anything to prevent it. I'm angry with the previous vet who didn't believe me.

I am worried that I don't have it in me to do this. It might be residual mourning but all I want to do is cry.

I haven't told anyone about the possible EPI because I know the advice I will get is to euthanize him. I can't even think about that yet but when I look at him and he is so thin and his ribs and spine are all you can feel when you pet him...I just wonder how this will all turn out.

The pic is from a few months ago when he was still healthy. He doesn't look like that anymore.
Thunder 1.jpg
Thunder 1.jpg (12.38 KiB) Viewed 312 times
Last edited by Thundersmom on 14 May 2022, 09:21, edited 1 time in total.

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Posts: 4
Country: Canada
Pet name: Chase
My name: Diana

Re: Newbie to EPI

Post by Obie426 » 14 May 2022, 09:11

Hi Meredith

Please do not despair. Your post touched me as your worry was what I was feeling before Chase was diagnosed in January. I was watching him waste away before my eyes and I honestly thought we would lose him. I found this site and it has been a sanity saver. I actually knew what was wrong before he was tested for EPI. Once he was on the enzymes and weekly B12 shots, at the beginning, he immediately started to gain weight. He is back to his optimal weight and I actually had to cut back on his food as he was soon going to be part of the chunky monkey club. The advise you will get from the wonderful people here will make the journey easier to bare. Hang in there. If this is EPI, you and you new companion can have a long and happy journey together

Posts: 3
Country: United States
State: Illinois
Pet name: Thunder
My name: Meredith

Re: Newbie to EPI

Post by Thundersmom » 14 May 2022, 09:26

@Obie426 - Thank you for your kind words.

Your little guy is adorable and I'm rejoicing with you that he is doing well.

I am hoping for a quick test and rapid results so we at least know what we're dealing with.

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Posts: 1490
Country: United States
State: Washington

Re: Newbie to EPI

Post by jilbert57 » 14 May 2022, 09:30

Hi Meredith and welcome to you and Thunder. He is handsome!
First off I am so sorry you lost your other pup. That is hard on everyone.
It will be good to have the cTli test done for a definitive diagnosis. Please have B12 and Folate tested also. There are are a few conditions that share some symptoms so it will be good to know.
There are some cornerstones of Epi that need to be met to set a pup straight such as Enzymes, Diet Antibiotic and B12 supplement. If one is off the whole thing is off!
What antibiotic is being used?

My name is Jill and we live on the Hood Canal in Washington State. We currently have 2 Jack russells, TJ is 6 and Sadie is 8months.

Mickey and his pancreatitis brought me to site in 2012 to help manage it.
He lived from 6/99 - 8/2014

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.

Posts: 3
Country: United States
State: Illinois
Pet name: Thunder
My name: Meredith

Re: Newbie to EPI

Post by Thundersmom » 14 May 2022, 09:51

His current meds are: Prednisone, Proviable DC, and Metronidazole.
Prior to that he was on Clomicalm, CBD oil, and Sucralfate. The vet believed the anxiety was causing an ulcer. I think the vet saw the EPI symptoms but attributed them to anxiety and not possible EPI. New vet dc'd the Clomicalm, CBD, and Sucralfate while we treat with the new meds and wait for the EPI testing. She was uncertain whether or not he has to finish the course of antibiotics before fasting for the EPI test.

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Posts: 2502
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Newbie to EPI

Post by Olesia711 » 14 May 2022, 12:54

Hi Meredith and a VERY a very warm welcome to you and THunder.

As Jill suggested, the first thing you want to do is get the cTLI blood test done.... which you are already planning to do. Just do NOT give any food for 12 hours prior to the blood being drawn for the TLI.
ALso.... while the blood is being drawn for the TLI... tell the vet you also want a Cobalamin blood test done simultaneously which will let you know where the B12 levels are at. This will be helpful no matter what "gastro" condition your dog might have. THey will also test the folate which is now deemed useless regarding EPI ... UNLESS the folate score is dramatically high.. they used to use high Folate to indicate that an EPI dogs has SID/SIBO.... but have since discovered that ALL dogs with EPI have SID.... no matter what the score is... BUT if your dog does NOT have EPI then a high Folate score is indicative of SID/SIBO and a low Folate score is indicative of small distal proximal disease (this often is a food sensitivity... kind of like IBD).

SO........if your dog does have EPI... please don't be discouraged....cause if your dog has EPI , once you find the right balance of the recommended EPI protocol and this entails:

1. Enzymes
2. Diet
3. B12 if Needed
4. SID addressed if out of control

ONce this is achieved (and we can help you with this) your dog WILL blossom, and live as long as any other dog without EPI and will be able to do anything ANY other healthy dog can do.... please check out the Before and after video on our home page to visually see what i am referring to!

Also.... for reasons unknown.....many of the EPI dogs, once recovered back to well managed health, become that extra-special once in a life time dog. Again, not all but, many MANY EPI pet pers and owners go on to develop an extraordinary bond.

Many of these dogs look like they are at deaths door, before EPI diagnosis and treatment.... and afterwards the transformation is AMAZING.....

SO please, do not lose hope.

Oh... and NO your vet does not need to stop anything EXCEPT do NOT give ANY B12 (no B12 shots for 1 month... and no B12 pills for a week) prior to have the Cobalamin (B12) blood test.

REgarding the TLI test.... nothing needs to be stopped... HOWEVER.... PLEASE let your vet know that if this turns out to be EPI or some other gastro intestinal condition.... STOP THE METRONIDAZOLE! Cause it kills ALL gut flora bacteria ... and some strains will never come back no matter how many probiotics you give afterwards............. but if an antibiotic is needed (for any chronic gastro condition) .... then have your vet prescribe Tylan (Tylosin Tartrate soluble powder- twice a day). ... Tylan is a macrolide antibiotic and does NOT kill all the bacteria but hinders reproduction.... so it is safer... at least .

Keep us posted on the testing and if EPI, we can help you going forward!
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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Posts: 213
Country: Canada
Pet name: Montgomery (I'm a CAT!)
My name: V

Re: Newbie to EPI

Post by Montgomery » 14 May 2022, 20:01

Everyone told me to put Montgomery down, too, for years. Looking into his big yellow eyes told me he wanted to be here, and we did get through it. I wonder if they would be so cold if it was their family member who was so ill.
Sometimes it gets worse before it gets better. Sometimes it's a lot of trial and error. Sometimes the mess and the smell is truly awesome. Hang in there. You guys'll get there.
Montgomery was born 20 March 2012. He eats extra lean ground chicken completed with Alnutrin and freeze-dried chicken liver, with hard-cooked egg. He gets two size zero capsules of Enzyme Diane's enzymes at each of his six meals, and one size four capsule of Tylan three times a day. He's a strong, fearless little Spitfire with a real Merlin engine.

Tuckaboo Pam
Posts: 1086
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: Newbie to EPI

Post by Tuckaboo Pam » 15 May 2022, 09:26

Oh, Meredith, please hear this with my voice being kind & nurturing, not judgy & condescending--- c a l m d o w n "heart". You can do this.

You're gonna get him tested, and then you will figure it out, with the help from hundreds, if not thousands of us who have also been in your shoes.

If someone tells you to put Thunder to sleep, run for the hills, because EPI is very manageable, usually with tweaking for your own individual dog. My vet told me all kinds of reasons why Tucker had every single symptom, non of the reasons were EPI, then when we got him on the right course he gained 25 pounds. Took a little time, but it was miraculous, really.

I won't lie, sometimes I wish I could just scoop some kibble into his dish at meal time, and I think about the added expense of the supplements, but it has all worked out, and he is worth every penny & every minute of my time.

I am so sorry you lost your older pup, but how wonderful Thunder was able to give him a year of youthful energy before he passed.

I don't know what the staff has said, but I think if I were you, I'd start looking into EPI diet & get that started. Many of us feed Sport Dog Elite for Herding dogs, as it fits all the requirements. A more economical choice is Taste of the Wild Pacific Stream. You could begin transitioning, and get that out of the way. (if I'm wrong, someone will say so)

Keep us posted about what you're doing. You have definitely come to the best place in the world, if Thunder ends up having EPI.

Take Care---Pam
Tucker is a shepherd/lab mix; he has tested positive on the ScheBo test for EPI, as well as the fasting TLI. Results--- TLI 1.3, Folate 9.7, Cobalamin 666, Lipase 38. Currently taking Diane's Enzymes 4 teaspoons/day, Wonderlabs B12 one capsule per day, two capsules slippery elm/evening, 1 Proviable capsule/day, and Tylan 1/32 teaspoon/ morning (to hold SID at bay). Sport Dog Elite, herding dogs 4 cups/day. No more poop eating, has gone from 60 to 80 pounds, and he is a happy member of the family, though a bit of a stinker, if you ask the other dogs. Tucker is my boyfriend, and my husband is OK with that.

Posts: 778
Country: United States
State: New Jersey

Re: Newbie to EPI

Post by Barb » 15 May 2022, 13:56

Hello, Meredith. A warm welcome to you and Thunder. So many of us have been where you are. Once you have a correct diagnosis, you will be able to proceed with confidence. If it is EPI , there are many people here to let you know that it is manageable and our dogs thrived and/or are thriving while they are being treated. Our Kolby lived for 11 years until he developed an aggressive form of cancer which was unrelated to EPI. There are many similar stories here. Try not to lose hope. You are on the right track and moving forward. Getting the correct diagnosis is the first step.

Let us know Thunder's test results.


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Forum Director
Posts: 1520
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: Newbie to EPI

Post by Jean » 16 May 2022, 06:33

Good morning from the UK

Firstly you are not to blame for anything, you took him to a professional for an opinion and diagnosis

My Kara was 39 pounds at 14 months old at her worst, and the vets notes said massively emaciated, cried all the way home, and for God knows how long after, the song "cry me a river " comes to mind big time

I wonder, can you tell us what are you feeding ?

the big thing is patience, and I had none, Kara taught me patience

you do not need to share things with people who do not have empathy, we are here and have been there over the years, my best friend said the same to me, and I asked my vet was I going to lose her , his answer was "not on my watch you are not" the young vet who saw her first wouldnt have it saying she was too young, I had had a cat with EPI and you never forget the smell of the poo, so I insisted on the test, and he rang back full pof apologies when the resuly was positive,

remember, its your dog and your money

anyway good luck give yourself a huge hug

My name is Jean we live in Liverpool in Uk

I am the Forum Director which I am very proud of

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


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