Charting

In order to stabilize Piper I had to keep track of EVERYTHING going into as well as EVERYTHING that was coming out of her and the more details the better! My family dinner conversations have been less than appetizing, just ask my husband. There are so many factors that can affect the stabilization of an EPI dog, the amount of enzyme, the amount of time you soak their food, the amount and type of food. They say that the proof is in the pudding? Well, in Piper's case it is in the pooping. What color is it, what is its consistency and yes, what does it smell like.



Now the best advice I have been given has been to keep a journal and only every change one variable at a time. I started using a chart to keep track of the information but soon realized I needed more room and more details so, after several working drafts I came up with a method that works for me. Based on Piper's needs I have developed two charts. A weekly chart which allows me to write notes on food preparation, the time of her feedings, when she received her supplements, a description of her BM's as well as her behavior and her condition. This has come in handy when her BM's have been slightly off but I can look and see that the day before she hijacked one of the kid's snacks.



Although the weekly charting works well I didn't want to have a million pieces of paper floating around my kitchen. That was where my days of a C.N.A. came in handy. Based on an activities of daily living chart I constructed a chart that would give me a quick look at her progress over a month's time. The following are charts can be downloaded for your use.

WEEKLY EPI CHART
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download

MONTHLY EPI CHART
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download

Week One - A Summary

I am happy to say we made it through the first week! It already seems like I have been doing this forever. We are very lucky that for the most part she is stabilizing quickly and we just have some fine tuning to do. For the most part she is having normal BM's with the exception of her evening poops which were just ever so slightly off. I am wondering if I was feeding her snacks and meals to close together and her body was processing them as one meal. So, adjustments were made! We are back to three meals but have increased the amount of food and we will give it a few days and see what we get. What I am truly amazed at is the difference in volume. Before the enzyme supplement not only were the “gifts” she left nasty looking and smelly but there was a lot. She would go approximately three times a day, roughly 2 C. at a time (this is of course an estimate I did NOT pull out the Pyrex and measure). She is now down to twice a day and less than a half a cup at a time! Of course, my neighbors think I have a dog poop fetish, each morning we go out to the corner of the yard and I coax her, “Do your business” as she gets ready to go I am trying to peer under all that tail hair so I can see how to chart her poop for the day. When she is done she gets a big cheer and we race for the house. I mark down EVERYTHING so that if there is a change in her behavior or physical condition it will jump out at me and I can figure out what change in her diet has affected her. It also helps to identify patterns both healthy and unhealthy. Once she has been stable for a while then I will be able to make the next change to her diet. At this point our goal is regular poop and weight gain. I hope in the future to decrease the amount of enzyme she is receiving.

The following is an example of a chart that I use to keep track of her progress. I have adapted it a few times to meet Piper’s personal needs. I am also trying to develop a monthly chart so that I do not have to hold onto all of the weekly charts.

One of the truly wonderful side affect of treating Piper’s EPI is that our lawn will finally be able to heal. This is a picture of our lawn with divots of grass missing because it was the only way in which to clean up the yard. If you wanted to get rid of the poop you had to sacrifice the grass.

Piper's First Diner ala Enzyme

Piper does not like to wait while her food digests in a bowl on the counter so I try to make 2 days worth of food at a time so that I always have it on hand. At this point she will eat it right out of the fridge and could care less that it is cold.

When treating a dog with E.P.I soaking their food is important and has two purposes.

1. It helps to physically break the food into smaller pieces increasing the surface area and allowing more the food to come into contact with the enzyme.


2. The warm water helps activate the powdered enzyme which is otherwise dormant. The enzyme powder actually consists of three distinct enzymes: Lipase, which chemically breaks down fats into fatty acids, Protease which breaks proteins down into amino acids and Amylase, which chemically breaks down carbohydrates into simple sugars. Once broken down Piper's body can then absorb them into her system.

It is important that you allow the enzyme enough time to break down and predigest the food. If the enzyme has not had enough time to react with the food your dog will not acquire the maximum nutrients, still may display the symptoms of E.P.I and there is a greater risk that it will cause oral ulcers and sores. Piper's food soaks for a total of 45 minutes.

Hair loss due to malnutrition

Just before we started the enzyme treatment I noticed that there were a few pink spots along Piper's muzzle. Within a day or two I noticed the top of her nose was also pink. She had started to loose her hair due to malnutrition. Like any other dog she was shedding but due to her condition her body was unable to replace the lost hair because she was unable to process the food she was eating. Her body could not unlock the nutrients required to synthesize new hair.

She may be thin but she has energy to burn

June 16, 2009

She was diagnosed and we were waiting for our enzymes to arrive in the mail. Although Piper had dramatic weight loss she still had energy to burn. I tried to keep her energy expenditure down to a minimum but, NOTHING would stop her from playing with her Frisbee, of course before she can have the Frisbee she must do a trick!

Piper's Weight Over Time

In the beginning Piper's weight was not an issue it was easily maintained as she grew. She started out in 2005 at 54 pounds and for two years grew at a steady pace. In 2007 I was having a difficult time keeping weight on her and she just seemed a bit slim, so we increased the amount of food she was receiving and she gained a few pounds. She held steady weighing in at 63.1 pounds for a year. She was never driven by food, would never touch food left out on the counter (anything on the floor or children sized furniture was fair game), if we were training at the kennel she would refuse treats and so she received a ton of praise instead.

She started to loose weight slowly in 2008 dropping to 58 pounds which was not noticeable because of all her hair. In early 2009 she dropped a pound but we assumed it was water weight or due to an increase in activity level. It wasn't until she started loosing weight drastically during the spring of 2009 that we were able to notice the weight loss. From April 27th to June 9th she dropped almost 10 pounds and was RAVENOUS all the time.



A year ago we could have left a steak on the counter and she would not have touched it, now nothing is safe. After feeding her dinner last night I went upstairs to check on the kids only to hear a crash in the kitchen. I ran downstairs only to find that she was cleaning off the dirty dishes in the kitchen sink. She is currently being fed a 1 1/4 C. of kibble (which is pretreated with enymes) three times a day and a 1/2C. of the treated kibble as a snack when she needs it. On June 9th she weighed in at 46 pounds.

Why start this blog?

Although this is a treatable disease dogs living with E.P.I have individual treatment plans that suit their personal physiology and their physiology changes with time, as her pancrease continues to atrophy adjustments will need to be made to accommodate her needs. That being said, it is helpful to keep a journal of what works and what doesn't work as well as pictures to show how she is progressing. I thought that a blog would be the best way to accomplish this.

Piper at 9 months old.

A summary of her history

Piper at 8 Months

Oh, where to begin? I guess we always just assumed Piper had a sensitive stomach. It started when she was just about two years old. She would get the runs and we assumed she had either gotten into a snack left out by one of the kids or she was eating her poop (a nasty habit she had from the start). It happened often enough that I knew the protocol by heart, the vet would prescribe Lomotil (an antidiarrhea medication) and antibiotics for bacterial overgrowth, she would be fed rice and boiled chicken for a few days and then slowly put back on her regular food and eventually everything would be fine. That is until the next time.

On September 6th 2008, she was almost 4 years old, I noticed she was a bit lethargic, she threw up and there was a trace amount of blood, then she started having bloody diarrhea. I slept on the floor by her kennel for the night and in the morning when there was still blood in her stool we took her to an ER vet where she was rehydrated, treated and released. We took her the following day to our vet where she was treated and a course of action was discussed. We decided that even though every fecal sample run had ALWAYS come back negative we would de-worm her and this would help ensure that she was not suffering from a parasite. She was dewormed in September and had the runs (or as we fondly called them pudding poop) in November. December came and went without an incident but, then in January it happened again. We tried everything from adding a meat tenderizer to her food, putting her on Metronidazole and even plant derived enzymes. When all else failed and she started to lose weight we put her on Hills Science Diet ID a a prescription food that would cover any food allergies she may have and it was easy to digest. At about $50.00 for a 20 pound bag I was a little frustrated when she had the runs AGAIN!

After reading a post about another dog with similar symptoms and her diagnosis with EPI, I took Piper to the vet and had the vet run a blood test called a trypsin-like immunoreativity (cTLI) which is the only way to properly diagnose this condition. While we were there I had them weigh her, she had dropped from 56 pounds at the end of April to 46 pounds in June. On June 12th 2009, when the results came back she was diagnosed with EPI. A healthy dog will have a range of 5-35 and Piper’s was less than 1. She was literally starving to death.

She was always hungry, so hungry in fact she would steal food off of the counters and eat items she otherwise would NEVER have touched - like strawberries.

Piper is pictured here guarding marshmallows for our s'mores. Now a days they wouldn't have lasted 30 seconds !

Piper is currently being treated for this disease and we hope to find just the right balance of enzymes, food and supplements so that she can live a long and healthy life with our family.