New to EPI questions from the UK!

[scoozle]

I’m so glad I found this forum! Hello from a cold and wet Wiltshire UK
Our Sproodle (Springer x Poodle) Oscar got diagnosed with EPI or at least something very similar 5 days ago and we started him on his new meds yesterday (27 Jan ’25)
I have lots of questions and would love to hear from other dog parents (esp others in the UK)on their experiences

Oscar has a history of gastrointestinal issues but this feels like the first time we’ve pinned something down. Two years ago he went off his food, became lethargic, lost weight etc. He had blood tests and a CT scan but vets didn’t know what it was. Ended up trying loads of different food and settled on Royal Canin Hypoallergenic. Last year he had a bout of gastroenteritis which was horrible but eventually passed with help from probiotic paste and rehydration fluid.

This time, his symptoms over the last two months included bright yellow poop with undigested food, lots of stomach noise and farting!! ravenous appetite and losing weight. It was the steady weight loss that made us go to the vet for a blood test and I’ve attached the results here. A quick google tells me it looks like its pretty textbook for EPI?

20250128_190443.jpg (2.41 MiB) Viewed 34071 times

20250128_190500.jpg (2.42 MiB) Viewed 34071 times

Oscar was 12 in December, his ideal weight is 15kg, he currently weighs around 13.5kgs

His diet until about 3 weeks ago:
- Royal Canin Hypoallergenic (hydrolysed protein) dry food– 180-200g/day over two meals
- YuMove joint supplement x1
- YuMove probiotic as and when he had soft poop x1

His diet for the last 3 weeks(homemade):
- Per day over two meals: Plain cooked chicken 340g, Chickpeas 80g, Veg (squash/broccoli/carrots) 80g
- YuMove joint supplement x1
- YuMove Multivitamin x1
- YuMove probiotic x2/day

He is now on:
- Same homecooked food as above
- Same joint supplement - £13/month
- Lypex – 2 capsules a day although I understand it’s not about dosage so much as making sure he has the enzyme when he eats? - £90 for a months supply (eek) from the vet but have found it for £70 online
- Protexin B12 supplement x1/day - £25 ish for two months
- Penecillin x2 per day £25 ish for a 5 day course

Our plan is to weigh him every week and see what he’s like in 2-3 weeks time. Our vet said we don’t have to get another blood test unless he hasn’t improved. Blood test is £180 so we won’t do one unless we need to!

My questions:
- I have seen the enzyme page on this forum and it’s quite overwhelming! What’s the difference between them all and for those in the UK, what’s the most cost-effective option to try? Eg I’ve found Protexin Pro-Enzorb for £48 for 2 months as opposed to £70 for 1 month with Lypex!!!
- We have stopped his probiotics because he’s on antibiotics and I assume it will cancel out the probiotic. Do others keep their dogs on a probiotic forever as well as enzymes?
- Will he need to stay on B12 supplement or is a multivit worthwhile? I know we will never know for sure unless we get blood tests.
- Food: our other dog is on Wagg, which is £15 for 12kg (very cheap). Once Oscars settled on his enzymes, we want to try and move him to this food but it’s a cheap one, has grains etc in it (although fibre content is only 3.5%). Is this a waste of time? Any UK peeps have recommendations for cheaper good quality options? One I like the look of is Forthglade but it’s still more £ per month than we’d like to spend.
- Are we feeding him enough? I’ve seen people mention needing to feed 150% but we also need him to gain weight so should we feed him even more?! Which also leads to: Should we feed him 3x day while he’s settling on his new meds?
- Overall, we are daunted by the ongoing potential cost of food and meds. Oscar’s insured but after first year they won’t keep covering a lifelong condition. Any tips welcome!

Sorry for very long post, but any thoughts much appreciated and thank you again for such a great forum!!!

[Olesia711]

Hi Susie, Doug and of course Oscar!

Yes Oscar has EPI AND he also has SID/SIBO/Dysbiosis.... and although Penicillin will help, it is usually not the most effective in battling SID/SIBO/Dysbiosis. Ask your vet if you can swap out the Penicillin for Tylan (Tylosin Tartrate antibiotic) Even though Tylan was originally created for CHicken, pigs and honey bees... they found that it really works with SID/SIBO/Dysbiosis in EPI dogs. ALso... Tylan does NOT kill all the bacterial like Penicillan... but rather it jsut inhibit further reproduction... so with TYlan you can still give probiotics... although i like to still recommend giving probiotics about 2 hours away from a Tylan dose just to keep it simple.

SO... here are your questions and i will try to answer them (in red) as best i can:

My questions:
- I have seen the enzyme page on this forum and it’s quite overwhelming! What’s the difference between them all and for those in the UK, what’s the most cost-effective option to try? Eg I’ve found Protexin Pro-Enzorb for £48 for 2 months as opposed to £70 for 1 month with Lypex!!!
IN THE UK, SOME FOLKS USE PRO-ENZORB, BUT MANY MORE USE LYPEX...
if you want to know about some of your other choices in the UK.... please check out the UK link here: https://epi4dogs.com/epi-quick-guides-outside-usa/. Some other enteric coated enzymes are CREON (human drug) and Microzym (check with Amazon/no prescription needed. HOWEVER must tell you NEVER EVER incubate enzymes that are enteric coated. just open capsule, sprinkle on"moist" food and serve immediately!
- We have stopped his probiotics because he’s on antibiotics and I assume it will cancel out the probiotic. YES the most antibiotics will cancel them out... but ask the vet to swap out the Penicillan for Tylan... Tylan does NOT kill all the bacteria Do others keep their dogs on a probiotic forever (usually not... just until the gut gets straighten out) as well as enzymes? Enzymes are for life.
- Will he need to stay on B12 supplement or is a multivit worthwhile? Don't go by the B12 in Enzorb.... always give a separate B12. I suggest looking at Chemeyes, LLC https://chemeyes.co.uk/ they carry EPI products and their B12 product is the same as the product (Wonderlabs Pet Factor B12) that we recommend in the USA I know we will never know for sure unless we get blood tests. Correct... BUT..... if they get too much B12, they just pee it out
- Food: our other dog is on Wagg, which is £15 for 12kg (very cheap). Once Oscars settled on his enzymes, we want to try and move him to this food but it’s a cheap one, has grains etc in it (although fibre content is only 3.5%). Is this a waste of time? Start with a no grain food with fiber content of 4% or less..... once things have settled down then sure, go ahead and see if Oscar can handle the same food as your other dog..... you'll be able to tell, if his poos get soft, then it's not agreeable. Any UK peeps have recommendations for cheaper good quality options? One I like the look of is Forthglade but it’s still more £ per month than we’d like to spend. I'll ask one of our UK members to pop on
- Are we feeding him enough? I’ve seen people mention needing to feed 150% but we also need him to gain weight so should we feed him even more?! Which also leads to: Should we feed him 3x day while he’s settling on his new meds? Oh gosh yes!!! with EPI dogs (until they get straightened out) do feed 150% of food BUT be sure to feed smaller portions of food than what Oscar was getting... which means he will now need to be fed 3 to 4 times a day....

Hope this helps you get started.
- Overall, we are daunted by the ongoing potential cost of food and meds. Oscar’s insured but after first year they won’t keep covering a lifelong condition. Any tips welcome!

[Patsy]

Hello from Yorkshire. I had an epi spaniel for many years when it was virtually unheard of in the Uk. Information from vets is generally vague due to their lack of experience with it, and tendency to suggest high price meds. They will never mention the cheapest option of using frozen chopped raw pigs pancreas that is easily available in small packs by Durham Animal Feeds and others. Most Uk folks find Chemeyes products for their enzymes and B12+ intrinsic factor.
Epi isn’t cheap but there are worse conditions tobave . Assuming your pet gets back to normal, the costs are much cheaper than injuries and other lifelong illnesses . Luckily I never asked what my OH spent on restoring old vehicles , and he never asked what I spent on the dog! Vet practices vary enormously now the corporate companies are buying them out. Independent vets can give you ‘mates rates’ and older vets are more experienced and less reliant on unnecessary tests.
I will try to address your questions in the morning.
So pleased you’’ve joined us!

[Patsy]

To simplify inform we often go through the 4four cornerstones of epi

1. Enzymes… in uk lypex is excellent but expensive and confusing on dosage.Proenzorb contains some B12 but not enough. Chemeyes are great and you get experienced telephone help from the owners who developed the company with their own epi dog.
2. B12plus Intrinsic factor … Chemeyes again . Your B12 is very low so a quicker fix is a course of injections (the red stuff) from the vet . It is an amazing improvement in mental and physical health. Aim for a high level of 600. I got it cheaper by signing a disclaimer form to have the identical agricultural bottle.
3 SIBO/SID. can be improved with probiotics but antibiotics are quicker. Penicillin isn’t usual for it, Tylan is good but again it’s for licences for farmers . We used to have a 2 week course of oxytetracycline.
4. Food……Low fibre means grain/cereal free. Also we recommend fermentable(soluble) fibre.ie sweet potato ,French beans, broccoli, cauliflower, spinach. Not peas , sweetcorn or beans with husks.
There are many commercial foods now ,very trendy and pricey so ignore them . I would recommend Skinners wet food which is very simple, though bland . I cheer it up with a spoonful of tasty food eg tuna, stew or cheese. It is around £1.35 a pack and you would maybe need one to two a day. There is a high calorie Energy one. in their Get out and Go range. It is easier to mix enzymes into wet food . Suitable kibble is harder to identify. But you can certainly get Salmon and sweet potato.
Forthglade is fine if they still do one without peas. (a cheap protein)

You may get side effects, smelly breath, excessive drinking. My dog was in a bad way and consequently developed auto immune problems .
Don’t get discouraged, it becomes a normal situation . Treats can be difficult but I used a tiny bit of melon or cooked veg.

[scoozle]

Patsy and Olesia THANK YOU so much for your replies and for taking the time to answer all my qu's!! It's so appreciated.

Antibiotics - My vet said Tylosin is not available in the UK. Oscar is only on a 5 day course of Pencillin so only two days left - it's obviously made him feel rubbish, poor boy, but will hope he perks up over the weekend once he's off them.

B12 - I was a bit surprised after getting back and reading up that our vet didn't suggest B12 injections. From what you both say it sounds like the tablets are a bit rubbish? I might double the dose if it's harmless to see if I can boost it. I'm not sure we can afford B12 injections at the moment.

Olesia, thank you for sharing the outside the US page, I hadn't found that one yet! I will have a read. Patsy, really appreciate your recommendations, and I totally agree it could be much worse, Doug and I are just coming to terms with having to find an extra £100+ per month for at least a few years. Doug also doesn't tell me how much he spends on the cars!!!! and I suspect Oscar has auto-immune issues as his previous gastro issues were undiagnosed. I'm sorry to hear about your doggie. Vets seem very inexperienced in general re gastro and auto-immune issues in dogs.

Food - thanks also for the rec's. We looked at raw pancreas but the feeding guidelines were confusing. I am also not sure we can add raw pancreas to his cooked food safely. I'll have to get my calculator out and do some more research!

Fibre - It is odd as all the trendy expensive cold pressed grain free dry food has higher crude fibre % than Wagg!? which is what made me ask the question.

I think I am hoping we might be able to get him on a 50/50 wet/dry mix eventually but I'm also not up for experimenting a lot - we've been through that with him and it feels cruel/unfair esp at his age.

So I'll be checking out Chemeyes for when we finish our current supply of Lypex and Protexin B12, and will check out Skinners for wet food.

[Tuckaboo Pam]

Hi Scoozie, and welcome to you and Oscar!

I wonder, since you aren't able to get Tylan, if your vet would be willing to try the Chinese medicine called Liver Happy. My Maltipoo always had squirty poos (she does NOT have EPI), and she'd been treated for IBS with intermittent success. A holistic vet checked her over & said her liver was sick, so started her on the Liver Happy. Her poop is well formed & she no longer stretches her back as if she's in pain.

My late EPI sweetheart dog Tucker was on it before his EPI diagnosis, and it even solidified his poop at that time. I suppose one dog is one organism, and all the systems are connected, but why it works is a mystery to me. Maybe your vet could explain it.

Take Care & keep us posted.

Pam & Nina

[scoozle]

Hi Pam and Nina, thanks so much for the tip on the chinese medicine! There is a holistic vet in my town that I've been curious to get a second opinion from, but I think we just need to get our heads around it first and see what we can afford.

From everything I've read, even before this EPI test when Oscar had other GI issues, Poodles seem prone to GI issues but there is so little definitive information or research on it!

Thanks again and I will no doubt have more questions as we update our situation!!!

[Chance]

Hi Pam and Nina, thanks so much for the tip on
From everything I've read, even before this EPI test when Oscar had other GI issues, Poodles seem prone to GI issues but there is so little definitive information or research on it!

Thanks again and I will no doubt have more questions as we update our situation!!!

Poodles do Addison's disease quite well! They're kinda like the German Sheppard with EPI. 90% of EPI dogs are Sheppard. It's about that with Poodles and Addison's! But ALSO like EPI, any and all breeds can be affected. But it's most common in Poodles. And they've progressed a lot there since I started dealing with Addison's. It was I think 5 years after my dog was diagnosed that they stumbled across the gene that caused Addison's. Interestingly enough, it was first identified in a duck tolling retriever, despite Poodles being their main test subjects. I wouldn't be surprised if they'll figure out some new useful tidbits of information soon with EPI too!

[scoozle]

Thanks Chance! Yes, Addison's was on my suspect list when Oscar was ill two years ago. After doing my own research my gut was saying it was autoimmune but the vets seemed incredibly reluctant to entertain that idea, despite not having any other ideas as to what was wrong with him!!! Quite frustrating and I don't feel confident pushing my own theories with vets, as I don't want to be that patient that googles everything and thinks they know what they're talking about (fully aware I don't!) but the more experiences I have I am realising that the vets vary hugely in their approaches.

Update on Oscar, he had his last dose of penicillin this morning - I thought I'd have to call the vet 4 days in as he was getting worse, really lethargic and obviously uncomfortable but must have been the antibiotics working through because he's got a bit of bounce back now.

- Weighed him today and he's stable since last week - 14kgs (ideal weight is 15-16)
- Fed him lunch (usually just brek and dinner) for the first time today and he looked like christmas had come early
- Ordered some Skinners wet food on Patsy's recommendation worked out we might be able to get his wet food to £2.50 a day which is much more manageable than we first thought.
- We're going to hold off putting him back on probiotics for now as his poop is solid.
- Will up B12 to twice a day.
- Once we run out of Lypex, going to order enzymes from Chemeyes.
- Going to call vet in a week or two once we know he's gaining weight and ask about his B12 levels - how to tell they're ok/whether we should fork out for another blood test etc plus let her know about this forum of course!!

Thanks again everyone for answering all my questions so thoroughly, I really appreciate it and feeling a lot less worried about the situation.

[Chance]

I do agree with you; looking at the blood work you've posted, there's absolutely no red flags pointing to Addison's disease. I'm just pointing out that it's relatively common in Poodles. But just like not every Sheppard has EPI, so also not every Poodle has Addison's. Like EPI, it can pop up at any age.

Glad you are getting sorted with enzymes and food! I hope Oscar responds very quickly, and begins to improve daily. It sounds like it's not a huge amount of weight loss, so that's a positive!

Keep us posted!