Connie -- I see they say that Berte's Zyme emzymes can be used in cases of EPI but I can't see whether they are to be used in place of regular pacreatic enzymes like vio=case, or in addition to them -- do you know? Thanks again....Michael

 Quote: michael reis

Connie -- I see they say that Berte's Zyme emzymes can be used in cases of EPI but I can't see whether they are to be used in place of regular pacreatic enzymes like vio=case, or in addition to them -- do you know? Thanks again....Michael

In addition to.

I am as surprised as you that no trypsin-like immunoreactivity test was done. Any chance that it WAS done, and just wasn't talked about much?

I would want those results asap:
"What is his TLI score?
Have you had him tested for SIBO (small intestine bacterial overgrowth) by checking folate/cobalamin levels?"

My curiosity here - would it be beneficial to add in green tripe and raw pancreas for a dog with EPI?

If you are having the TLI and SIBO testing done, make sure you fast your dog first! Many vets seem to forget to tell you this!

 Quote: Mara Jessup

My curiosity here - would it be beneficial to add in green tripe and raw pancreas for a dog with EPI?

Personally I think green tripe is good for every dog Raw pancreas replaces the necessity for the prescription enzymes, which are in essence dried, ground pancreas.

thanks again for all this input. I'm bringing Shambo Monday for theblood work. It has not been done in several years at least. They told me to fast him for 12 hours. I like our vet a lot, but got pretty upset weith them. They make a point of having me weigh him and they record it, every time I bring him in -- what's the point if they never look at the data series and evaluate it?

Thin dogs with loose stools often respond to a good dewormer and a course of metronidazole/coccidia Rx.
Whipworms, hookworms, coccidia, giardia,and chronic salmonella will all produce the clinical picture that you describe. A bowel irritated by these agents, who can be difficult to isolate, is inefficient in absorbing nutrients.
I would consider it malpractice not to rule out these agents before poking around looking for conditions which are incredibly rare. As an owner of a dog such as you describe, I'd spend my money on Flagyl or Panacur before I spent money on blood work.

Betty -- thank you. He definitely has EPI, he was diagnosed four years ago, and he's been tested for parasites every year. Also our other two shepherds have no parasites.

Betty, he was said by the vet to be diagnosed with EPI four years ago. However, we don't know exactly how.

Dr. Betty may have come into the thread late, but I have to say, reading her post, that it dawns on to me that if the same vet not doing the trypsin-like immunoreactivity test or folate/cobalamin levels is the one who diagnosed EPI, I might well be looking to confirm.

When you say "I'm bringing Shambo Monday for the blood work. It has not been done in several years at least," what blood work was ever done? That would probably be my first question. As far as I know, a typical blood test can't diagnose EPI, even with elevated ALT or low cholesterol. The cTLI & Cobalamin/Folate tests are necessary, which is why you are reading so much surprise at not having those results while having an EPI diagnosis.

Maybe I'm totally wrong and Dr. Betty will say that yes, a clinical diagnosis can be sufficient with no need of testing -- I just never heard of such a hands-off approach to EPI, apparently with no diet suggestions or support.

Again, JMO, and I am not a health professional.

I'm glad Dr. Betty saw the thread.

 Quote: michael reis

.... he's been tested for parasites every year. Also our other two shepherds have no parasites.

"Tested for parasites" almost never means giardia testing, as far as I know, or salmonella either.

This is also a good Dr. Betty query.

 Quote: connie sutherland

what blood work was ever done? That would probably be my first question. As far as I know, a typical blood test can't diagnose EPI, even with elevated ALT or low cholesterol. The cTLI & Cobalamin/Folate tests are necessary, which is why you are reading so much surprise at not having those results while having an EPI diagnosis.

I would ask for a copy of his blood work from the time of his initial diagnosis. Some vets will give enzymes without the testing...kind of a "try it and we'll see" approach.