Exocrine Pancreatic Inefficiency

[mychip1]

Hi All,

 

My Reagan is highly symptomatic of EPI. An ultrasound at Tufts showed inconclusive for reasons for excessive wait loss, constant elimination of yellow colored stools, and a ravenous appetite with traits of Pica. I had a GI panel done that read totally normal along with his blood work.

 

Rather than having another blood panel done for EPI, I spoke with my vet about treating for it regardless as the symptoms were pretty telling - and treatment, while expensive, couldn't hurt him. The time to get him there with my work schedule, wait for results, and order meds would be far longer - and, frankly, to spend several hundred more on a blood panel didn't seem worth it.

 

Anyone have experience with this?

[MandysMom]

My Dalmatian, who passed away in 2004 (wow, how has that much time gone by?) had EPI. It was diagnosed before I adopted her, and I've archived all her records, but I remember they had done some blood tests. It definitely sounds like you're dealing with EPI. The greasy yellow diarrhea and ravenous appetite with pica while wasting away are the hallmarks. Back in the day, we only had a few choices for enzyme powder, but I have read there are some new products out there. We used Panakare Plus until they changed the carrier (my dog was allergic to the new carrier) and Viokase, which was ridiculously expensive. If you look at the EPI4dogs site, they have some enzymes that are less expensive. With my girl, the vet had her on Purina Canine EN, though I think there are better foods out there now. The EPI4dogs site has some recommendations for food as well. I did have to restrict her treats -- she was able to tolerate carrots and plain, hot air unbuttered popcorn.

 

It's such a hard disease, because they are literally starving every minute. Hopefully you can find the right combination of enzymes and food. One note, most of the enzymes need to be put on the food and then made wet with warm water and sit for 15-20 minutes for the enzymes to start working. If you don't wait, they don't break down the food fast enough and are of little use. Also, the enzyme tablets that Viokase sold (not sure if they are still out there) were worthless.You can also get raw pancreas and feed it, but I couldn't bring myself to do it. It's discussed on the EPI site.

 

Even though EPI can hit any dog, German Shepherds seem to be afflicted more than most. When my girl died, I gave all her supplies to the local GS rescue, as they had three dogs in foster with EPI. I'm sure there are some GS boards out there, you may run into more experience with EPI there.

 

Please feel free to PM me if you have any questions or want to vent about EPI, I know how it goes.

[mychip1]

Thanks, Beverly. I saw you pop up in an older post when I searched EPI...so happy to hear from you.

 

Thanks for the input. The ravenous behavior is unbelievable. He pulls things off counters...like coffee cups, bottles of olive oil, etc. he eats everything....plastic, paper, etc...I have to lock everything up...I'm terrified he will eat something toxic.

 

I saw the raw pancreas option....I wondered how tough that would be to do....lol

 

Did your dog live a healthy full life?

[heartdogs]

Have your vet do a CTLI blood test as well as a foliate test. If the CTLI comes back showing EPI you only have to do the test once. My whippet Noelle had EPI & lived 10 years 2 months. The is a wonderful yahoo group for EPI that was a big help to me. If you want email me at forevergreys@yahoo.com & I can give you a contact for the enzymes you need & many tips for living with EPI. Really this isn't hard to live with once you get use to it. Noelle was found to have it at 3 months along with diabetis & having major seizures. She died of hearth failure & terrible lung problems not connected to her EPI. I would take another dog with any of these problems again.

[turbotaina]

My friend's GSD had it and he lived a nice long happy life once it was under control. He was on Viokase and I remember it was crazy expensive. I don't recall her using a prescription food for him. I think he lived until 15 or so, which is excellent even for a healthy GSD .

[mychip1]

Thanks so much for the responses....I feel better that I have direction as to why he's so skinny...

[MandysMom]

Thanks, Beverly. I saw you pop up in an older post when I searched EPI...so happy to hear from you.

 

Thanks for the input. The ravenous behavior is unbelievable. He pulls things off counters...like coffee cups, bottles of olive oil, etc. he eats everything....plastic, paper, etc...I have to lock everything up...I'm terrified he will eat something toxic.

 

I saw the raw pancreas option....I wondered how tough that would be to do....lol

 

Did your dog live a healthy full life?

 

Thank you! Yes, the ravenous hunger is crazy. One night, I was walking to the table with a slice of pizza on a plate. She jumped up and grabbed it off the plate as I was walking. We wrestled frequently over food. Probably the funniest time was when I dropped one of the huge containers of Pepperidge Farm goldfish crackers on the kitchen floor. She sailed off the couch, I don't think she hit the floor for at least 20 feet. It was then a race to see who could grab the most crackers fastest, with me flinging handfuls up onto the counter. One of the worst things was the trying to eat animal droppings (for the protein). There are a lot of nasty people around here who don't clean up after their pets, so it was always like a minefield.

 

Pretty much everything food related had to be in the cabinets or on top of the fridge. I will tell you that a friend's GSD had EPI and he actually jumped on the counters to reach the top of the fridge to get a huge bag of Hershey's Kisses, which he devoured, wrappers and all.

 

It was a non-stop fight to keep weight on her. I had few resources at the time. She died at 12 from cancer. Other than the EPI, until that last week, she lived a good life. I didn't even realize she had cancer until the end, because she was always rarin' to go.

 

On the EPI site, they talk about SIBO, that is often seen in concert with EPI. I learned to keep Metronidazole on hand at all times.

[NeylasMom]

Oh my gosh Bev, I know the dx isn't funny at all, but your description of the goldfish incident.

 

To the OP, I'm sorry, no advice, but I hope you can get your pup feeling better soon.

[mychip1]

Thanks, Jen!

 

Bev...that's how it is here....yes...it's a competition as to who will grab what first.... and the feces thing is a challenge in the yard!

 

Given Dustn's IBD, we have metronidiazole around here all the time. I'll watch for diarrhea or blood.

[heartdogs]

With SIBO it isn't always bloody diarrhea, more terrible "tummy rumbles" & lots of burps. After Noelle's EPI was under control she wasn't such a food hound. Also giving her more small meals helped keep things under control too.

[cmc333]

I had a terrier that had EPI, along with allergies and CHF. I used the Pancrea-tabs from the vet and it helped. I always felt sorry for her because she was always so hungry. They really will eat ANYTHING they can get in their mouths. Kelli died from CHF at age 12. The constant watching her like a hawk just became the new normal.

[4My2Greys]

Reading this makes me feel so bad for the dogs that suffer with this. Imagine always feeling starved and wasting away no matter how much or often you ate.

[cmc333]

Reading this makes me feel so bad for the dogs that suffer with this. Imagine always feeling starved and wasting away no matter how much or often you ate.

You are so right. I always thought that Kelli figured we were deliberately starving her and not understanding why we were so mean to her. I always wished I could just explain it to her so she knew we were doing what we had to in order to keep her alive. I still don't know if her last year(s) were worth keeping her alive when she was so starved all the time.

[mychip1]

With SIBO it isn't always bloody diarrhea, more terrible "tummy rumbles" & lots of burps. After Noelle's EPI was under control she wasn't such a food hound. Also giving her more small meals helped keep things under control too.

 

Because I have another hound with Intestinal issues, I feed four small meals a day to all of them. reagan doesn't get the gurgles like that hound. But the other dog definately benefits from the extra meals. Edited February 5, 2017 by mychip1

[marion]

My sister's German Shepherd dog has got EPI. She put the dog on a very well elaborated raw diet as he could digest kibble sufficiently.

So the dog gets a raw diet and pancreas tablets with digestive enzymes. The dog is pretty fine, his stolls are perfect and he could put some weight on.

[mychip1]

Thanks for sharing. I haven't switched him to raw -but may need to......

[mychip1]

I am seeing no improvement after two weeks on enzymes.

[cmc333]

It took me much longer than 2 weeks to see an improvement. It was more 4-6 weeks before Kelli starting feeling better. So maybe you're just being impatient and the enzymes will help, tho not as soon as you'd like.

[JJNg]

If the original GI panel bloodwork included a TLI and it was normal, then your dog doesn't have EPI. In dogs that have been diagnosed with EPI, with an appropriate dose of enzymes, you see a pretty fast improvement in the stools. It can take longer for them to gain weight and feel better, but in the cases I've treated, the stool volume and consistency have improved quickly.

[mychip1]

Interesting. The stool was the one place I saw some improvement. I have also noted that he no longer appears to be losing weight (so I guess that is a positive) - particularly since I added the probiotic to him.

 

He's about four weeks into this....so in response to CMC 333...maybe it just needed more time.

Edited March 1, 2017 by mychip1

[cmc333]

Interesting. The stool was the one place I saw some improvement. I have also noted that he no longer appears to be losing weight (so I guess that is a positive) - particularly since I added the probiotic to him.

 

He's about four weeks into this....so in response to CMC 333...maybe it just needed more time.

So glad for him. I'm a fairly impatient person and I wanted Kelli better sooner rather than later. She died of congestive heart failure and the EPI didn't affect that at all.

[mychip1]

So Reagan hasn't gained weight and the amount of poop is disproportionately large and almost unmanageable. I don't know what to do. He eats four meals a day w enzymes. He is sometimes playful and happy, but other times is just ravenous and aggressive snapping at my other hounds

So Reagan hasn't gained weight and the amount of poop is disproportionately large and almost unmanageable. I don't know what to do. He eats four meals a day w enzymes. He is sometimes playful and happy, but other times is just ravenous and aggressive snapping at my other hounds

[cmc333]

I am so sorry to read this. I have no suggestions - as I said, I'm not sure I did the right thing for Kelli by keeping her alive. I just don't know how happy she was when she was always hungry. Did the EPI group have any ideas?

[Batmom]

 

What are you feeding?

[mychip1]

My vet had me switch to a prescription diet - but there was no change - if anything worse.

 

I put him back on the Regal adult bites that JJ eats. I read things that say no grain - but then some people say it made no difference.