Epi4Dogs

Hello everyone,

please share your experience with Creon 25000.
I started giving this med to my GSD yesterday (after months of using Almazyme Powder). After two meals with Creon 25000 yesterday I was happy to see that his stool firmed up. However after his meal this morning, he had diarrhea again.
For each meal I took 3 capsules, pulled them apart to get the powder/granules out and mixed it in with wet canned food and immediately fed it to my dog. Few minutes later I gave him a regular serving of Kibbles (2 cups). He also gets Probiotics and B12 daily.
Did you experience any "transitional period" with mixed results before the med delivered good results?
Is there anything in what I am doing that you would recommend to change?
Since he was diagnosed with EPI in December last year, I have been feeding him Hill's Z/D Prescription Diet (hydrolyzed protein).

Any advise would greatly appreciated.

Thank you,

Monika and Bugsy

Hi Monika and welcome to you and Bugsy,
Will you give us some background Information?

What were the test results of the Tli, and B12 and folate? Does the B12 supplement you give daily contain the Intrinsic Factor (IF)?

Was there an antibiotic given for tummy grumblings, excess gas and burping?

Usually people start out with a 10,000 Creon and adjust up. When you say you open 3 capsules are these 25,000 each so 75000 per meal?
Thank you for a little more information.

From our ENZYME tab:

"CREON (available world-wide!!!!)

CREON is enteric coated microspheres of enzymes encased in capsules. These capsules may be given whole or sprinkled on food if served immediately. Alternately, some people find that after giving Creon waiting for approximately 5 minutes before feeding is more effective. Every dog is different and experimentation is required to find the most effective method. Please note: if you are going to sprinkle the contents ensure that the dog eats the entire meal so that all of the Creon is ingested. If in doubt, give the capsule whole before trying the sprinkling method.

CREON is commonly used in many places outside the U.S. Existing CREON enzyme capsule products vary from region to region with not all strengths available in all regions. They can come in 5 , 6, 10, 12, 25, 40 strengths and new strengths approved as of 2009 of 6, 12, strengths are becoming more readily available mainly in the US. Because the enzymes in CREON is enteric coated- -the recommended enzyme potency to treat EPI is dramatically different from pancreatin powder or pills! When initially treating an EPI dog, it is recommended to start with CREON 12 or CREON 10 which has 10,000 USP of Lipase, 37,500 USP of Protease, 33,200 USP of Amylase. There is some latitude using Creon as its effectiveness is dependent on the dog’s pH level (you do not need to test for this) so getting the exact strength is not strictly necessary.

The CREON the potency measurement comparison is as follows:
CREON 10 Composition : 150 mg Pancreatin
Amylase 8,000 PhEur units (BP Units) also equals 33,400 USP units
Lipase 10,000 PhEur units (BP Units) also equals 10,000 USP units
Protease 600 Ph Eur units (BP units) also equal 37,500 USP units

CREON 25 Composition : 300 mg Pancreatin
Amylase 18,000 PhEur units (BP Units) also equals 74,700 USP units
Lipase 25,000 PhEur units (BP Units) also equals 25,000 USP units
Protease 1,000 Ph Eur units (BP units) also equal 62,500 USP units

SINCE CREON is a human EPI drug…PLEASE SCROLL TO THE BOTTOM OF THIS PAGE TO READ MORE ABOUT CREON AND “HOW-TO” ADMINISTER"

https://epi4dogs.com/enzyme-list/

Jill

75,000 CREON is too much...... start with just opening up 1 CREON 25. Prepare the food as you normally would. Make sure there is some moisture in the food so that when you open up the CREON capsule and sprinkle the little pellets on top of the food, the pellets have something to stick to.... and serve immediately. Do not mix in the food.

CREON will work, but it can be a lot of trial and error in the beginning when you first start using it.... but we can help you figure it out.

Do one CREON per meal and let us know how things go..........................

Thank you so much for your valuable input, Jill and Olesia!!!

To respond to Jill's questions - immediately after Bugsy was diagnosed with EPI (Dec 2022), they started him on antibiotics for two weeks. Also, he was receiving a shot of B12 every 3 days, total of 5 times. Right after that they switched him to B12 pills that people take.
In addition, from the time he was receiving Pangrol 20 000 tablets, 10 tablets in each meal. for a period of 3 months. There wasn't much benefit from this treatment, as he only gained 1 kg.
Then about 3 weeks ago, my vet suggested to try Almazyme powder. This change didn't bring any improvement either. After reading about Creon on FB, I tried to source it here in Czechia. They don't have the Pantenex available here, so I had to settle for the Creon, instead.

I have an update: last night I only used one capsule of the Creon 25 in his meal and he had not pooped until this morning. And good news(!), the poop was "nice" and firm.

Today I will pick up B12 shots from my vet and, once again, I will be giving him a shot once a week.

Thanks again!

Monika

Thanks for letting us know the poo was much better. this is good news and hopefully will continue without having to make too many more adjustments.

Thanks also for sharing the test results. You dog has low B12 and so close to clinical EPI, that i would say your dog has EPI.
But your dog is also leaning towards low protein levels.....and low albumin. keep an eye on these blood levels and have your vet retest these levels in 3 or 4 months.
Also.... be prepared .... your dog, as all dogs with EPI have SID (small intestinal dysbiosis).....often times, the enzymes work great for a few weeks, and then it seems the enzymes stopped working. In reality the enzymes are still working but what you are seeing is the results of SID.... we currently suggest treating with a prebiotic, and if that doesn't work, then treat with a pre+ probiotic... but if that fails after a few weeks.... THEN ask the vet to prescribe Tylan (Tylosin Tartrate antibiotic powder) to be given at meal times, twice a day, for 45 days...
https://epi4dogs.com/antibiotics/
OR... if your vet cannot get Tylan.... then ask for a 30 day course of Oxytet. (Oxytetracycline)


Hope this helps!

Thank you so much again, Olesia, for this valuable information!

How about if I start with a little update on his condition. Since the last report, Bugsy's stool has turned loose again,. The frequency of pooping went down from 4 times a day to only 2 times a day. As far as what he has been getting 2 cups of Hill's z/d (hydrolyzed protein)3 times a day, one capsule of Creon 25 with each meal, prebiotics in AM, B12 one pill in AM and PM and Vitamin E in AM.

Regarding the Hill's z/d food, I was wondering if switching to another brand could bring the protein level in his blood up, in your opinion.

Lastly, I have a question about the grain-free dog food, that many EPI dog owners seems to like. From your experience, are EPI dogs benefiting from it?

I really appreciate your help, as it has been keeping my spirits up on this emotional rollercoaster that I've been on.

Thanks,

Monika

Did the vet put your dog on Hydrolyzed food for a reason.... like possible food sensitivities? If so.. let's first try to work with this food and the CREON.... but if we can't get it to work as expected... then we suggest changing food.

Because this food is a little higher in fiber then what we think usually works well....... it might be part of the problem.... BUT... if your dog has food sensitivities, a little bit high in fiber is a lesser problem to deal with then a food sensitivities......

SOOOOoooooooo.......

1. Do you know if your dog has food sensitivities and that is why it is on this food??

2. Next.. are you giving the CREON capsule whole or are you sprinkling it on top of the food? I know i already told you not to mix the opened capsule in the food, but rather sprinkle on top of the food that has some moisture and then serve immediately... is this what you are doing?
If so.... then try this next:

Give the one CREON capsule sprinkled on just a tsp of wet food .... wait 3 to 4 minutes.... and then serve the rest of the meal..... do this for 1 to 2 days.... see if this improves things or not.

3. If this does not improve things.... THEN give 1+1/2 CREON capsule sprinkled on top of the wet food for 1 to 2 days..... see if this improves things or not.

4. Everything else you are doing "appears" to be fine for now..... however... i do have a question about the prebiotic... what is the name of the prebiotic that you are giving and how much are you giving. Prebiotics work and actually improve bad gut flora........ BUT... you have to be careful not to give too much cause they can then trigger loose stools...... so this "might" be another thing you will want to test if the above tests with CREON doesn't change anything...... in which case you might want to stop the prebiotic completely for a few days and see if that helps the poo firm up (which would mean your dog was getting too much prebiotics) or if the stools continue be loose or get worse (in which case, the loose stools had nothing to do with the prebiotic you are giving.......)

Also, in case i have not mentioned it yet.... start keeping a journal and recording EVERYTHING or else trying to keep track of all these "tests"/"trials" you will be doing will drive you nuts!

Thank you, Olesia!

When I took him to this vet in November to address the weight loss/diarrhea issues, the vet put him on Hill's i/d low fat diet. Then, when all the testing revealed that he had EPI, the vet switched his diet to Hill's z/d. I have to add that the vet admitted that she had had no prior experience with EPI dogs.

Bugsy had never been diagnosed, nor we had any reason to suspect that he had any allergies/sensitivities to food. As far as prebiotics, he has been on Purina Fortiflora, 1g in AM.

I am giving him the Creon the whole capsule covered in wet food out of a can about 5 minutes prior to feeding.

Thank you again for your patience and guiding me through this!

Monika