Exocrine Pancreatic Inefficiency

[Cricket57]

Poor Reagan. I don't have any first hand knowledge of this, but thought I'd link to these two articles (just in case you hadn't already come across them.

 

http://www.dogaware.com/articles/wdjepi.html

 

https://www.whole-dog-journal.com/issues/12_3/features/Exocrine-Pancreatic-Insuffinciency-in-Dogs_16109-1.html

 

Cricket

[mychip1]

The last paragraph of that first article is where I feel I'm at. I realize that I could try ten different foods with ten combinations of dosages for enzymes, but it seems futile as the changes I've made when I have tried - even taking him off meds totally and putting him back on have showed only minimal progress.

[cmc333]

The food that worked best for Kelli was Diamond Naturals Grain Free. I added chicken and pumpkin to that. I admit, it was a daily struggle with Kelli. I used both the BioCase V and pancrea-tabs. I had looked into the raw pancreas, but couldn't afford it. Kelli was on abx about every 6 weeks and flagyl almost every other month. She was still skinny (though not nearly as skinny as she had been when diagnosed) but seemed happy with life. That's why I kept her going, even though she was always starving. It was a very hard decision to make and like I said before, I'm not sure I made the right one for her. If I had to do it over again, I honestly don't think I would have kept her alive as long as I did. But I don't know.

[NeylasMom]

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

I know virtually nothing about EPI, but wondering, going back to JJngs post and the fact that his tests were negative, anything else that could fit here as a possible diagnosis?

[mychip1]

Possibly of an intestinal cancer, but biopsy would require sedation and I'm not sure he could handle it.

[Batmom]

You may have already done this but if not, it might be worth adding something simple like a small hamburger patty or hardboiled egg to each of his meals, to see if that helps him any. I feel for you -- so difficult to know that something isn't right but not be able to find the root of it.

[NeylasMom]

Possibly of an intestinal cancer, but biopsy would require sedation and I'm not sure he could handle it.

An ultrasound wouldn't show that?

[palmettobug]

I don't know about dogs, but they found my cat's mast cell in his intestines by ultrasound first, and then got the definitive diagnosis via biopsy after surgery.

[mychip1]

We had an ultrasound - that did not show anything...but they indicated there is a unique cancer that can inhabit the lining of the intestine that the ultrasound would not have shown. The only reason I am hesitant to think it's that is that he has stabilized a bit on the meds....he hasn't gained, but he seems to have stopped losing weight - and has less episodes of raw spots on his skin.

[NeylasMom]

We had an ultrasound - that did not show anything...but they indicated there is a unique cancer that can inhabit the lining of the intestine that the ultrasound would not have shown. The only reason I am hesitant to think it's that is that he has stabilized a bit on the meds....he hasn't gained, but he seems to have stopped losing weight - and has less episodes of raw spots on his skin.

So again with the caveat that I know virtually nothing about EPI, but thinking from a broader perspective, have you thought more about trying a raw diet? If operating under the assumption that anything more digestible would be helpful for a dog with EPI (???) a raw diet could be a real plus. And I have read where adding pancreas to the diet specifically can be helpful. Hare Today sells pancreas from pastured cows: https://hare-today.com/product/raw_pet_food/ground_beef_pancreas_1_lb

I'm sure there are other options as well. My local source for quality meat for the dogs often carries it. You could also try My Pet Carnivore as well, as they ship smaller boxes.

 

Also, I'm wondering whether there are any quality supplements geared toward this condition. I like Standard Process supplements because they use whole foods. They don't seem to have one for pancreatic issues, but they do have an enteric support supplement that contains pancreas. Not saying this would be a fix, but can't hurt, might help?

https://www.standardprocess.com/Products/Veterinary-Formulas/Canine-Enteric-Support#.WXjEQIjyvIU

 

Good luck. This sounds like a horrible condition to deal with.

[mychip1]

I'm actually going to try yogurt for him... I'm Armenian - and my old grandmothers always believed that the cultures in yogurt cured all digestive ills.

 

I do have a butcher I could get raw from - and have thought about feeding him pancreas. I would rather get it from the website you suggested though - if they can do the packing and transport. Thank you!!!

[NeylasMom]

Oh, yeah, I was also going to suggest probiotics. Not that I would expect that would cure EPI, but anything to support gut health/proper digestive function seems like a good idea. And I personally believe all dogs should take them. But I'm not sure that many yogurts contain enough to really do much, plus you have the possibility of the dairy being an issue. I really like Vetri-science's every day probiotic capsule. They also make a gut health version that has additional gut soothing components that I love called Probiotic BD. You can get both on Amazon.

[mychip1]

OK. Thanks!

[Cricket57]

Yogurt made from goat's milk (or even just goat milk). Dogs (& people) seem to be better able to digest goat's milk than cow's milk.

 

Cricket

[mychip1]

Thanks, Cricket

[3greytjoys]

Robin, I'm so sorry you and Reagan are dealing with these health problems. I have no experience with EPI.

 

Just a mention that we recently had to do an abrupt food change (regular kibble was out of stock). The new food is resulting in urgent and greatly increased stool output.

The timing happened to be coupled with a round of antibiotics for one hound. The antibiotics caused temporary coprophagia and pica. A few years ago, same result occurred during treatment with a different antibiotic. Thankfully, the behavior was eliminated both times after a medication washout period. (Fortunately, I happened to be able to supervise outings, so the hound hadn't developed coprophagia as an ingrained habit.)

 

I realize you've already tried changing food, enzymes, etc., so the above is likely of no help, but I wish you much luck finding a workable balance for Reagan.

Edited July 30, 2017 by 3greytjoys

[MandysMom]

I know how frustrating it is. Jen pointed out about pancreas, in the past, some EPI owners I talked with supplemented with actual pancreas, but they used pig pancreas, at the direction of their vet. There are multiple brands of pancreatic enzyme supplement, not just the insanely expensive Viokase. If you use one of the enzymes, it's imperative to cover it and the food in warm (not hot or cold) water and let it set for 15 minutes. If you don't do that, the food gets pushed through the system too fast for the enzymes to work. The pills never helped my Meg, we had to use the powder. Some dogs need more of the enzymes than others, so it may be helpful to add a bit more. It can take time to see improvement and I had to constantly tweak everything with Meg.

 

Many EPI dogs do best on a low fiber diet, but each dog is different. I've read that some EPI dogs do well on a raw diet, but others don't.

 

The increased output is likely due to the EPI not being under control plus concurrent SIBO. I would ask for Metronidazole and/or Tylan. When adding those, I would probably add a probiotic.

 

I know how frustrating it is. I hope you can get this under control. Hugs to you and sweet Reagan.

[cmc333]

How's Reagan doing with his EPI? Or have you discovered it is something different? I know how heartbreaking and discouraging it is, when nothing seems to really work. Hopefully you'll find the right combination of food, enzymes, yogurt, probiotics, antibiotics, etc. to have Reagan have a good quality of life.

[mychip1]

Just an update. I had a vet that comes to the house for my cat look at Reagan as well for another set of eyes - to decide if it was time to make the decision as I was seeing no improvement beyond a little initial bump with the viocase.

 

She agreed with diagnosis, and wanted to at least go all out before I made a decision and put him on Predinisone, metrondionzole, and Pancreate - which is also an enzyme. Her own dog had EPI and didn't respond to viocase, but did to pancreate.

 

Just like with the viocase, the first week or so looked good. Less, and more firm, poo....but still no weight gain, still has massive pyka issues, and poo is degenerating again - probably because he's eating everything in site - and it all passes right through, i.e. paper towels, coffee filters, bottles of dressing that he opens and eats, etc.

 

He's also started to get growly again with the other dogs which had subsided for a week or two as well.

 

Unfortunately, both vets have agreed that despite his tail wagging and playing with toys, his quality of life is not good given his appetite and weight. It's a hard decision when they are still upbeat and playful - but the bottom line is that he's starving to death.

[palmettobug]

Dr. Robin, I'm so sorry. I know you have tried your darndest to give Reagan the best life possible.

[NeylasMom]

I'm so sorry. EPI sounds like a horrible disease to have to deal with and I can't fathom having to make the tough call you are making right now.

[mychip1]

Some people seem to maintain it just fine. I just can't seem to make it work for him.

[greysmom]

It's NOT a failure in you. Each dog and each person and each situation is entirely different!! You've gone every single mile you can go with Reagan. Not everything can be fixed, as much as we want it.

 

[BatterseaBrindl]

You have gone above and beyond for Reagan

[mychip1]

Thanks. I am putting him back on the prednisone for a few days. I had weaned him off - thought hey had said just to wean him down - but I'm so leery of keeping an animal on that...but I guess it can't hurt. It did seem to help his poop a little.