# EPI-Exocrine Pancreatic Insufficiency



## vrmueller (Jun 14, 2008)

Ruby is now 8 years old and has continually had digestive problems. I've had allergy testing done, changed up diet, probiotics, you name it. In the last year and a half she has lost about 13-14 pounds. She is absolutely ravenous. She will eat anything she can get her mouth on, even poop. She had parasites earlier this year and was on the proper protocol to get rid of them. Her food behavior was still there. I came across EPI today and it fits her to a T. I have an appt the the vet tomorrow to discuss my concern. It is so hard to take her on walks as all she does it scavenge for food. I can believe how many banana peels she has found. Anyone else have experience with this?


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## Ljilly28 (Jan 22, 2008)

That sounds so upsetting, and I hope this is a fit for her so your vet can help her. I have never had a golden behave that way , although some real chow hounds. It does sound beyond the norm.


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## fostermom (Sep 6, 2007)

EPI isn't common in Goldens though, is it? I've really only heard of it in GSDs. I am assuming her thyroid has been checked and that she doesn't have hyperthyroidism? I know it's not very common, but I wonder if that may be what's going on.

Excess Thyroid Hormone in Dogs | petMD


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## rooroch (Nov 7, 2012)

I have a friend here with a GSD that has it, diagnosed by a specialist vet. He has pills meant for humans 3 times a day in his food. He has vitamin B12 injections twice a month and very expensive special kibble for this digestive problem. If he did not have all this he would have died. He is now 11 years old and was diagnosed at 3 years old.
It is treatable but you have to follow all the vet instructions and be careful what she eats. Good luck.


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## Karen519 (Aug 21, 2006)

*Ruby*



vrmueller said:


> Ruby is now 8 years old and has continually had digestive problems. I've had allergy testing done, changed up diet, probiotics, you name it. In the last year and a half she has lost about 13-14 pounds. She is absolutely ravenous. She will eat anything she can get her mouth on, even poop. She had parasites earlier this year and was on the proper protocol to get rid of them. Her food behavior was still there. I came across EPI today and it fits her to a T. I have an appt the the vet tomorrow to discuss my concern. It is so hard to take her on walks as all she does it scavenge for food. I can believe how many banana peels she has found. Anyone else have experience with this?


Please let us know what the vet says about Ruby.


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## GRluver (Sep 29, 2013)

We run across this quite often in cats in my clinic. The test is expensive so if we suspect it we add some of the pancrealipase powder to their food and voila the next day their stool is completely normal. Cats hate the powder so since this disease focuses around a high protein low/no carb diet we had the owners feed a raw diet and NO powder and their stools remained normal. if you truly suspect this you can try feeding her a raw diet (no treats) and see if her stools improve. Are her stools large and pale in color?


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## Ljilly28 (Jan 22, 2008)

So much to learn- I had never heard of this. Will be following and hoping this is the ticket for your girl.


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## vrmueller (Jun 14, 2008)

Update on Ruby:

Ruby does have autoimmune thyroiditis. It was dx by Dr. Dodds 5 years ago. She is tested yearly now and on the appropriate dosage of Soloxine.

She is on a raw diet and has been for 5 years. Before the raw she would vomit daily and have 10 to 12 runny bowel movements. Ruby cannot tolerate any type of grains. 

The vet suggested we do a more intensive fecal screening and labs. Results came in yesterday and were all negative for anything suggested, including Cushing's.

Today, I brought her in for a fasting blood test for EPI. Hopefully, we will get results by the end of next week.

Her stools vary. Even on a raw diet she poops a lot. Some may be firm and some may be soft serve. My biggest concerns for this test are weight loss over a year period without a change in diet or exercise, poop eating (hers and others) and a ravenous appetite. An 8 year old Golden could never eat like her and not pack on the weight. I know EPI is more common in GSD, but you just never know.

Thanks all!! I will update as soon as I hear something.


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## Tahnee GR (Aug 26, 2006)

My girl Suva is suspected of having EPI as well. Her first test for cobalamin did come out very low. She goes in for a TLI (TLI (Trypsin-Like Immunoreactivity) test next week, if her fecal test is normal. It is considered to be the gold standard test for this.

I have had an EPI dog before, in the early to mid-90's, a Belgian Tervuren, and Suva's symptoms are nothing like his. He lost weight, did not look thrifty and every time he pooped, my dogs would go racing over like it was a sundae bar  It was because he was not digesting his food . His poops were terrible  I had to get enzymes from a GSD person in Milwaukee, which pre-digested his food for him. He improved tremendously after that.

Suva's coat is terrible but she is actually a bit overweight and no one is particularly interested in her poop 

In her case, the vet feels it is either EPI, IBD, some kind of parasite overload or cancer


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## vrmueller (Jun 14, 2008)

I'm wondering if there are varying degrees of EPI. Most of what I have read on it states their poop has undigested food in it. This was Ruby prior to having her on a raw diet. Her poop firmed up nicely. However, when she gets into something on a walk all bets are off and the poop is soft serve. I hope Suva gets help and she feels better. Keep me posted on her results. Ruby's fecal panel came back quickly. I'd say it was 2 days.


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## Tahnee GR (Aug 26, 2006)

vrmueller said:


> I'm wondering if there are varying degrees of EPI. Most of what I have read on it states their poop has undigested food in it. This was Ruby prior to having her on a raw diet. Her poop firmed up nicely. However, when she gets into something on a walk all bets are off and the poop is soft serve. I hope Suva gets help and she feels better. Keep me posted on her results. Ruby's fecal panel came back quickly. I'd say it was 2 days.


I will, and I will be following Ruby's progress as well.


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## SandyK (Mar 20, 2011)

Poor Ruby...and you. I hope you are able to get some answers as to what it is and how to fix it. Thoughts are with you!!


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## Anon-2130948gsoni (Apr 12, 2014)

Thanks for this thread. We discovered last week when I took my ten-year-old Aussie to the EV for quills that she is now down to 50 lbs from her normal weight of 60 at her annual exam last spring. I've been dealing with diarrhea with her on and off all year, but all the fecals were negative and metronidazole didn't work. We put her on higher doses of prednisone and Purina OM food, thinking it might be IBS...and that's been a disaster. She's STARVING and everything is going straight through.

So now we're thinking EPI, as well. It's actually found in most breeds, but GSDs and a couple of other breeds seem to have a genetic tendency. 

She's on canned EN for the weekend and the enzymes arrive Monday. We're skipping the test for now and going straight to the treatment, because it was going to take a week and she's too miserable. We'll see how she responds and test her cobalamin and folate in a few weeks.

You probably already know about these sites, but in case anyone is interested...

http://www.epi4dogs.com

http://www.enzymediane.com


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## rooroch (Nov 7, 2012)

Specific CID Digestive Support 8 kg order online.

This is the link for the food my friend feeds her GSD with epi since 3 years old (now 11). Her specialist vet prescribed it and it works really well. He still eats poop but is not as ravenous as he was and his weight is normal and has stayed normal all these years. His coat is thick and shiny and he has good energy on walks, etc. 
She tried to feed home cooked food thinking it would be cheaper and better and he got sick again.


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## vrmueller (Jun 14, 2008)

Noreaster, please let me know how your love responds to the enzymes. I did join a FB forum group last week and they posted the go to person for enzymes. Wishing you the best!


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## Tahnee GR (Aug 26, 2006)

Suva's panel came back, and she does NOT have EPI. She has been diagnosed with an overgrowth of "bad" bacteria in her intestines.

Apparently the cause of this overgrowth is genetic. I don't have a name for it yet, but I will ask when the vet calls me back.

She has a milder case-she is only low on cobalamin, not folate too.

There are two approaches to treatment-antibiotic (metronidozale?) or probiotic. We have opted for probiotic therapy and I have started her on Probios, while my vet researches some other probiotics I asked her about. She does get double the recommended dosage though. The probiotics will be lifelong, as on her own she will never have the appropriate balance of bacteria.

She will also need cobalamin injections for, I think, six weeks. My vet will show me how to give the injections, since I do my own vaccinations and have given sub-q fluids as well.

Once her cobalamin is normalized, she will require annual testing to make sure it stays normal.

It should not be expensive to treat-the Probios is very affordable at Fleet Farm, and the test is just once a year. 

I am pleased to have an answer and anxious to get Suva started on her injections.


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## rooroch (Nov 7, 2012)

Glad you got a diagnoses that is relatively easy and cheap to treat.


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## SandyK (Mar 20, 2011)

Glad to see you got Suva's results back. Good luck with treatment!!


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## vrmueller (Jun 14, 2008)

Ruby's EPI test also came back negative. Her folate level was elevated and vet says it's SIBO, small intestine bacterial overgrowth. She started on an antibiotic called Tylosin or Tylan powder. All of her other levels were normal. Interestingly, my vet spoke with an internal med vet friend of hers regarding Ruby. That vet said she is seeing more and more dogs with SIBO that have been on a commercial raw diet. My vet wants me to try a prescription dry Royal Canin. Ruby has done so well on Nature's Variety. Before the raw, she was a mess of vomiting and the runs. The day she started the raw, she never had an incident of either and that was 5 years ago. She has however, put on a few pounds since starting the antibiotic. She's back up to 55 pounds which is a good thing.


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## Tahnee GR (Aug 26, 2006)

Interesting. Suva is on Fromm's Adult Chicken and Rice. My vet thinks the change to that from Fromm's Performance caused her issues to escalate. 

Her folate level was normal but her cobalamin level was extremely low. She is actually a tad heavy and has been since this started, but her coat is the worst I have seen on a Golden-dry, thin, coarse, no feathers to speak off  And no heat cycles for a year now.

Apparently Suva will never be able to generate a good mix of bacteria on her own, so will always have to be supplemented with probiotics.

I keep Tylan on hand, and just got a new order in before her diagnosis. We are going to try just probiotics though, at least to start with.

Glad it is not EPI, and I hope Ruby is on the road to recovery!


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