Saturday, March 19, 2011

Beaner Has Exocrine Pancreatic Insufficiency: Beaner's Story (Part II)

Beaner's story is shared by Angie Falcsik of  Pawsitive K-9 Obedience. You can also follow her on Twitter or Facebook. If you haven't yet, don't forget to read the first part of the story first.

Check out my earlier article to learn more about Exocrine Pancreatic Insufficiency and what pancreas does.

Everything Beaner ate was going right through her and that she was likely suffering from EPI; Exocrine Pancreatic Insufficiency.

I said, “exocrine, what?” The vet explained that there are certain cells (acinar cells) found in the pancreas that are needed to produce and secrete enzymes needed to digest food. They are:

  1. Amylase for digestion of carbohydrates (sugars & starches in grains, fruits & vegetables);
  2. Lipases for digestion of fats and oils; and,
  3. Trypsin and Proteases for digestion of proteins.

Beaner can no longer produce what is necessary to digest her food and allow her body to absorb and utilize the nutrients – basically, she was literally starving and without treatment, would not live!  

EPI is not curable, only treatable with specific enzymes. I made another appointment to go in as soon as the other tests were completed.

After hanging up with the vet, I sat down and cried!  

How could I not have known it was this serious? What kind of mom am I?  Why didn’t I take her in sooner?  I decided to do some research.  I read more about the enzymes that were needed to digest food, about how this disease can affect other parts of a dog’s body; organs, immune, nervous system, and mental status. Dogs suffering from exocrine pancreatic insufficiency can become depressed, aggressive and/or fearful.

I also found out that this disease is very hard to diagnose and that many times the obvious symptoms do not reveal themselves until 80-90% of the exocrine pancreas acinar cells are destroyed.  

While that did not change anything, it at least eased my mind a little in that I was not beating myself up – as much. I pride myself on being very aware of my dog’s health and daily routines and now this is the second dog that something serious has happened and I didn’t realize it immediately. First Indy with his dysplasia and now Beaner with EPI.

A few days later we were back at the vet.

Beaner’s urine test was perfect and her blood work was as well. No protein loss and no cancer.  

The vet discussed a more specific test where blood would be drawn again and sent down to Texas, the only lab in the US that conducts this particular test and runs approximately $200.00. This test, called a cTLI test, is the only test that can confirm EPI. One is looking for a range between 5.0-35.0.

Now I had to decide what to do.

Her blood work was normal, her urine was normal, her stool was grey, slimy, running, she was loosing weight, bony frame, losing hair, fur turning brittle, mental status changes, tummy gurgling/gas – classic EPI symptoms. The enzymes she would be started on is $150.00 a bottle which lasts approximately 6-8 weeks.

I made the decision to start Beaner on the pancreatic enzymes without having the cTLI test as I completely trust my vet and he has seen this many times before and has patients suffering from this disease.  

Of course, we could perform the cTLI at any time if I chose to do so but for now, I chose to get her started on the enzymes right away.

There are a few ways of treating this, but the recommended treatment is powdered porcine pancreatic enzyme, which, by the way, does not smell very good.  

The vet warned me it smells like vomit and I asked if Beaner will even eat it if it smells that bad. His response, “she eats poo doesn’t she?”.

Touché. As it turns out, it is not as bad as they made it out, but you definitely do not want to get your nose too close!  I picked up a few cans of pumpkin and canned dog food on our way home with enzymes in tote.

The directions state that the enzymes must “incubate” for a minimum of 10-15 mts so I measured 1 tsp with a good size spoonful of canned food, mixed it really well and let it sit for the appropriate time. Meanwhile, the dogs are going crazy because they know it’s dinner time, they see me preparing the food and then they have to wait! Not happy campers I tell you! 

I continued this regimen for a few days.

I got Beaner’s food ready in the morning after my work out and while I was getting ready for work which worked out well, but it was the dinner time regimen that was a nightmare for everyone.

I remembered a Yahoo Group that I found and joined for owners of EPI dogs and posted my dilemma. 

I received a number of really great responses! Many people had to same situation I did. They worked late, multiple jobs and didn’t want their dogs to have to wait to eat after a long day.

It was also recommended that depending on the level of the disease, feeding small amounts multiple times a day was the best thing to do until it was under control.

The idea that worked best for me was place her dry kibble in containers along with the enzymes and shake really well so all the kibble is coated. I have about 5-6 containers in the fridge at all times. When I feed the dogs at night, I add just enough water to barely coat the kibble and let it sit over night for her morning feeding.  In the morning, I do the same thing for her evening feed.

This is a great idea if one is going on vacation and either has a pet sitter coming in or wants to make sure the boarding facility has the appropriately mixed food/meds.  It was even suggested to mix food, meds and meds, let it incubate a few hours and then freeze it! 

With my schedule, working 3 jobs, and crazy hours, this formula works great for Beaner.  If I’m going to be running late, I can have a neighbor come over and feed the dogs and know she is getting exactly what she needs.

Okay, so back to our story.

The first week was difficult as I was not seeing any changes in her behavior, appetite, poo eating regimen, attitude, weight – nothing!  

I called the vet and he said we needed to give it a bit more time. If I was still not seeing any changes in another 4-5 days, we would move forward with cTLI test.

A few days later I was looking out the window and saw Indy outside doing his duty and Beaner right next to him waiting for him to finish. I was just about to tell her to leave it so I could pick it up when much to my surprise, she sniffed it and walked away!  I knew that this meant progress was occurring and she was feeling better!  The enzymes were working!

Each day I noticed more and more signs that she was doing better.  

She was not as ravenous at the food bowl, her fur started to feel less brittle and after about a week, actually started feeling soft again! She began to get that spark back in her eyes and spunk in her attitude!  She even began to smile and wink at me again!

She was able to play and walk longer without getting so tired she could barely stand up and her mental status became more stable.  

She became tolerant of the little things again and her depression was going away. I knew she was really feeling better when her nosework started going from hunting for the food box because she was starving to hunting because she loved the game!  My girl was back!

It has now been about almost a month and she has gained 5 pounds!  

Her fur is really soft again, she plays, throws her toys at me, runs and has that sparkle in her eyes again!  We still have a ways to go to put another 12-15 pounds but we are well on our way to better health.  Although her normal weight when she was younger and healthier (developing some hip/joint issues), the vet and I decided not to bring her weight back to her 76-80 pound weight but to keep her at about 70-72 so as not to put too much pressure on her joints. 

Beaner will need to have her enzymes for the rest of her life, but now that we have finally gotten the right diagnosis, she is getting healthier day by day!  

I do of course, continue to read and converse with my Yahoo EPI group as  there is always something that comes up in someone’s life that we can learn from to help Beaner in her recovery. They have been a wonderful support group and wealth of information.

***

For nearly 10 years, Angie Falcsik has been professionally dedicated to the training, rehabilitation, and rescue of dogs. But the roles of trainer, rescuer, and rehabilitator have been a large part of her life since she was a child. Angie's life-long passion and the goal of her professional career is to educate people regarding responsible dog ownership and the realities involved in being a responsible dog owner. Angie has been working with Animal Control agencies and shelters for many years and has offered expert advice and testimony in animal abuse and neglect cases. Angie has been professionally training dogs since 2002 and is an AKC Canine Good Citizen Evaluator. Through her classes, private in-home training, and rescue work, she has trained hundreds of dogs. In her own home alone, she has fostered and trained over 350 dogs!

Angie's unique obedience class (Language and Leadership) focuses on pack leadership, body language, and positive reinforcement. Her classes involve training the owner and family members and rehabilitating the dog. Angie's method uses body language as well as voice commands to develop and establish an appropriate relationship between owner and dog. If your dog is not listening to you, chances are, your dog does not have sufficient respect for you. Angie will teach you how to become a pack leader and earn the necessary respect so that following your lead becomes second nature to your dog.

In Angie's class, you will learn the importance of pack leadership, establishing rules and boundaries, along with an exercise regimen, and how to implement these essential aspects of responsible dog ownership into your lives. You and your dog will also learn basic obedience such as heel, sit, wait, down, and come, as well as additional training/rehabilitation measures that are specific to your dog and family. While some basic training is essential for all dogs, Angie believes that not every technique works or is appropriate for every dog and family. Each dog and family is unique and Angie's training philosophy and methods are designed to address and work with different family/dog situations and living styles.


Related articles:
Weight Loss, Brittle Fur, Starving All The Time ... Beaner's Story (Part I)
Exocrine Pancreatic Insufficiency (Maldigestion)


Further reading:
Exocrine Pancreatic Insufficiency (Maldigestion Disorder) in Dogs
Exocrine Pancreatic Insufficiency at Veterinary Partner
EPI – Exocrine Pancreatic Insufficiency
Exocrine Pancreatic Insufficiency Forum for dog owners

9 comments

  1. That's a great story and that you are taking such good care of Beaner.

    I knew nothing of this disease until you wrote about it and now I feel I know quite a bit.

    Keep it up and enjoy life with Beaner.

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  2. You were absolutely right not to waste anymore time for the last test and start treatment. In the end I think that is what safed Beaner. There is always a risk in those kind of decisions. It must have been very tough for you, but now you can rejoice you did it. Happy you still have your beautiful girl and she is alright.

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  3. Kenzo, I think that particularly if there is very little risk with the treatment it can't hurt to start the treatment and also use it as a diagnostic confirmation.

    It would be a different story if the treatment potentially had serious side-effects or it was the kind of treatment that universally makes symptoms better across the board but doesn't solve anything, such as steroids.

    ReplyDelete
  4. I was thinking liver.
    So glad to hear that Beamer is doing well and has gained 5 pounds. Wonderful.
    The idea of having the food premixed and ready to go is excellent!

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  5. Hi Jen, exocrine pancreatic insufficiency is actually the better diagnosis, as it is treatable with the enzyme supplementation.

    So good to see a dog turn around, isn't it?

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  6. Wow, I am so happy for Beaner, but this post made me sad because I think our Boston Terrier had this! She had all the symptoms and had suffered from pancreatitis many years earlier, and yet her vet never mentioned this illness to me. She lived almost 15 years but was very skinny by the end, ravenous, ate poo, had gray slime on her poops, etc. She finally started having cluster seizures and we had to put her down. I surely wish I had known about this illness in time to possibly have helped her. Sigh...thanks for the wonderful article.

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  7. Hi Emily, so sorry about your dog. It seems that chronic pancreatitis is a common cause of EPI in humans and cats, but rarely in dogs. In dogs it seems it's most likely an inherited condition. Terriers are in the affected group.

    It is possible that your dog had this. Kind of strange that your vet wouldn't have considered this as one potential cause of her symptoms.

    But there are other conditions that can cause similar symptoms. I'm sure your dog loved her 15 years with you, it is a good age. (((hugs)))

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  8. So sorry to hear about Beaner's illness, but so glad she is feeling better. May the new health regime work well for her. Husky hugs to Beaner!

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  9. Thank you for you kind words. Yes, the enzyme supplement does what her pancreas cannot. So that takes care of business.

    Hugs to you sibes

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