Oh jeez. It seems like I’ve inherited something from my mom… being absolutely terrible at keeping a blog.
The last time I wrote it was April 2021, and I was jumping at recycling bins. Now, it’s June 2022, I am almost two years old! (One year and eight months, to be exact.) I’m not a puppy anymore, I’m a full on teenager (at least that’s what mom says. She always seems a little exasperated when she calls me that.)
A lot has happened since April. I’ve been on a bunch of trails, rode on a paddle boat, met a cat, had to wear a cone of shame, met lots of dog friends! Had a birthday party, celebrated my first Christmas, took LOTS of naps, and, most recently… was diagnosed with Exocrine Pancreatic Insufficiency (EPI).
Weren’t suspecting that last one, were you?
What is Exocrine Pancreatic Insufficiency?
Because I am *not* an expert, all information below is from a non-profit organization dedicated to helping pet parents manage their doggo’s EPI, spreading awareness about the condition, and supporting veterinary research, Epi4 Dogs. So check them out for more information, links to full studies, and many, many more resources.
EPI, Exocrine Pancreatic Insufficiency, is the inability of acinar cells in the exocrine part of my pancreas to produce and secrete the necessary enzymes needed to digest food. This is a chronic, life-long condition, but it is manageable. The main enzymes my pancreas has trouble producing are:
- Amylase, which helps digest carbohydrates (sugars & starches in grains, fruits & vegetables),
- Lipases which helps digest fat,
- Trypsin, and Proteases which help digest proteins.
This means that without a supplement of these enzymes in my meals each day, my body literally cannot digest my food, and cannot absorb nutrients from it. My kibble goes right through me (as my mom can attest to) and I’m constantly hungry.
I’m back at this blog thing because I want to spread word about this for other puppers and their humans. (EPI can effect cats too, but I’m not a cat, so you might want to do your own research if you are a cat or a cat parent.) My mom was pretty worried and stressed while we were figuring this whole thing out, but reading stories of other puppers living active, full, long lives with this condition has made her happier.
So… how did my mom figure out I had EPI?
Common Symptoms of EPI
The tricky thing about EPI is that symptoms don’t appear until anywhere between 80% and 95% of the exocrine pancreas acinar cells are destroyed. And they can be easily mistaken for other digestive issues at first. After all, us young dogs like to get into things. We’re curious! And some of us have sensitive tummies even when we’re perfectly healthy.
Here is a list of symptoms pet parents should watch out for:
- Gradual wasting away (weight loss) despite a voracious appetite,
- Eliminating much more frequently, sometimes every hour or two,
- Stools that look like greasy voluminous yellowish cow-plops, sometimes grayish,
- Your dog might eat their own stools, or other inappropriate substances (guilty as charged…)
- Increased rumbling sounds from the abdomen, and
- Passing increased amounts of flatulence.
Though, some dogs show no typical signs. Some may experience intermittent watery diarrhea or vomiting, some might not. Some dogs display personality changes, like fearfulness of sudden aggression.
For the doggos, your coat might get wiry, you’ll be losing weight, you may feel very lethargic and have no energy, since you’re not getting the nutrients you need. My biggest symptoms were weight loss, sudden increased appetite when I used to be a grazer and take all day to eat my kibble, and voluminous yellowish cow-plop stools. (Yeah, it’s a little gross, but, medically necessary to watch your poo!)
At the end of the day, the diagnostic test for EPI is a trypsin-like immunoreactivity (cTLI) blood test, which requires an 8-12 hour fast. For the pet parents — if your pupper is experiencing persistent gastrointestinal upsets and weight loss, ask your vet about a cTLI blood test as soon as you can!
My Diagnosis Journey
It’s hard to say exactly when my EPI started showing itself. I’m the goodest girl, of course, but, if you talk to my mom she might mention my penchant for eating mystery leather, sandals, socks, and shoelaces…
But anyways, by late March 2022, I was having intermittent digestive issues — my poops were cow-plops. With EPI not on the radar, mom tried to get my tummy right with pumpkin puree, then chicken and rice, before she finally took me to the vet. First the vet had mom change my food and did a fecal test for parasites. It was negative of course.
After several weeks of my poo almost going back to normal, but staying soft, and then eventually getting even more cow-pie-y (if that’s an adjective…) it was time to go back to the vet. I got an IDEXX blood panel, some antibiotics, and my food changed to a prescription diet. But that first blood test was pretty much normal. And the antibiotics (metronidazole) didn’t work either (though I enjoyed the mini-peanut butter sandwiches I got with them.) All the while, my appetite was ravenous, and I was losing weight, regardless of how much I ate.
With my mom anxious to get a diagnostic explanation for what was wrong, instead of trying different foods until one worked for me (spoiler alert — none of them would have!) the vet suggested another blood test, a Pancreatic Lipase Immunoreactivity, Cobalamin & Folate Panel sent out to Texas A&M. Now, this tested for more things than just EPI, because we didn’t know what was wrong with me. But sure enough, my Serum TLI levels were below 1 µg/L.
All of this took time, so it was only 20 June 2022 when I finally got my diagnosis. I started on enzymes with my dinner on 23 June 2022. After just two meals with enzymes, my stool started to firm up. After just one weekend, my energy levels were up, and my coat was a little bit softer. I still have to weight to gain back, and a few more things to test. EPI will be a life-long journey for me; but I’m already doing better.
What’s Next?
It was pretty scary when I first got my diagnosis, because my humans had never heard of this condition before. But before too long, they realized how many resources are available, and they started reading stories of other doggos who lived to 12, 15, 16 years with EPI.
So my plan is to let you know monthly how I’m doing. I want to answer questions you internet doggos might have about this condition. And most of all, to any pet parents or anxious puppers searching the internet, I want to give you some reassurance. EPI is a little rare, but there is community, there are resources, and it is manageable. You’re not alone, you can do this! It’ll be okay.
<3
Until next time!
-T