Seeking information (a bit desperately!)

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.
thereseiam
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Country: United States
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Pet name: Albie
My name: Therese

Seeking information (a bit desperately!)

Post by thereseiam » 07 May 2023, 08:59

Hi all, I will apologize in advance as I'm afraid this is going to end up to be book length. I will try to keep it to just the facts.

I have an eight year old male German Shepherd, who has a lifetime history of severe allergies. About 10 days ago now he went from eating everything put in front of him to not finishing his ration. Around that same time he got violent diarrhea. This is a dog who was extremely fastidious and never had a house training issue and I started waking up to liquid diarrhea on the floors on a daily basis.

His typical weight was 107 pounds (he's a moose and well over breed standard, not fat) and as of the vet appointment Friday he was 89.1 pounds. I would be willing to guess he is less than that now.

I've had two very frustrating Veterinary visits in the last three days, during one of which the vet went on and on about pain relief and his unstable hind end. My dog is wasting away before my eyes, he happens to be on Adequan injections for pain, but none of that is relevant if he dies due to violent diarrhea, dehydration, and anorexia. I had to request that the vet give me Metronadizole, and he is also on Cerenia, kaolin pectate, probiotics, and lactated ringers.

Despite all he's getting, none of this is helping much. This morning at about 2 AM I was woken up to horrifying flatulence and diarrhea sounds as he was emptying his bowels in the dining room.

I have tried to get into multiple vets for second opinions, I spent yesterday in tears getting turned down by veterinarians who would not see my dog. I live rurally, and there are just not many veterinarians in my area. I am terrified that my dog is going to pass before I can get this figured out.

I have a source for the digestive enzymes. Would those enzymes be harmful to administer before a blood test? I will be calling the veterinarian first thing tomorrow morning about the blood test recommended on this site, but my dog is fading at an alarming rate. That said, after seeing some of the pictures of the dogs on the EPI websites, my guy is not nearly as compromised as some of the EPI dogs who went on to recover and regain their body mass.

The main difference in the list of symptoms of EPI so far is it my dog does not have a voracious appetite, he has started turning down food, even boiled rice and hamburger. I did pick up some ID from the veterinarian yesterday, and he is eagerly eating that, though I am hesitant to give him more than a tiny spoonful or two at a time, because eating anything sets off the violent diarrhea.

I just learned about the existence of EPI yesterday from a friend, so I'm trying to get up to speed, fast. Any advice, thoughts, or anything is hugely appreciated!

And I will say that all of that hair and floof is covering a very ribby, bony boy.
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Montgomery
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Re: Seeking information (a bit desperately!)

Post by Montgomery » 07 May 2023, 09:37

No, it is not harmful to give enzymes before a blood test, I know this from my own veterinarian and my own experience.
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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Jean
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Re: Seeking information (a bit desperately!)

Post by Jean » 07 May 2023, 11:21

Good Afternoon from the UK, Liverpool

My girl at her worst was 39 pounds

my advice is

ITS YOUR MONEY, YOUR DOG,

INSIST ON A cTLI test which is a 12 hour food fasted blood draw, and while you are there ask them to test Folate and cobalamin, also food fasted test, and test Gardia which is fecal test, the tests generally go to labs in USA , so get an early appointment and maybe not a friday

You mention you have a source of enzymes , what are they ?

Metronadazole is not the best it has side effects

https://www.dailypaws.com/dogs-puppies/health-care/dog-medications/metronidazole

we prefer Tylan which is tolerated well

I really feel for you, and have been there

as far as food is concerned if it is EPI the animal cannot digest anything without enzymes , and what comes out is undigested food

I can see you are terrified and the poor dog looks shattered

Enzyme Diane does small bags of enzymes

https://enzymediane.com/

maybe get in touch,

please let us know
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


Jeanx

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Olesia711
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Re: Seeking information (a bit desperately!)

Post by Olesia711 » 07 May 2023, 19:18

Hi Therese and thank you for writing us about your 8 yr old male GSD.

Yes, please do have him tested for EPI.... however... be sure to "food" fast him for 12 hours prior to the blood being drawn for the cTLI blood test for EPI.
Also... you can continue to give the enzymes, they will not interfere with the testing at all.

Regarding the possibility of this being EPI, even though he does not have a voracious appetite.... every so often, a dog will test positive for EPI even though they do not have the voracious appetite as a symptom... so it is a very good thing that you are looking to still have him tested.
\
After reading your post, some other things to consider is:
1. tick disease... especially with the weight loss, diarrhea, and lameness
2. kidney issue (everything you described PLUS that not wanting to eat)
3. low folate (low folate level - -below 7.7) may also trigger these symptoms or it may indicate a food sensitivity
4. if this is not EPI, please insist that your vet also run Cortisol tests for issues like Addisons and Cushings....

Like Jean said, it's your dog, your dollar.

Also.... it might help if you start keeping a journal even if you dog does not have EPI.... keep track of everything (and the ingredients) of all products/food/meds that you give your dog and record reactions and even take poop pics to correspond... this will help you and your vet better figure out what might be going on....... you can down load some various EPI template samples from this page:

https://epi4dogs.com/epi-log/

i hope this helps a little and please keep us posted.
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.........

thereseiam
Member
Posts: 2
Country: United States
State: Illinois
Pet name: Albie
My name: Therese

Re: Seeking information (a bit desperately!)

Post by thereseiam » 08 May 2023, 14:50

Thank you so much everyone for all of the wonderful information. I took my dog to the hospital today where he has been undergoing multiple tests and is on IV fluids, antibiotics and other supportive measures.

He did not fit the test levels for Addison's so that can be ruled out.

He does have an elevated temperature, which is always a huge concern. He is being started on IV antibiotics.

He has had a radiograph done, and there are no obvious masses.

He tested negative for giardia.

As my vet said, right now, things just are not adding up. My vet does not believe this is EPI, though she said she will certainly run the test if I want her to. She said it is rare to have the onset of EPI at this advanced of an age. Thoughts? I was under the impression it was fairly common in older German shepherds. I might hold off on having the bloodwork test done and use the fecal test that I can get from Diane's enzymes.

There are some other scary potential diagnoses being mentioned with this type of violent diarrhea, such as something cancerous. Also, being discussed is irritable bowel, and infection of the G.I. tract.

Needless to say, I'm more than a little concerned, but I do feel that he is receiving the best care possible now.

Here's hoping that the antibiotics kick in and do their thing. Again, I appreciate everyone taking the time to respond.

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Montgomery
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Re: Seeking information (a bit desperately!)

Post by Montgomery » 08 May 2023, 18:28

Rare doesn't mean impossible, it just means uncommon. If you feel like you want to try enzymes, you won't do harm, you won't skew a TLI test should you decide to run one later on. He's your pup, follow your gut.
Is he on B12, by the way? Anyone with diarrhea like that should be.
I hope he improves. It's clear how loved he is.
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.

Barb
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Re: Seeking information (a bit desperately!)

Post by Barb » 08 May 2023, 19:40

I am so sorry you and your pup are going through this. I'm so glad you got him to the hospital and are getting him fluids and nutrients. It is so hard to see our pups suffer. Please let us know the results of the tests and if you decide to do the Tli
.We are thinking of you.

Barb

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Olesia711
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Posts: 3858
Location: North Carolina
Country: United States
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My name: olesia

Re: Seeking information (a bit desperately!)

Post by Olesia711 » 08 May 2023, 21:34

Oh MY!!!!!!! your pup is really having a rough time of things... But thankfully you are getting him the best help possible, with IV fluids, etc.... as things can really spiral downhill when fluids are depleted.


...when we first started Epi4Dogs 15 years ago..... they (vets) thought only GSD and Rough Coated Collies got EPI.
They also thought it was primary EPI if it happened in young dogs around 1 year old to about 3 years old or...
secondary EPI that happened in dogs 4 years or older triggered by something else such as chronic pancreatitis.

Over the past 15 years... they now realize that EPI can and does happen in ALL breeds, and it happens in very young dogs (even just a month or two old) and it can and does happen in dogs over 8 years and older..... we have actually seen some not develop it 12 years old.....

SO.... it is all over the map. :(

However, my suggestion would be to FIRST investigate what your vet "thinks" are the top most probably causes... however... if the first few "most probable" causes prove not to be the case, then i would have them run the cTLI blood test to test for EPI..... actually... i wouldn't wait too long before running the EPI blood test (cTLI) , mainly because testing for EPI is a simple blood test, not invasive and it only takes a few days for the test results.... so if nothing else, you can quickly rule out EPI if need be.

I hope this is helpful.... and PLEASE do keep us posted.

Again, thank you for being so proactive getting your pup the care that it needs!!!!!!!!!!!!
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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Jean
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Posts: 1707
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: Seeking information (a bit desperately!)

Post by Jean » 09 May 2023, 05:12

I can remember a young vet telling me Kara was too young at 14 months to have EPI. I stood my ground and had her tested , 4 days later the vets rings, and says you were right

I had a cat in the 80's aged 12 who developed EPI so I was used to the smell ov undigested food

the point is, as the animal gets older the pancreas CAN get less effective until it fails

You said he has had issues with intolerances for most of his life, what were these ?

The good thing is, some things are ruled out , but there is certainly something going on, and its worrying, you can cope better if you have a name for whatever is going on, well I can

As I said Metro can cause lethargy, I cant take it personally, I become really ill

its obviously up to you but it might be a plan to have cTLI , Cobalamin, and Folate tested, just as a reminder its a 12 hour food fasted test

anyway please let us know
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


Jeanx

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Montgomery
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Posts: 418
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Pet name: Montgomery (I'm a CAT!)
My name: V

Re: Seeking information (a bit desperately!)

Post by Montgomery » 10 May 2023, 10:55

How's the patient, and how are you?
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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