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EPI - Exocrine Pancreatic Insufficiency.
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Austin, TX
Member Since:
28 April 2011
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25 October 2011 - 12:56 pm
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Hi guys! I thought I'd add this for anyone who might need it. As an EPI mom I've been handling this condition since March 30, 2011, when Vito was diagnosed, so I wanted to offer my assistance to anyone who has an EPI pup or thinks they might have one with EPI. I'm not a vet, but I can point you toward some great people and great resources for managing this disease.

Okay, first off. EPI is NOT a world ender! If your vet diagnosed your pup with EPI and said there was nothing you could do, DON'T LISTEN. There have been many pups that were diagnosed who went on to live long, healthy, happy lives once they were given proper treatment. My own pup gained 32lbs once he was given the right treatment and you can't even tell he has EPI anymore. It is a very dramatic and scary disease, and you will think you're going to lose your best friend, I know, I've been there. But it CAN be treated and you CAN have your baby back! Don't give up!

Second, it isn't going to kill your wallet. EPI is treated with a combination of pancreatic replacement enzymes, Tylan, and B12. Of these the enzymes are the most expensive, but thanks to people like EnzymeDiane you can get them far cheaper than the vet. I have a 90lb GSD with EPI and I purchase Pancreatin 8x from her. 1/2 kilo costs me a little over $80 and it lasts about 2.5-3 months. The dosage changes depending on the dog, but that shows just how inexpensive it is to treat.

Finally, while vets are wonderful people and great resources, keep in mind that EPI is a rare condition and many of them only had it briefly mentioned in vet school. Their information may be out of date or sometimes altogether incorrect. Have your information ready when you go in, and insist that they do the proper tests and understand the disease.

Now to get into the important stuff.

Symptoms.

EPI, Exocrine Pancreatic Insufficiency, is the inability of the pancreas to manufacture and secrete the necessary enzymes required by the body to digest food and absorb nutrients……causing the body to starve no matter how much food the dog eats.

The most common signs can include severe weight loss, large, smelly, yellow or grey colored cow-pie like stools, eating of their own stools, a ravenous appetite no matter how much food is given, attempts to eat odd objects, and nervous or aggressive behavior. The dog (or sometimes cat, they can have this too) is literally starving. It is scary to see, I know.

How to diagnose.
There are three tests that need to be done to get a full diagnosis. They are called the cTLI, Cobalamin, and Folate tests. Fasting for 12 hours before the test is required for accurate results. Ask your vet for a copy of the results, as the numbers of each will give you a good sign on where you'll need to go next.

Treatment
I'll say it again, this CAN be treated and it IS NOT a world ender. You can have your baby back, and it really isn't going to even impact your daily routine all that much.

Food
As a small footnote before I get started, most EPI dogs cannot digest grain, so a grain-free food will also help you on your way to a healthy pup. I buy Nature's Domain at Costco, and it's actually cheaper than most of the premium foods at the pet store while still being a good quality food.

SIBO
Pups with EPI are almost always diagnosed with SIBO (Small Intenstinal Bacterial Overgrowth), this is treated with a 30 day run of Tylan or Metro, with Tylan being the most commonly used. A minimum of 30 days is required to fully kick SIBO, and it is a good idea to keep some handy in case it does return. You can get Tylan on Amazon.com, and I believe it's about $40 for one jar of the powder.

B12
B12 is also essential. EPI pups will probably need a run of B12 injections as their bodies haven't been able to absorb it properly. Some pups are able to graduate down to pills, or like with my pup, I give sublingual and while not as effective as an injection, it does work. Price on B12 (also known as cobalamin) varies.

Enzymes
Finally, enzymes. I cannot say enough good things about EnzymeDiane. She is a godsend to those of us with EPI pups, as Viokase or Pancrezyme can cost upwards of $80 for one small bottle at the vet. The rule of thumb is 1tsp per 1cup of food for Pancreatin 6x, but this will be adjusted depending on the type of enzyme you use (x6 or x8) and your personal pup's needs. Some need more, some need less.

Remember what I said about it being easy? I know it doesn't look it, but it is. When I get up in the morning, I grab Vito's bowl, pour in his food, and then heat a small jar of water in the microwave. Only for a few seconds to get it warm, not hot. I scoop in the enzymes, close the lid, shake for a few seconds, and pour it over his food. This goes somewhere out of reach while I go get ready for work. By the time I'm ready to go (20-30 minutes) it has incubated and is ready to eat. I set it down for him and head out to go to work. See? It takes about as much time to tie your shoes! If he needs a dose of Tylan, I pop a gelcap on top of his meal (I have mine in gelcaps). B12? If it's an injection, they'll be so busy eating they won't notice. If you're like me and use sublingual, just stick the tablet under their jowls and call it a day.

Now this is really just a quick and dirty overview, if you want to get into the details and learn about this disease, go to http://www.epi4dogs.com. It is a wonderful site, and the forum is active and eager to help new people. All of the information I am giving you right now and TONS more is on there, plus they'll probably correct me on a few things. 😉 All in all, remember that you can do this, and caring for an EPI pup is still cheaper than paying for cable. If you need any help you can always email (lizziescouch@gmail.com) or PM me. I'm also on their forum all the time, so feel free to drop by!

Love to all of you fellow EPI moms and dads, you aren't alone!

Proud mommy of a Belgian Malinois tripawd named Lizzie, who is completely spoiled rotten, loves kids, and will be going into therapy dog training as soon as I can afford it. You can find her blog here.

Also proud mommy to Vito, 3(?) yr old GSD. Adoption weight: 58lbs. Current weight: 90lbs. Goal weight: 85-90lbs (ACHIEVED!). Tested positive for EPI on March 30th, 2011 and stable ever since.

"Sometimes it takes an imperfection to create perfection."

On The Road


Member Since:
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25 October 2011 - 5:38 pm
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What a great overview! You know so much about EPI, I'm just sorry you had to learn it at all! But lucky Vito, what a great pawrent you are for investigating and coming up with ways to manage the condition.

Thank you for sharing this with the Tripawds community, I'm sure that someone will be helped by this information.

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

Las Vegas, Nevada
Member Since:
14 August 2009
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25 October 2011 - 6:30 pm
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Vito is a lucky pup!  Thanks for all that information!

Her Retired AvatarComet - 1999 to 2011

She departed us unexpectedly  January 23, 2011 at the age of 12 1/2.

She was born with a deformed front leg and a tripawd all of her life.

Washington
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1 February 2011
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27 October 2011 - 11:44 pm
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That is a lot of really good info. After reading, I had a couple of questions... 1) What's the typical onset of this -- is it something that a pup usually deals with their entire life, or is it more like Cushings in that it usually hits older dogs. 2) What was the key trigger aside that made you look deeper?

I'm asking, because my Golden, Tosca, has recently dropped a lot of weight -- to the point where I'm starting to get concerned. She was overweight for a while (103 lbs at her peak) but then we kept her around 90-93 lbs. Then she dropped to 83 lbs. Granted, there was a lot of diet tinkering -- it was around the time I switched everyone to a fresh cooked diet plan -- but now I've feeding her twice as much for the last several weeks, and she's still bony. I'm starting to get worried because she doesn't seem to put on any weight regardless of how much I feed her. She doesn't have the "back end" problems that you mentioned, and she doesn't eat poo (grass yes, poo no), but all of your other symptoms seem a little too close for comfort.

Micki

the Woo

~ ~ Rio ~ ~
Forever in my heart...

April 2000 – January 20, 2012
Diagnosed with Mast Cell Cancer in June 2007. Left rear leg amputated Feb. 8, 2011.
Mets discovered Aug. 31, 2011. Read more of Rio's story here.

Austin, TX
Member Since:
28 April 2011
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28 October 2011 - 7:15 pm
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Hi Micki!

EPI can occur any time in a dog's life and it is a lifelong condition. There have been stories of pups that have miraculously recovered and no longer needed treatment, but that's 'unicorn sighting' level of rare. We've had pups of all ages come into the EPI forum asking questions and seeking help. It does seem to usually be most prominent past the 1 year mark, but that's just my personal observation and I don't have any scientific fact to back that up.

For me, it was the elimination of everything else. My vet really had no idea about EPI, and we had Vito tested for Giardia, allergies, you name it. When I found epi4dogs.com, I realized his symptoms were pretty spot on and insisted on the test.

As for your pup, there's so many different things that it could be. And since every pup seems to have slightly different symptoms, it could be EPI or it could be something else (IBD might be another possibility, but I really don't know much about it) If you don't want to spend the money on the test, you can always just try her on some enzymes. Enzymes are harmless (except those rare pups who are allergic to pork) and won't cost as much. If she were already diagnosed as EPI my first thought would be SIBO, since it can show up in other symptoms without showing up in the stools. Tylan is also harmless so you can give that a shot too. I don't wanna tell you specifically if that's what you're dealing with or not, since I don't want to accidentally send you in the wrong direction, but you can always hop on the EPI forum and ask…many of the people there have dealt with far more than just EPI, and might be able to better point you in the right direction. I hope this helps!

Proud mommy of a Belgian Malinois tripawd named Lizzie, who is completely spoiled rotten, loves kids, and will be going into therapy dog training as soon as I can afford it. You can find her blog here.

Also proud mommy to Vito, 3(?) yr old GSD. Adoption weight: 58lbs. Current weight: 90lbs. Goal weight: 85-90lbs (ACHIEVED!). Tested positive for EPI on March 30th, 2011 and stable ever since.

"Sometimes it takes an imperfection to create perfection."

Washington
Member Since:
1 February 2011
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28 October 2011 - 11:05 pm
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Thanks for your reply. I think I will do some more research. I'm trying not to be to hypochondriacal. Since I already have one sick girl, I think it's easy to get a little paranoid about the others. All of our pups have lost some weight on the new diet, but T has gotten so thin that I've started upping the amount of food she's getting to almost double, and still no weight gain. Granted, her Dr. loves her at this weight, cuz she's got joint issues.... I was just concerned because she doesn't seem to be able to put a couple of lbs back on with the added food. Hopefully, it's nothing, but I still appreciate all the info.

Micki

the Woo

~ ~ Rio ~ ~
Forever in my heart...

April 2000 – January 20, 2012
Diagnosed with Mast Cell Cancer in June 2007. Left rear leg amputated Feb. 8, 2011.
Mets discovered Aug. 31, 2011. Read more of Rio's story here.

Austin, TX
Member Since:
28 April 2011
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7
1 November 2011 - 5:49 pm
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I know how you feel. Every time Lizzie has an upset tummy I get all on edge thinking she's got EPI too. Gotta love being an overprotective mom!

Proud mommy of a Belgian Malinois tripawd named Lizzie, who is completely spoiled rotten, loves kids, and will be going into therapy dog training as soon as I can afford it. You can find her blog here.

Also proud mommy to Vito, 3(?) yr old GSD. Adoption weight: 58lbs. Current weight: 90lbs. Goal weight: 85-90lbs (ACHIEVED!). Tested positive for EPI on March 30th, 2011 and stable ever since.

"Sometimes it takes an imperfection to create perfection."

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