Elvira, 10.5 month old GSD, recently diagnosed.

[TheFatCampKid]

Hi,
We are new here.
After a month's worth of diarrhea, negative blood work, fecal floats, cultures, and a change of food, I requested an EPI test last week.
The results came back on Monday, February 11, 2024, and she is positive.
Her cTLI was <1.
B12 and Folate were normal.
Pancreazyme has been ordered by the vet and we will start her as soon as possible.

Elvira is currently eating Royal Canin Hydrolyzed Puppy dry and the can in adult (they don't make it in puppy). She had previously been on Science Diet Large Breed puppy. We only made this change to see if her diarrhea was allergy related.

Thanks for being here and reading our story!

[jilbert57]

Hi Julie,
Thank you for the introduction on you and Elvira.
Sounds like you are doing what needs to be done to get your pup in good health.

The Epi pups B12 needs to be in the upper end of the range and kept there. So a normal result might not be good enough. We like to see 600 and above. Any B12 not used by the animal will be excreted in the urine. So if the result was up near 600 I would order Wonderlabs B12 with Intrinsic Factor(wonderlabs petfactor) and give one daily.
https://epi4dogs.com/b12-in-brief-2/

Do you know if the Pancreazyme your vet ordered is tablets or powder? The powder seems to be easier to use.

When you get the enzymes the kibble will need a ratio of 1 teaspoon enzyme per 1 cup kibble, add a little room temperature water, stir and let set 20 mins. Stir and serve. The canned food is 3/4 teaspoon 1 cup canned food. Mix and let incubate 20 mins. It can all go in 1 bowl just note the different amount of enzyme to use.

https://epi4dogs.com/epi-quick-guide-usa/

Jill

[Tuckaboo Pam]

Hi Julie---

I just wanted say WELCOME, and I'm glad you found this wonderful group that has helped I don't know how many EPI pet owners in the time it has existed.

My advice is, listen to Jill, keep a journal of things you try, and post all the test results as soon as you can. This will be very helpful along the way.

Also, Elvira is a great name for a girl from Oak Ridge! --- Pam

[Olesia711]

Hi Julie and Elvira, and welcome to your both to our EPI family... ELivira looks like a real cutie!!!!!!

SO.... just a quickie comment about EPI.... "effectively managing EPI is all about finding the right balance of the recommended EPI protocol" and in English this means that if you do not see the expected results once you are doing everything everyone tells you to do.... it just means that something needs to be "tweaked" a little bit.... and this is what we at Epi4Dogs can help you with

Pancrezyme powder is what my vet started my Izzy on years ago. Good stuff.... but.... after you are revived from passing out at the cost.... when it comes time to re-order.... to save $$$ you might want to look at alternative food-grade pancreatic enzymes. Many of us here use EnzymeDiane's 6x enzymes instead. https://enzymediane.com/product/pancrea ... e-product/
You get approximately 3 times as much enzymes for the same price .

As Pam suggested, keep a journal.... here are some examples :
https://epi4dogs.com/epi-log/

As Jill suggested... ask for the B12 test levels, and you most likely will need to supplement with B12. Again, many of us here use WOnderlabs Pet Factor B12 pills https://wonderlabs.com/PET-FACTOR-B-12
and we have a coupon to where you can save 15% or 20% when ordering from WOnderlabs.... 15% Appreciation Discount (code: EPI4DOGS15 ) on ALL Wonderlabs products…

When it comes to food.... if possible, start with a food that has 4% or less in fiber content, and in the beginning avoid foods with grain in it and especially avoid foods with peas/lentils as the first top 4 ingredients- -or food that split pea ingredients,. for example if the product has peas, pea flour, pea protein, yadda, yadda... avoid! They are just stuffing the product with a cheap ingredient that tends to increase SID/dysbiosis in EPI dogs..........

The reason to limit fiber content in the begining is because fiber can destroy the efficacy of the enzymes from anywhere between 0% to 50% and we have no idea which dog if affected is affected by how much.... so... to start with, avoid grains.... but once dog is stable, feel free to try a food with rice or some other grain in it to see if Elvira can or cannot tolerate grain. We cannot test this .. so the best we can do is just try things........

please feel free to ask any questions

[TheFatCampKid]

Our vet ordered the tabs, but I also ordered the powder.
So far she doesn't seem to mind the tablets, but she would also eat the moon if it were available.

Does anyone have recommendations on food? Should we start with a low fiber, or a grain free, or both? What brand should we check out. Also, she is still a puppy and we would like to keep her on puppy until she's around 18-24 months.

Does she need the enzymes at every meal? We do A LOT of rescue in our home and have always had dry food available. We do breakfast and dinner with canned food, but the dogs can grab a few bites throughout the day if they please.

Do we need to stop this? Should should she only eat X number of times a day, with the meds?

Her B12 came back in a normal range, but we are still going to start her Pet Factor B12.
We have also made an intake and outgoing journal.

Sorry for all the questions. Our vet has only seen one other case of EPI, so I'm trying to find all I can from those who are more in the know.

[Tuckaboo Pam]

Julie---
In case this hasn't already been stated---You should feed her 150% the amount of food you would give her at her IDEAL weight, not what she weighs now. This will help with her weight gain, and like you said, she'd eat the moon, because she is used to feeling hungry. Tucker weighed 60, should have weighed 80. The bag said an 80 pound dog should eat 4 cups/day, so his serving was 6/day, with the appropriate amount of enzymes for that amount of food, broken into at least two meals. When his weight was good, I tapered off to the recommended amount. --- Pam

[Eddiespaghetti]

I like taste of the wild. Eddie seems to do quite well on it.
https://www.petco.com/shop/en/petcostor ... lsrc=aw.ds
She will need enzymes everytime she eats. Otherwise, they won't digest the food properly and that can lead to SIDs.
You may not have to take the free feed food away. It really depends on Elvira. If she doesn't eat it then no problem. As of right now, she is probably starving and will eat everything and anything. Once you get the EPI managed, that should subside some.

[TheFatCampKid]

We have been doing the 150% food intake about 2 weeks ago. Multiple small meals a day.

She weighed 62 pounds at the beginning of January, this started at the beginning of February. She hasnt lost much weight on the scale, but her ribs and spine are easily felt and her belly is big.

We will pick up the food until we get her balanced and slowly work things in. We will look into The Taste of the Wild.

Are there treats available or that can be made? I know temperatures are an issue with the enzymes.

[Olesia711]

Hi Julie, i personally would not leave any food around for "free-feeding" opportunities just in case Elvira sneaks a bite or two throughout the day . WIth some dogs, ANY food that is not treated with enzymes will trigger loose stools.... and yet with some dogs, they can handle a little "cheating". So i would advise in the beginning not to leave anything out for possible free feeding... but once Elvira is stable.... you can re-evaluate and see if she is one of those dogs that can cheat with a little food with no enzymes.... but there is a technique to this and we will help you out with how to do this.

WHen you say her B12 was normal.... what exactly was the test results..... 400 is normal but not acceptable for an EPI dog. 600 is acceptable for an EPI dog.... depending on where her B12 test results are.... you might be able to only have to give her the Pet Factor 3 or 4 days a week.. or every day... so if you can let us know that would be great.

YES, there are lots of idea for treats...
https://epi4dogs.com/treats/
BUT..... in the beginning all treats need to have enzymes in them... so we often advise no treats until she is stable (delivering normal stools at a normal daily frequency) then you can test her with how much of a treat she can have without enzymes.... but you are not there yet... you will want her "stable" for about a month first.

Regarding food.... if you are going to feed a commercial food.... when first starting out...... select a food that has
4% or less fiber content (sometimes 3.5% is often much better.
avoid food with grain in it (for now)
avoid food that has peas as one of the top 3 ingredients listed
avoid foods that split ingredients with peas/lentils, etc... Example: one product will have peas, pea flour, pea protein, etc.....

The reason for this is because fiber can interfere with the efficacy of the enzymes from anywhere between 0% and 50%. The problem is we have no idea which dog is affected by how much. Many EPI dogs simply have issues with too much fiber.... however some are fine with grain . SO... we advise to start with a low fiber food and then as time goes on, try a food with more fiber/ grain in it.. For grains, if it is going to be well tolerated, rice is usually the better grain. Sometimes there are even EPI dogs that do not do well until they have a food with grain in it... but this is not very common.... so start with a low fiber content/no grain food and then take it from there. Here is our dog food options page:
https://epi4dogs.com/dog-food-options/

[TheFatCampKid]

We have picked up the free feed bowls, just until we get her settled and regular.

Her B12 was 612. We’re going back in a month for a recheck. If it’s still around 612, should we look to up it with the supplement?

Elvira is very food oriented. We may have to hold off on training classes until we get her sorted. The trainers rely heavily on treats to train.

Looks like I’ll need to buy a dehydrator in the near future.