EPI Diagnosed…diets and moods?

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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Milly
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Country: United Kingdom - England
Pet name: Wilf
My name: Milly

EPI Diagnosed…diets and moods?

Post by Milly » 12 Mar 2023, 18:35

Hello everyone, Firstly I can’t tell you how grateful we are for this forum 👏 and the thorough advice which I’ve applied as our beautiful 2yr old Border Collie has been diagnosed with EPI (two blood tests confirmed).
Sadly our vets practice isn’t very experienced with this condition, each vet seemingly having their own approach that doesn’t/didn’t appear to be aligned with the advice here. Every EPI dog owner knows how stressful it is watching your bestie suffering, weight loss, lethargy and awful puddle poops and all you can do is research here attempting to educate/persuade vets that you do know something of the condition but then when your met with quizzical gazes and counter advice and all the time the weight keeps falling off and you’re left helpless!!!
Our BC should be 20Kg, his lowest weight was 14.3Kg but after using Protexin pro-enzorb enzymes and Arden Grange Sensitive senior/light kibble (grain free/hypoallergenic)70grms and Partners wet food 40grms - white fish and potato his weight has very gradually increased now at 16.3Kg, taken 3 months which is concerning as I don’t know how long should it take for weight to increase?
Last advice from the nutritional vet was overfeed until his 20Kg goal is reached, we overfeed 150% he poops x5 a day scoring 1-2.
The food is good quality but he still has a rumbling tummy at night and gets very tired he looks so sad sometimes it’s really upsetting, he’s by no means the BC he used to be!
Not sure if we should keep going with his food, tried other diets (Purina science combo which was disastrous/cold pressed didn’t suit either) can’t tolerate more than 12% fat. I’ve got Millie’s Wolf Heart Highland mix on standby but anxious it might cause a setback transitioning to another food causing weight loss. Is it best to stay on the AG or not, worried he’s not getting enough energy from the food so maybe a more meaty kibble would be better (MWH highland is 8.5 % fat comprising duck and wild boar highly digestible).
As an aside, we had a scan done looking for signs of IBS nothing found and the pancreas looked well despite his EPI - phew!!!

Last bloods showed:

Low *Trypsin-like Immuno-reactivity 1.9
Low RBC 5.08
Low Haematocrit 0.382
Low Haemoglobin 12.9

*Cobalamin (B-12) >1000.0 - Supplemented in the Protexin Enzymes 1mg per capsule.
*Folate : 9.5

I asked if the anaemia may be slowing his progress and if he needs a supplement and was told no. What do you think?
Will his energy levels ever increase if he gets back to 20Kg or will he always tire easily due to EPI?
He loves his walks and zoomies in the fields chasing his toys, get glimpses of how he used to be.
Should I stick with the AG food or transition to MWH?
I supplement Purina Fortiflora and multivitamins and Slippery elm…trying really hard here to get it right but when I see my boy asleep for most of the day, can’t help but think there must be more we can do?
He’s ravenous and his personality has changed, less tolerance and more anxiety/reactive, booked a behaviourist to help.
Thanks for taking the time to read my post any experience and advice most welcome, thanks again - Milly

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

Re: EPI Diagnosed…diets and moods?

Post by Montgomery » 12 Mar 2023, 20:11

I can only speak from personal experience. It was a long haul getting Montgomery diagnosed in the first place, and getting him stable after the fact was a journey. I won't bore you with all the details, but I will tell you this. If there is a good naturopath in your area, go. I think it saved our little furball. He was able to help us find the exact right diet, and Montgomery went from a skinny six pound string bean to a fierce nine pound spitfire in a year. He was also able to come off the medication that was keeping the gas from building up in his small intestine because he is now on an appropriate diet. I cook for him. It works. Secondly, we did red light therapy, which worked wonders on the inflammation in his gut. We also used this on his frienemy, Mary, who has IBD, and it worked beautifully on her. Once we weaned him off his previous diet and onto the new one, improvement was rapid. I am now the proud human of a soon to be eleven year old kitten. I am currently sitting beside a pile of shredded cardboard, catnip, marbles, and sticky wandy toys to prove it.
Don't give up. Write everything down. Keep a journal. Write down questions. If your veterinarian is a good veterinarian, they will help you, even inf they have to call around for advice.
Montgomery was born 20 March 2012. He eats extra lean ground chicken, lean ground pork and lean ground beef 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 a size four capsule of Tylan three times a day. He's a fierce little Spitfire with a roaring Merlin engine.

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Olesia711
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Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: EPI Diagnosed…diets and moods?

Post by Olesia711 » 13 Mar 2023, 00:37

HI Milly,

I am so sorry that your pet is going thru this. Personally i would get a second opinion.... ASAP ...because of the anemia situation.
Did you vet examine your dog further to determine WHY your dog is anemic??? This is very important...and knowing the cause of the anemia may also be part of an answer to your question about lack of weight gain... or not.... it may depend on the cause.

Regarding feeding 150% to an EPI dog, that is actually recommended.... BUT.... when doing this you need to feed smaller portions and in doing so, feed more meals throughout the day. And of course each meal needs to be treated with enzymes. Are you feeding 3 to 4 meals daily at 150% ?

To answer your question " but after using Protexin pro-enzorb enzymes and Arden Grange Sensitive senior/light kibble (grain free/hypoallergenic)70grms and Partners wet food 40grms - white fish and potato his weight has very gradually increased now at 16.3Kg, taken 3 months which is concerning as I don’t know how long should it take for weight to increase?" it can take anywhere from a few weeks to a few years for an EPI dog to put on weight.

regarding "so maybe a more meaty kibble would be better " ... i don't think i would try a different food at this time but rather maybe try adding your own home-cooked meat that your dog can tolerate ....so you can better control the diet and provide more nutrition. If your dog can tolerate dairy products, another thing you can try giving is low fat cottage cheese (since too much fat appears to be troublesome....)

regarding "The food is good quality but he still has a rumbling tummy at night and gets very tired he looks so sad sometimes it’s really upsetting, he’s by no means the BC he used to be!"... since you already are using a probiotic and supplements..... my strong suggestion at this time is to talk to this vet or another vet and tell them you want a course of TYlan (Tylosin tartrate antibiotic) for 45 days, twice a day... here is the dosing recommendation:
https://epi4dogs.com/antibiotics/
It sounds like there is a lot of SID (SIBO) going on and it has not been responding to the probiotic.... time to do antibiotics... Just do NOT let the vet prescribe Metronidazole (flagyl)

Just wondering... the B12 is high and yet the HCT is low.... when your dog urinates... see if you can capture some of the urine and check to see if it is rusty (brown-orange colored)... if so, contact your vet right away and have them check for immune mediated hemolytic anemia...

Be sure to let your vet know what the supplements are that you are giving your dog .... so that there is not a conflict with meds or supplements.... as sometime this too can skew test results.
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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