What is Exocrine Pancreatic Insufficiency?
And why are we writing about it? Exocrine Pancreatic Insufficiency, EPI for short, is a condition where the pancreas doesn’t create a sufficient amount of digestive enzymes to allow digestion of food consumed. We wouldn’t even know it existed if our poor pup, Rocket, hadn’t been diagnosed with it.
We “adopted” him right before Christmas of 2019, just after his first birthday, from a friend I used to work with. Long story short, he and his family had to move, but wouldn’t be able to bring him with them. Still saddens me to think about it, but at least they can watch as we post his antics on Facebook.
We met at my friend’s house to get acquainted. At first, all Rocket did was bark at me. Thankfully Nick was able to step up, taking him outside on the lead. They hit it off immediately, walking around the neighborhood. Fifteen minutes later, we were on our way home in the “Shepherd Shuttle”.
Why is this background information important? It provides a backdrop of the quick onset and the circumstances of Rocket’s declining health. He was healthy and thriving when he first came to stay with us. He spent the first several weeks with Nick, but that didn’t work out, so now he lives with us.
Mystery and Uncertainty and Too Much Information
If you’re squeamish, you may want to stop reading now. We’ll be talking about runny stools and other digestive and behavioral issues. I’d like to say if you have children, then none of this will shock you, but I could be wrong…
Rocket hadn’t been with us two months and was already on his third trip to see the vet. First his ears. Then his “surgery”. Third time to have the stitches removed. In that short amount of time, he lost weight, but his energy level never dropped. He only slows down for a minute, then he’s right back at it.
But over those short two months, he’s developed a chronic incontinence. Ann started cooking beef with rice and chicken with rice for his meals, to avoid any potential issues with the dog food, like allergies. He was doing better until we tried to get him back on his regular dog food. We even tried Brigel’s food. It wasn’t long before we were back to cooking meals for him.
Clean Up On Aisle 5!
One last warning before we go into the details, if you’re still reading, this is difficult to discuss. When we saw Rocket eating his own poop, we knew he had problems. And now so do we. Imagine having to clean up after your dog when they poop in the yard, every single time, and before they can eat it!
I can’t imagine how hungry the poor guy must have been, compelled to eat his own poop. I think most of us would rather starve… Thinking we identified the problem as an allergy to chicken, we continued to feed him anything but, and more of it. His weight came up to 60 pounds, both of us finally in agreement that he needed more food. I thought he looked skinny!
As happy as I was that I was right about feeding the little guy more, he was soon back to having diarrhea constantly, and by now his ribs were starting to show. Ann discussed the situation with the vet who recommended testing him for EPI. The vet told us he weighs 54 pounds. He weighed 72 when we got him. Poor little guy.
Mystery Solved
Sure enough, the test came back positive. This affliction results in the inability to digest food. So even though we were feeding him more, he wasn’t able to digest it, continuing to lose weight. The vet ordered the enzymes he needs every meal, added to for the rest of his life… To the tune of $150 for a 12oz bottle.
We’ve only had Rocket for three months, and worried we’d lose him to this scourge. At this point we’re just happy to have a diagnosis and a remedy! Little did we know what was in store for us! That sounds ominous, but it has has to be done. We already have to keep a close eye on when he poops anyway.
The idea of having to keep such a close eye on your dog’s poop is already beyond the tolerance of some, but snapping pictures to send to your spouse? That’s right, pictures. We need a record so we can adjust the ratio of enzymes to food accordingly, before the stool is bagged and disposed of.
It’s a Labor of Love
The treatment for EPI is by no means a once and done cure. In fact, it’s not a cure at all! It’s an ongoing, life long treatment. The cause? Unknown. At first it was thought to be restricted to the German Shepherd breed. But slowly, over time, different breeds were diagnosed. Even cats can have it.
When we say life long, we mean we have to monitor Rocket every day, making adjustments as necessary. Feeding a different food may require a different amount of enzymes, starting with roughly a teaspoon of powdered or granulated enzymes per cup of food. The ratio will depend on the dog and the distribution of the various nutrients in the blend.
What are these enzymes and where do we get them?
To be concise, they are porcine enzymes, extracted from pig pancreas. There is an enzyme type for every single nutrient. Lipase for fats. Amylase for sugars and starches. Protease for proteins. Pepsidase for peptides. And a whole variety of many more different “-ases”.
While we’re happy to have a diagnosis, we’re not all that thrilled with the enzymes cost from the vet. Thankfully there are a number of places to get them online, and at a significant cost savings. We usually order a month’s supply at once, keeping only enough stored in a sealed container for daily feedings. When we open the last container it’s time to order more.
We currently use the Pan-tenex brand, mainly because of its more granulated formulation. We have also used Enzyme Diane’s brand too, more of a powder. Both are closer to a powder, somewhere between table sugar and confectioner’s sugar.
Meal Preparation
When preparing Rocket’s meals, we carefully measure out his dry food with measuring scoops. Then we measure the enzymes with measuring spoons and sprinkle it on top the food. The mixture is wetted with warm water and mixed to activate the enzymes, then left to sit for twenty to thirty minutes to work its magic.
This takes the edge off feeding the enzymes raw. They will digest flesh almost as well as food. There are other supplements necessary for associated conditions that may accompany EPI. One common supplement necessary is vitamin B-12.
Another is “Slippery Elm Bark”, to suppress overactive biota in the gut. It’s kind of like an antacid, helping to keep the excess bacteria feasting on the nutrient rich mixture in the gut at bay. Even people take it, sort of like beano I guess.
Regardless of how bad it sounds, Rocket continues to gobble down his food. He’ll even give his complements to the chef in the form of a nice belch. If only our persnickety Jasper was so easy to please at mealtime! He’s just following in his brother Brigel’s footsteps, the brother he never met, taken from us way too soon.
Updates and Questions
We’ll continue to add to this post as circumstances warrant. We were dancing around the living room we got the news Rocket had regained his former weight of 72 pounds! He’s well on his way to 75 pounds as of this last update!
If you have any questions or concerns, please feel free to leave us a comment, and we’ll be happy to address them.
We wouldn’t wish this on anyone or anything, but as long as Rocket continues to thrive, we’re happy. And so is he!