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  #11  
Old 04-11-2018, 04:56 AM
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Raysaint Raysaint is offline
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Default Re: Exocrine Pancreatic Insufficiency (EPI)

The pancreas can stop making insulin (diabetes) but still makes enzymes to digest food.
If it stops making enzymes, then you have EPI.
I discussed it with my vet.
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Riley, 7 yr. old maltipoo, 25 lbs., diagnosed Feb 2017, taking thyroid meds, had pancreatitis and DKA mid March, eating Wellness Senior formula can food. NPH dosage now at 8.0 units Humulin N. Adding either pumpkin, spinach, blueberries, yams, or green beans to his food. Also omega-3 oil.
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  #12  
Old 04-11-2018, 07:33 AM
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Default Re: Exocrine Pancreatic Insufficiency (EPI)

there's an EPI dog forum if you want some info

epi4dogs.com
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  #13  
Old 04-11-2018, 07:43 AM
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Default Re: Glucose test poke success

New to this forum, I am not sure how to reply to all the responses to my post. I appreciate all the information and experiences. It makes me feel good that others have experienced this difficulty. Thank you.
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  #14  
Old 04-11-2018, 09:22 AM
Steve Steve is offline
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Default Re: Exocrine Pancreatic Insufficiency (EPI)

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Originally Posted by jesse girl View Post
I believe EPI is the complete failure of the pancreas . Now i believe it includes no natural production on insulin anymore making a dog diabetic and the loss of digestive enzymes that the pancreas use to produce .

So you have to give a dog with EPI digestive enzymes when they eat . We have had EPI dogs on the forum and they did well once they figured the combination of enzymes food and insulin . I dont believe there are any active members at this time .

Is your dog EPI
Thank you all for your help. In response to "Jesse Girl" the information I have seen on EPI seems like the symptoms are very similar to diabetes. Though not trying to find the solution for long, I am a little frustrated with the treatment of the diabetes diagnosis thus far. I try to get Rusty some exercise time for two or three hour in the park every afternoon.

I hope this is not to long of a post, but I will try to give you the back ground over the past three months.

We have had little success with insulin doses and insulin changes. We started with 2 units of NPH every twelve hours. We progressed by one unit per day after a week with a glucose test at the vets in the AM prior to insulin and any food. The glucose levels remained 5 to 6 hundred during the morning tests. After numerous in office tests, I found out I could perform the test myself and I began coordinating with the vet over the phone. Once we reached 9 units, I performed a glucose curve (per vets instructions, ten blood tests). First test prior to insulin or food. For the next two hours, every thirty minutes followed by tests every two hours until the end of the day.

The levels were as follows: 473, 394, 369, 183, 72, 112, 137, 554, 579 (The last test was prior to food and insulin)

Let me add here, with nine units twice a day Rusty's behavior seemed to be improving. He had more energy, was consuming much less water and seemed a lot more lively.

The doctor did not like the wild swing in levels, but seemed more concerned about the low readings than all the high readings. After he consulted with a Urologist friend, he had us drop back to four units every twelve hours and a few days later wanted me to perform another curve.

Dropping to four units made a notable change in Rusty's energy level and water consumption.

The second curve was as follows: 604, 531, 496, 434, 444, 228, 131, 121, 236, 503, 676, 623 (the last two were two and four hours after evening meal and insulin injection).

After this curve (doctor was out of the office for a few days) I raised the level to 8 units every twelve hours. Upon the doctors return and his review of the curve, he wanted me to change insulin type and amount to Vetsulin, two units twice a day.

I noticed an immediate negative change in Rusty, as well as a body odor I had not noticed before. The doctor was out of the office once again and after five days and random blood test results between 400 plus and Hi (over 750 according to meter instructions) I discontinued the Vetsulin and reverted back to the NPH 9 units twice a day.

I sent an email to the doctor. I told him I had changed back to NPH 9 units twice a day and was trying to change Rusty's diet, though he was very rebellious to any modification in his diet. I told him Rusty was getting very annoyed by all the poking (which he hated). I told him his condition with the Vetsulin use turned immediately worse. I asked him if there could be a problem with the vial of NPH insulin. I questioned the accuracy of the Accu-Trak tester. My frustration with the methods of treatment and the negative results in Rusty's behavior was evident in the email. The doctor had mentioned me taking Rusty to a specialist, which I told him I could not afford.

Upon the doctors return, the doctor seemed upset with me and told me diabetic dogs need consistency and these changes were not helpful. He requested that I lower the level of NPH back to 4 units and discontinue glucose testing for a couple of weeks and then we can try another curve and see were we are at that time .

Tomorrow, April 12th will be two weeks. Since the change to 4 units Rusty's lifeless behavior and excessive water consumption has resumed and the body odor seems to be present at times. I have not spoken to the doctor for two weeks, but plan to performed glucose curve tomorrow. I purchased a new vial of NPH insulin and a new container of test strips. I don't have much optimism in he curve. I performed four tests yesterday.

Prior to food and insulin: 540
Prior to our walk and run in the park: 305
Following three hours of walking and running and a little digging: 683
Bed time 10 PM: Hi
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  #15  
Old 04-11-2018, 11:06 AM
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Default Re: Exocrine Pancreatic Insufficiency (EPI)

Are you exercising your dog at the park on curve days ? The only reason i ask is a dogs blood sugar can drop substantially during exercise . this can cause an artificially lower number preventing the dose from being raised but actually more maybe needed

Seeing a reduction in symptoms can point to the higher dose was helping . What may need to be corrected is that big drop in sugar
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jesse-26 lbs - 13 years old - 8 years diabetic - one meal a day homemade and a vitabone snack - 3 shots of novolin a day sometimes novolog or r as a correction to higher sugar . total insulin for a 24 hour period is between 6 and 8 units of nph insulin depending on her fasting number
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  #16  
Old 04-11-2018, 11:21 AM
Steve Steve is offline
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Default Re: Exocrine Pancreatic Insufficiency (EPI)

Yes, I exercise Rusty everyday. Some days he is not as energetic as others.
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  #17  
Old 04-11-2018, 12:09 PM
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Default Re: Exocrine Pancreatic Insufficiency (EPI)

Following up on jessegirlís comment, Iíve had to be strategic about when I exercise my Lucy. A 15-20 minute walk can drop her 100+ points some days. I know testing is hard for Rusty but I only learned this by testing immediately before a walk and then when we return. Sometimes itís only a 50 point drop but if we happen to see a cat and insanity ensues sheís dropped as much as 150! This is not normal but you never know whatís normal for your dog. It could throw off curves if you exercise at diff times on days you test.
Iíve learned I can only exercise Lucy in the 4+ hrs before her next insulin dose when sheís always higher.
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  #18  
Old 04-11-2018, 03:58 PM
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Default Re: Exocrine Pancreatic Insufficiency (EPI)

The exercise could be the problem with the substantial drop you are seeing . As lolo sugested you may need to test right before the walk and after . If you are seeing a large drop that is a problem that will need to be solved to regulate your dog . there are ways to do that
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jesse-26 lbs - 13 years old - 8 years diabetic - one meal a day homemade and a vitabone snack - 3 shots of novolin a day sometimes novolog or r as a correction to higher sugar . total insulin for a 24 hour period is between 6 and 8 units of nph insulin depending on her fasting number
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  #19  
Old 04-12-2018, 09:23 AM
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Default Re: Exocrine Pancreatic Insufficiency (EPI)

Vets shouldn't get upset, they should understand what you are trying to do. And what you were doing seemed not bad. The dog had better numbers on the higher dose, symptoms diminished. Cutting back the dose raised the numbers and had him drinking/peeing again.

And not testing for a couple weeks?? When you are making all these changes? That's when you test more, in my opinion. Especially knowing he had lows of 72, but that doesn't mean it happens every day. You might want to test a few days around nadir time and get an average.
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Riley, 7 yr. old maltipoo, 25 lbs., diagnosed Feb 2017, taking thyroid meds, had pancreatitis and DKA mid March, eating Wellness Senior formula can food. NPH dosage now at 8.0 units Humulin N. Adding either pumpkin, spinach, blueberries, yams, or green beans to his food. Also omega-3 oil.
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  #20  
Old 04-12-2018, 10:07 PM
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Default Re: Exocrine Pancreatic Insufficiency (EPI)

I would worry about those big swings and in all honesty, the vet does have a legitimate concern with your dog going from 500s to 72 and back to 500ís. Low numbers are dangerous and that up and down points more to an imbalance with insulin and food and processing food. What exactly are you feeding and in what quantity? What times are you feeding and injecting? Anything in between?

I think the vet was thinking rebound but going down to 4 was probably too low of a dose. What you need to do is try to figure out by breaking down what you are feeding and possibly changing the % of protein and carbs or which protein or carbs you use. Regulation is about balancing the food they take in and how it is metabolized and matches up with insulin. It could be timing or adding a different carb source or lowering protein or feeding more fiber to try to balance with insulin. There are options but you have to do the testing in the beginning while trying to figure it out. The problem is with many vets, they donít really have answers when a dog is outside what the ďbookĒ suggests. And dogs react differently to foods. I used to try things that worked for others and it was a no-go for Maggie. I kind of had to just keep trying things.

If you can post your entire routine and food, we can see if anything jumps out and give some ideas to tweak it. You can actually figure this out without the vet. Many donít get how to tweak food - they donít really get in depth on nutrition.
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