newly diagnosed- super hungry dog

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.
chrisPC
Member
Posts: 7
Location: Port Clinton
Country: United States
State: Ohio
Pet name: Layla
My name: chris

newly diagnosed- super hungry dog

Post by chrisPC » 05 Mar 2023, 20:53

Hello,
My golden doodle Layla was diagnosed with EPI last week. TLI lab value 2.1
I am following advice from this forum and am so appreciative! We live in a small town, and my vet office told me they only have experience with one cat in the practice having EPI. It's only been a few days, but my first question is how to deal with her being voraciously hungry. Her dog food is PUrina pro plan sensitve skin and stomach Salmon. I am feeding 2 cups 4 times per day, and even at that, she is barking and begging for more, often demanding a late night feeding when we are already in bed. She sometimes wants more just 1 to 2 hours after the previous feeding.
Should Slippery Elm be given once daily, or with every feeding?
I am using Pancreaplus tablets from my vet until my Enzyme Diane order arrives. Should the tablets be crushed?
With all of these feedings, she is obviously pooping a lot, mostly a 6 on the poop scale, and that often occurs in the middle of the night also. I know I have to be patient but am so desperate for some improvement.
any advice would be much appreciated.

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jilbert57
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Posts: 2095
Country: United States
State: Washington

Re: newly diagnosed- super hungry dog

Post by jilbert57 » 05 Mar 2023, 22:18

Hi Chris ,
you are correct the enzyme tablets must be crushed, added to the food with a little room temperature water, stir and incubate 15 to 20min. Use at least 2 tablets plus 1 tablet for the bowl PER CUP OF FOOD. So 6 tablets per 2 cups of kibble crushed and incubated on each meal. Do this each meal for a few days and see if it helps.
We usually recommend a grain free diet(grains interfere with enzyme activity) with a fiber content of 4%or less avoiding peas, lentils, legumes if possible.
What is the B12 test result?

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

Mickey and his pancreatitis brought me to Epi4dogs.com 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.

chrisPC
Member
Posts: 7
Location: Port Clinton
Country: United States
State: Ohio
Pet name: Layla
My name: chris

Re: newly diagnosed- super hungry dog

Post by chrisPC » 06 Mar 2023, 08:24

I just got Laylas B12 and folate results. Her B12 is 198, folate 19.5
I’ve already started her on Wonder labs Pet factor B12, giving her two 1000mcg capsules, opened and sprinkled in her food once daily
Is Slippery Elm given once daily or on each meal?
Her food is 4'% fiber

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jilbert57
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Posts: 2095
Country: United States
State: Washington

Re: newly diagnosed- super hungry dog

Post by jilbert57 » 06 Mar 2023, 09:21

Ok good on supplementing the B12 as 198 is quite low. TAMU reference range for B12 and Folate:
SERUM COBALAMIN (VITAMIN B12) AND FOLATE
REFERENCE INTERVAL
Cobalamin Folate
Canine 251 – 908 ng/L 7.7 – 24.4 µg/L
Feline 290 – 1,500 ng/L 9.7 – 21.6 µg/L

I gave SE twice a day am and pm.

Please be aware that the ProPlan Salmon contains both rice and barley. So if after you have implemented the EPI protocol (enzymes, addressed SID/SIBO, B12 up in upper range and grain free diet) things don't come together I would look at the diet.

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

Mickey and his pancreatitis brought me to Epi4dogs.com 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.

chrisPC
Member
Posts: 7
Location: Port Clinton
Country: United States
State: Ohio
Pet name: Layla
My name: chris

Re: newly diagnosed- super hungry dog

Post by chrisPC » 13 Apr 2023, 08:06

I started treatment for Layla about 6 weeks ago and we have been stable for about one month.
A few questions:
Should I back off on slippery elm? She is getting 1/2 tsp bid in her food. I read it can interfere with nutrient absorption when given with food? Should I not be giving with food?
What is the recommendation for vaccines? To give or not to give? And why
What about heart worm protection and flea and tick 3 month pills?
Should I slowly try to decrease her enzymes? And by how much?

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jilbert57
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Posts: 2095
Country: United States
State: Washington

Re: newly diagnosed- super hungry dog

Post by jilbert57 » 13 Apr 2023, 09:38

Hi Chris, good to hear Layla has stabilized.

Are you still using enzyme tablets or did you switch over to Dianes?

How much enzyme are you using per meal/cup of food?

Is Layla at the weight that is best for her?

Are her poops consistently good?

There are a lot of members here and everyone has their own thoughts on heartworm, flea and tick meds and vaccinations. Rabies shots differ from state to state. I have gone to titering for the DHLPP shot as research points to immunity being good for 7 years, possibly life. I titer every 3 years. Rabies (mercury free) we do once every 3 years and I give milk thistle daily for a week after.

As far as heartworm, flea and tick I have gone to natural preventatives as my one aussie had a reaction that coincided with application of spot on. There are great FB sites I can recommend if you want to brush up on these things.

Personally I would not tweak with anything in the diet if all is going great. As far as the slippery elm that is up to you. About the only way to see if it is needed is to stop it and if the poop goes south it's probably needed. You can mix the dose of SE with some warm water, let thicken and feed about half to 1 hr before eating.

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

Mickey and his pancreatitis brought me to Epi4dogs.com 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.

chrisPC
Member
Posts: 7
Location: Port Clinton
Country: United States
State: Ohio
Pet name: Layla
My name: chris

Re: newly diagnosed- super hungry dog

Post by chrisPC » 13 Apr 2023, 11:17

I am using enzyme Diane 6x powder. 1tsp/cup of food. Layla is a a good weight. 60# at last check. She is a golden doodle but her build is very poodle so i think that’s good for her. Maybe a couple more pounds wouldn’t hurt.
So slippery elm should not be With her food?
Do most vets readily do titers instead of vaccines?
What is the thinking and science on why EPI dogs shouldn’t get vaccines and parasite preventatives?
How do owners deal with groomers, pet boarding, etc when vaccines aren’t current?
Her poop has been very good until she at some sticks or something outside two days ago. Now a bit soft with mucous coating.
Why milk thistle after a rabies vaccine? I guess I’m not understanding why EPI dogs are different in the vaccine preventative realm.

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jilbert57
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Posts: 2095
Country: United States
State: Washington

Re: newly diagnosed- super hungry dog

Post by jilbert57 » 13 Apr 2023, 11:56

Ok first let me back up. I am talking about dogs in general, not JUST EPI dogs but ALSO EPI dogs, pancreatitis, ibd, cancer, EVERYONE.
That was my mistake in answering you, sorry.
In dogs already compromised like Mickey with pancreatitis, I felt it more so to do the titers than just vaccinating since he was protected. Does that make sense? And we travel on a boat to and from Canada so they need their Rabies. I had to ask for the blood titer specifically. Most vets are along the line of vaccinate not titer in my findings.

No I am saying if you are worried about absorption in the SE give it premeal. I mixed it with my pups food and had no problem with absorption.

EPI dogs should keep right on getting vaccinations, heartworm and flea and tick meds if you are along those lines of thinking. If it is a chewable beef or the likes please give after an enzymed meal. Also you might stagger the two meds so you don't overload their system. The 3 month pill seems a little riskier to me because they take it all at once.

I don't see a reason to vax my dogs if they still have antibodies from 3 yrs previous vax. But not everyone feels this way. :D

Milk thistle after vax's help clear the liver. My personal preference.

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

Mickey and his pancreatitis brought me to Epi4dogs.com 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.

Barb
Staff
Posts: 918
Country: United States
State: New Jersey

Re: newly diagnosed- super hungry dog

Post by Barb » 14 Apr 2023, 16:44

Hi Chris,

Congratulations on getting Layla stabilized. You did a great job.

With regard to vaccinations, we asked our vet to do titers with Kolby because he reacted to everything it seemed. Once he had his first vaccinations, when we did the subsequent blood tests in the years following, he kept his immunity for his entire life. We figured at some point he would have to be re-vaccinated, but he kept his immunity for 11 years. We did have to give a rabies vaccine every 3 years as our state requires, but he did not need to be vaccinated for anything else. This meant that he was safe to be around other dogs also. We were quite surprised, but glad we did not over vaccinate.

Barb

chrisPC
Member
Posts: 7
Location: Port Clinton
Country: United States
State: Ohio
Pet name: Layla
My name: chris

Retesting B12 and maintenance dose

Post by chrisPC » 15 Aug 2023, 14:24

4 months after diagnosis I asked my vet to recheck Laylas B12 and folate.
She was taking two wonderlabs pet factor B12 daily.
Her B12 was 98 on 3-3-23. Folate 19.5

Retesting was done 7-1-23
B12 >2000. Folate 16.3.

Two things to note here. My vet said Layla had to fast 8-12 hours for this test and did not tell me to stop the supplement for any length of time before hand. I have read here that it should have been stopped for at least a week
This test is very expensive!.

So from my interpretation, she is probably getting enough B12. (Supranormal result). And folate is normal.

Can I drop her to one B12 capsule daily? Vet says “oh you can just keep it the same”. I know kidneys will excrete extra but why over dose?
I am So frustrated with Vet who seems to know less than I do about EPI.
THANK GOODNESS FOR THIS GROUP.

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