EPI - Exocrine Pancreatic insufficiency

Oh bummer, after months of various tests we finally got to the bottom of it . my boy has EPI. well, this will have to be a rapid course on finding out everything about it and also if there are any homeopathic or natural things to give him.. any help much appreciated...

I am very sorry to hear this, but if you have not already done so, have a read through Managing EPI

I know there are various Lists/Groups helping owners of EPI dogs, but am not sure whether I should post them here. You can probably find them quite easily.

The reason I know about it is because Pereg is an Epi - has epilepsy - and there frequently tends to be confusion between Epi and EPI.

You can send me a PM for more information if you would like and I will do my best to help you.

(((hugs)))

Hi Mastines, yes, my previous shepherd was an EPI girl, diagnosed far too late, but I was just lucky that changing vets, I finally got a vet who knew all about this condition and got her tested for it because of his suspiscions with her history.

As soon as we changed her food, he recommended the Royal Canin Sensitivity control capelin and tapioca, and started her on the powder (sorry, forgotten the word for the powder now ) wow, an immediate change in her. The poo's returned to normal immediately, no more diarrhea with undigested food, blood, yellow chronic diarrhea, it was quite miraculous and it stayed that way with flare ups now and again.

We had to restrict all treats, especially any fatty ones, so tripe sticks etc. were out of the question for her, and you can't really put ah, I remember now, pancreatic powder onto a Bonio. Just remember, everything your dog now eats has to have the powder on, otherwise there will be no enzymes produced to digest the food properly if at all.

Vitamin B12 injections are good for this condition, although we never had any as the vets never seemed to have it in, neither could they get it, but if you Google, it does seem to keep those flare ups at bay, i.e. the SIBO attacks (severe intestinal bacteria overgrowth) which this condition tends to cause them.

One vet told me once they've got this condition, they will always have it, and yet another vet way down the line (years later), said she didn't have it anymore he stopped the powder and I insisted he got her tested again after 6 months because she just wasn't right again. It came back positive (low tli count of 4 I think?) and he gave me a big apology!

It's not all bad, and there is a very good Yahoo group that somebody sent me to where I got loads of help and I suggest you might do the same.

Good luck, but my dog lived with this for many, many years until cancer finally got her, so I'm sure yours will be able to cope with the pancreatic powder. It's very, very expensive and sometimes the vets run out of it so beware of that too.

hth

Hi Helena, thank you for your response.. been reading up so much about it and am a bit giddy at the moment.. have ordered the powder but in tablet form from the UK from chemeyes, very helpful as they have a Shepherd with the same condition.. also joined the forum of epi4dogs very informative.. At the moment we don't know how the levels are, won't know until we see the vet on Monday.. There is just so much information on it and so much to digest.. I understand that every dog is different and will find the right levels of enzymes to be helpful.. also looking into making homemade treats myself.. It will be difficult to seperate everything when you have 3 large dogs but it will be done.. That's why I opted for the tablets instead of the powder so it doesn't really matter if one eats the other one's food.. I also wondered if pro biotics would be good.. I have homemade kefir myself, which I think is better than your average yakult etc.. would this be good to give him as well? also am giving them diatomaceous earth, should I stop this?? So many questions all at once but will study more over the next few days and hopefully we will get him back to his young self.. think even my vet will be reading up on this as I think it could be his first case too..

Hi Mastines, and yes, you're right about the rarerity of this condition, my vet had only 2 cases on his entire database, hence the reason the other vet hadn't even seen a case of it.

Yes, pro biotics most definitely! The diatomaceous earth I have my doubts on, and I would like to have used it on my current dog for keeping worms at bay, but I have my doubts on it because of what I've read up on, too many adverse opinions for my liking to risk it, but of course, you'll have tomake up your own mind on this. The only time I ever used it was to slap it on my horse's saddle sore to aid healing which it was very good indeed at, but as for administering orally, I do have doubts.

I'm going back here about 8 years, but a pot of the powder would cost £50 and last me a month, but for me, sprinkling it over the whole food area in the bowl seemed a much better idea than popping in a pill, but again, if it works in the same way, especially if it's cheaper, then it's the wtg in your circumstances.

Fat is your biggest enemy, and if you look up the Royal Canin Digestive Low Fat food you will see that this food is specifically designed for this very problem and my dog did well on this when I changed her over to it.

Regarding the tli test, which of course you already know is a very expensive test and I think I'm right in saying there are only a couple of labs that actually do this test in the UK. Hopefully, he will give you the result printed out and you can then share them with that group and get a very helpful response. I think my girl was 4 on the last count, but at first I think she might have been "2" I can't for the life of me remember whether it's the LOW score that tells them or the "high" but those two figures do ring a bell with me, so I would be interested to hear what your boy's results are.

The Lipase level is another very important factor, another thing which springs to mind when trying to remember how much I Googled back then!

The bad news is, you WILL be getting those awful SIBO attacks, but once you see them rearing their ugly head, I'm sure you vet will give him a quick course of ab's to stop it in its tracks, it worked everytime for us.

When you get a minute, what were his symptoms for you or your vet to consider doing this test, because my poor girl ended up in a terrible state with it because the vet didn't have a clue, hence the reason I changed to another one at that time.

It's supposed to be gsd specific and collies, and the problems I had with my current gsd a while ago, did make me wonder whether I had another one on my hands here, but hers has been diagnosed as IBS (he thinks!) so she's on a one a day Metronidazole which seems to be doing the trick. Just out of interest, next time you see your vet (Monday?) just ask him whether this treatment could help your boy if the powder doesn't work as well as it could. It should work, because your boy has been diagnosed with it, so you are replacing what his body is unable to make, and he will be fine I'm sure.

Try not to worry too much, we had a number of trouble free years once we got diagnosed which is more than I can say for the previous few years she suffered with this. Good luck and please keep us informed.

Hi Helena, just joined the forum on yahoo too and I have written to them as how it started, He started having big pads of bright yellow diarrhea after his dose of
milbemax about 3 months ago, the diarrhea did not stop and blood tests only showed an inflamed liver.
tried various different foods but still no improvement.
also started giving him kefir ( probiotic ) and Diatomaceous earth.

after another blood test ( as he was still losing weight ) we learned yesterday that he has EPI.
don't know the levels yet as we will see our vet on Monday.

I actually mentioned it to my vet as I had done quite a bit of research on the internet and we had already ruled out quite a few things and even giardia.. so we both ( vet and I ) decided to have him tested for EPI.
I think my vet is happy for me to come up with suggestions and we are working quite well together.. he learns and so do I
also he knows I buy things off the internet as it is quite a lot cheaper that way and he actually gives me sites to look at.
the lipase levels which were checked at the previous blood test were within limits and also the anilasa that's why he first thought that it could not be EPI..just shows.

he also thought it was IBS or IBD first or a food allergy.. so many tests done but finally got to the bottom of it.


I have ordered the enzymes in tablet form from chemeyes and hope to start on
them by early next week as soon as I receive them.
other than the large amount of large stools and having stabilized his weight I think ( the vet had not seen him for 3 weeks and said that he actually had put on some weight, even without any medication..
he lost some of his fur a few months back as he was biting his legs ( only his legs though) but that has grown back slowly.
he plays wildly, eats like a horse ( which is understandable as not getting the nutrition to absorb ) and is just his usual self.
does have quite some flatulence and rumbling in his tummy though.


I have also read that there are 2 types of EPI, one is chronic and the other is a one off.. trying to find where I read this but can't find it at the moment.. too many pages been opened since last night..

Anyway, will let you know the analysis when I get them back.

Thank you so much again and update you soon.

Hi I am not sure if this will apply to dogs but myOH has ulcerative Colitis,and he had a major flare up,with the same as what Helena was describing, he went to have Acua-puncture but the lady was a homeopathic practitioner,she advised ArrowRoot powder,maybe the powder that the vet has advised may have some of that,because he has Arrowroot sprinkled on his breakfast and he has been flare up free for some years.Its worth while checking out.crystalgirl

CG - EPI is not ulcerative Colitis, and the treatment is totally different. Especially treatment comparing a human to a dog.

Giving misinformation, as you tend to do, does not help anyone.

Incidentally, what is "Acua-puncture"?

Hi jacquie, will check that out straight away.. the powder which we are getting are enzymes though.. also we could give him pigs pancreas but will have to ask our butcher if he can get that for us.. all so new at the moment.. hut certainly will check the arrowroot too.. thank you x

Thank you Malka.. I did read about it though and aparently some of the thin biscuits made of arrowroot are a possible ( tiny ) treat.. would not know where to get them here anyway and still only suitable for some dogs..