[Jerry S]

Our “Black Golden” Somba is a 10 year old Black Lab x Golden who has been suffering from EPI (Exocrine Pancreatic Insufficiency) for 8 years. She has been on PancrePlus enzyme supplements, but just seems to continually be a “bag of bones” . She eats 5 cups of Purina ONE Smartblend daily with the supplement mixed in with water, and then let it stew for about 20 minutes. She has lots of energy, and has about 3 humongous poops every day. We have been told that she needs a low fat, highly digestible food in order to put some meat on her bones instead of just passing it thru for me to pick up. Am looking for a better food and/or supplement to improve her condition. Any suggestions?
DJ Sads

[Susan]

Hi Jerry, With EPI, dogs need a low fat & low fiber diet, the Purina one would have to much fiber for EPI thats why she is pooing so much ..My boy has IBD & Pancreatitis & was put on Eukanuba Intestinal low residue vet prescription this has really helped its 10% fat & 1.75% in fiber & he does just 2 nice firm small poos a day. Ive slowely been adding the “Holistic Select” Senior Chicken Meal & rice its 10%-fat 26%-protein & breaks up very easy, I add water & within 1 mintue the kibble has soften also the Eukanuba Intestinal softens within 1 minutue, thats how you can tell if a kibble is soft or hard the harder kibbles take forever to soften especially if they have potatos…hard kibble are to hard on their Pancreas & cause pain Ive found, can ur girl eat tin wet food cause thats better for Pancreatits a low fiber & low fat… there’s kibble & tin food that a few people on this site reconmend that’s sold at Walmart called Pure Balance or Rachel Ray that are suppost to be better then Purina one & are a good price there’s another one but I cant remember the name for tummy problems, I live Australia so we have different kibbles but we do have the Purina one sold at the supermakets & its high in fillers & the fiber is 5-6% I wouldnt feed that to Patch he’d be pooing & pooing & have his stomach pain..also I give Patch a probiotic to help with his digestion & bowel…

[losul]

Jerry, I think you’ll find this a great site for info about EPI.

http://www.epi4dogs.com/

They also have an active forum where you can participate and ask questions.

http://www.epi4dogs.com/apps/forums/

According to epi4dogs, most EPI dogs do respond best to a low fiber diet and higher or mid range protein food, but it may take some experimentation to find what works best for your dog. Have you considered raw or homemade food?

Also according to them, <b>unless there is a concurrent medical condition</b>, It’s usually best not to restrict fat intake, <b>as long as they are receiving the proper type and dose of enzymes, and B12 and antibiotics if needed</b>.

If your dog also has SIBO and B12 deficiencies, I think it’s usually much safer to try tylosin/tylan first rather than metrondiazole, which I would consider a dangerous antibiotic, especially in longer terms.

If cost of the pancreatic enzymes is an issue, enzymediane has a cost analysis, I think you will find theirs the lowest pricing ordering direct from them (pancreatin 6X or 8X)

http://www.enzymediane.com/enzymecomparisonchart.htm

It sounds like you are preparing the food with the enzymes correctly. (with water, near room temp., 20 minutes, etc. ) but maybe you need to experiment with the dosages?
——————

Sue66b, I know you and Patches have been through a tremendous lot and I really feel for you and Patches. Always wanted to tell you that I think Patches is a VERY handsome fellow. Would love to see a good and long lasting solution for Patches troubles. Just wondering, since Patches has had repeated bouts of pancreatitis, which can damage the pancreas ability to produce enzymes, also insulin, and also has SIBO ( I think?), has he ever been tested and diagnosed with EPI? Have you ever tried pancreatic enzymes?

“· Always confirm EPI with a trypsin-like immunoreativity (cTLI) blood test (12 hour fast). Normal range is between 5.0 – 35.0
· Whenever there is persistent gastro upsets and weight loss, it is advisable & economical to do a cTLI blood test.”

• This reply was modified 9 years, 10 months ago by losul.

[theBCnut]

I’m going to start by saying that I’ve never had an EPI dog, so this information is not first hand. Coconut oil is a medium chain triglyceride and is supposed to be a way to boost caloric intake in EPI dogs because it is a different type of fat and doesn’t use pancreatic enzymes for digestion. That being said, I would start adding it slowly and increase amounts slowly, so you have plenty of time to observe how your dog is adjusting to it and doing on it.

[losul]

Jerry, here is more sites for info; but I think epi4dogs may have the most up to date info;

http://www.globalspan.net/epi.htm

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

and a yahoo group

https://groups.yahoo.com/neo/groups/k9-EPIGLOBAL/info

I agree with the Nut on the coconut oil, it also has antimicrobial, and some anti-inflammatory properties.

[losul]

Jerry was just reading on the global span site – So i Guess even though coco oil is very easily digested and takes very little enzymatic action to do so, it might still be advisable to incubate first;

“Incubating supplements.
Some supplements should be incubated, because they require digestion
Example: Kelp, fish oils, coconut oils
Some supplements should not be incubated, or they will be destroyed
Example: Probiotics (such as acidophilus)
For some supplements, it doesn’t seem to matter
Example: L-Glutamine
Whether or not a supplement should be incubated can be confusing. A general rule of thumb is that if it’s a food-like substance which likely contains carbohydrates, fats, or proteins, it should be incubated. Some supplements may contain fillers or extra ingredients that require incubation, so read labels closely. Good advice on this topic is available from the K9-EPIGLOBAL Yahoo Group.”

• This reply was modified 9 years, 10 months ago by losul.

[Susan]

Hi Iosul, May I ask a few quiestions, Patch had an ultra scan last Thursday cause he was vomiting up only his kibble for 2 days & had his pain under right side rib cage again…his Ultra Scan came back all good, this new vet said IBD like Patches first vet has said but Im having troubles believing that he has IBD as Patch suffers more stomach reflux & burping, I feel that Patch has GERDs this new vet wants Patch on Prednisolone 30mg daily for 2weeks then we reduce, I told him about Patches stomach & Patches bad acid & bringing up his chicken & pumkin when he burps so I put it on toast now & this keeps it down, he just said give him Zantac as well then he said that the Prednisolone will fix his red paws, I told him that his paws go red only when it rains & he walks on wet grass as we’ve had rain again for over 1 week, now Patches paws have cleared up again cause there’s been no rain plus I try not to walk him on wet grass…Ive read that Prednisolone isnt good for dogs with Pancreatitis or Stomach problems as it can cause stomach ulcers, I still havnt given Patch his Prednisolone, Ive been giving him his Zantac again & Patch seem much better..see I stopped his Zantac about 2 months ago as he was doing much better & all his reflux went away he stopped waking up in the middle of the nite with Patch swollowing & swollowing acid, it all stopped only some mornings he’d be a bit burpy, The only way to see if he has IBD is to cut him open like his other vet wanted to do & I wouldnt let him as Patch doesnt have no diarrhea no more since Ive worked out that he needs a low fat diet, Im even wondering does he have pancreatits as the ultra scan came back all good but the Pancreas mite be getting better & not be swollen as Patches pain did start 2 weeks ago when I started moving, he started following me like I was leaving him behind, I feel that he started to stress himself out & has givin himself acid thru stress.. I have GERD & he seems to have alot of my symtoms.. first vet tried Losec 20mg but Patch had a reaction on the 2nd day his gums went white & he was acting real weird & falling over, I had to carry him home from the beach that morning maybe 20mg was too high for a 18 kilo dog he was 18kilo back then now he’s around 16-17 kilos …what would you do if Patch was ur dog, you mentioned supplements Ive read abit about L-Gutamine but I live Australia do I go to the health foods store & use a human one also what do u mean when u say incubating. I give Patch a probiotic every moring Ive been doing that since last August..Ive been too scared to try any oils at this time, I dont want to aggravate his stomach in anyway..

[theBCnut]

Not Losul, but incubating is the special soaking process that EPI dogs’ food has to go through before they eat it. Basically, they preactivate digestive enzymes to start digesting the food before eating it.

[Susan]

Hi losul, I just read the first link on EPI & Patch has all those symptoms, wet burps,vomiting indigested kibble, always hungry, looking for scraps on our walks,Temperament changes, he has started to fight back if a dog bites him first, bad aggression, failure to gain weight, gurgling loud bowel noises, abdomin discomfort after eating..Ive quickly read & I never saw anywhere about taking Prednisolone, so maybe its good that I never gave him the Prednisolone, Patch had a blood test last year September but he never fasted for the blood test blood test came back all good.. with the Vitamin B can he take human vitamin B.. Im sick of dealing with vets they just read Patches notes & what the other vet has written & was doing, then just say the same thing…I found a holistic Vet but she’s at the same vets pratice that Patch was going too, so they all talk & will come back with the same crap IBD…

[DogFoodie]

Sue,

Did you go to the holistic vet? I couldn’t decipher from your post if you had or had not.

I use several vets, including an integrative vet at an office where I’ve used two traditional vets. They have very different philosophies, but respect each other’s opinion. My integrative vet is, by no means, a shrinking violet; she speaks her mind and readily admits her beliefs differ from the rest of the practice.

If you haven’t been to her yet, maybe give it a try.

[Susan]

Hi Paddy, so you buy something that you have to add to their food, also if Patch was ur dog what would you do, where would you start, when I give Patch his chicken & pumkin at night he gets his gurgling bowel 2-3am so I have to stick with the kibble at nighs for his dinner,id love to either stop his kibble or maybe change his kibble, the Holistic Select senior is min fat 10% but max is 11.98% maybe this has been causing him his pain also the protein is 26% Ive found when I started giving him more protein he had more reflux & his pain. I was going to try the wellness Simple kibble heathy weight its 8% fat but the fiber is 6% & has peas is second ingredient then theres the Eagle packs new range & their low fat is 6% but the new formula is coming out until October..all the grainfree kibbles that I can get are too high in fat, I just dont know what to do no more…

[theBCnut]

I think I would try that holistic vet, even though s/he is from the same practice, s/he may have a different philosophy about treatment. They usually do, that’s why they become holistic vets in the first place. They are all about getting to the bottom of an issue instead of just treating the symptoms.

[losul]

Hi Sueb66. I replied to you, but for some reason it didn’t appear to post. Tried again and it said was rejected as a duplicate of what I already said. So I guess it’s in some kind of limbo, maybe because I included 4 links in it? I have still a copy of my reply, so maybe I’ll try again later.

[losul]

Trying this all over again, leaving out the last link this time…..

Hi Sueb66. The test for EPI would be a specific test for it, not included in ordinary blood work. I think in the U.S., Texas A.M. still does most of the current testing. If there is a B-12 deficiency and it is EPI related, no, an ordinary human B-12 supplement for it would
NOT work well at all. There is more info on the EPI sites, I provided to Jerry. Notice what the vet says about EPI in discussing IBD in the first link below, except she refers to it as PEI instead.

I can truly understand your frustration, and wanting to get a more reasonable solution than a surgical biopsy, and/or treatment with steroids which seems extreme, scary and a last/near last resort, I would be too. To be fair though, I can imagine your conventional vet(s) probably get frustrated also, and would much rather get a clearer diagnosis and treatment plan.

I don’t really know exactly how long all this has been going on, exactly what diagnostic testing has been already done, what has been ruled out and what has not, what medicines/treatments/alternatives/supplements have been tried, how much and whether you have adhered to your vets’ reccomendations etc. I also don’t really know what kind of diagnostics, drugs, supplements, foods etc. are available there in Australia. I can’t really say what i would do, as I’m not in your shoes, and so much is unknown. All one can do is research as best as possible, see that hopefully all the bases have been covered, learn risks, gain more knowledge, come up with some possible answers/solutions/alternatives, and make good decisions.

IBD is a pretty generalized but often complex condition, that can have several root causes and much interconnectibility with other issues. It basically means a chronic inflammation of the digestive tract. Left uncontrolled it can lead to more serious issues. I would guess the vets have explained that to you? A more holistic or integrative vet may come to some of the same conclusions as your current vets, but would likely differ on exact course(s) of action/approach. Perhaps you should still seek one out or try the one you mentioned?

Hopefully pointing you to some additional articles may help some;

http://www.veterinarypartner.com/Content.plx?A=598&S=0&EVetID=0

http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2006&Category=&PID=16071&O=Generic

http://dogaware.com/health/digestive.html#ibd

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