A few months ago, I noticed she was getting thin.
Now, I've always kept my corgis on the lean side. Obesity is a huge problem in the breed, so I've always tried very hard to not let it happen. But this wasn't just leanness - this was skinny. I increased her food, thinking she just needed a few more calories. Nope. I switched her to a better food, thinking she needed something with a bit more 'oomph.' Nope. Shoot. By this time, I could feel all her ribs, and her hip bones were starting to show. For a dog with such a full and luxurious coat, this was cause for alarm.
Once the oily poop started, I freaked out and made a vet appointment. Naturally, I also voiced my concerns on one of the more trustworthy internet dog forums I frequent. A friend of mine (a nutritionist) mentioned that it could be SIBO/EPI... that's Small Intestinal Bacterial Overgrowth / Exocrine Pancreatic Insufficiency. EPI basically means that the pancreas isn't producing the necessary enzymes for digestion, so the dog is literally starving to death due to malabsorption. I made note of this, and asked the vet about running specific blood tests to see if that could be the culprit.
The vet tentatively agreed with the possibility of it at least being EPI. He ran a CBC/Chem panel, and also sent a cTLI test out to Texas A&M. The CBC/Chem came back yesterday - normal, except for elevated ALT. Normal range is 9 to 99, and Revy's ALT is 213. Yikes. Yet another tick-mark on the long list of symptoms indicative of EPI. Since it's most likely EPI, the vet had us start treatment before the results of the cTLI came back. How's that for reassuring?
- Yellow-grey, oily loose stools
- Rapid weight loss
- Ravenous appetite
- Large, frequent stools
- Sour-smelling stools
- Coprophagia (eating poop)
- Pica (eating non-food items)
- Elevated ALT with an otherwise normal blood panel
Yep, that's her list of symptoms that fit in with EPI. Fan-friggin-tastic. There is no cure for EPI, but it can be managed with a specific diet and medications.
First, we had to find a kibble that fit the specific guidelines for a standard EPI diet. Grain-free, with 12% or less fat and 4% or less fiber. Talk about a needle in a haystack! For now she's eating Natural Balance Alpha Dog Lamb, Chicken Meal and Rabbit formula, but we'll be switching to California Natural Grain Free Chicken formula soon. (Any of the three original California Natural Grain Free formulas will work, but the chicken formula is the least expensive.) Instead of feeding it in kibble form, we grind it:
Side note: This also means I get to eat a lot of rainbow sherbet... for the plastic tubs, of course. Hooray!
Next, we add the prescription enzymes to the ground-up kibble. This stuff isn't cheap - roughly $100 for a 40 day supply. I guess you can put a price on love, and KV Vet says it's $94.95 for 8 ounces.
Next, we add warm water to activate the enzymes, stir up the glop and let it sit for about 45 minutes. Give the glop another stir, and Revy gets to eat her delicious pre-digested meal.
Once we get her stabilized, we may add coconut oil and/or probiotics to her regimen.
Oddly enough, I remember caring for an EPI dog back when I was fourteen years old and worked in the kennels of a local animal hospital. I didn't know it was EPI at the time, but to this day I remember the smell of the Pancrezyme powder. I remember liking the smell - how ironic that I get to smell it every day for the next decade or more.
Here are a couple great links on EPI. Before you ask any questions, at least read through the first link, as it's quite thorough and explains the hows and whys behind the disease.
Exocrine Pancreatic Insufficiency in Dogs
We've got a long road ahead of us, but I think we're going to be fine.