Food After Liver Shunt Surgery - Page 3 - YorkieTalk.com Forums

TLC · 04-26-2010, 09:05 AM

Here is a good page for EPI

EPI in Dogs

Deegan's mom · 04-26-2010, 09:28 AM

EPI - Exocrine Pancreatic Insufficiency

Help remove this suffering from all our canine friends.

Help our breeders positively identify the EPI carriers so as not to perpetuate this disease.

Help maintain quality breeding programs.

Help prevent the heartache that families have to endure when faced with this disease

Untreated or misdiagnosed dogs with EPI, will either die a painful death by starvation or organ failure.

The Disease
EPI is an exocrine pancreatic insufficiency disease. The pancreas has two major functions
(1) endocrine: to secrete hormones/insulin (2) exocrine: to secrete digestive enzymes.

Exocrine pancreatic insufficiency (EPI) is the inability of the pancreas to secrete the necessary digestive enzymes, amylase to digest starches, lipases to digest fats, and trypsin and proteases to digest protein. When these enzymes are not available to help digest nutrients, the nutrients cannot be used by the body. The body in essence starts to starve. In addition, due to the lack of proper digestion of nutrients, exocrine pancreatic insufficiency is usually accompanied by structural and functional changes in the tissue lining of the small intestine that further impairs nutrient absorption called small intestinal bacterial overgrowth (SIBO).

Symptoms
• Gradual wasting away despite a voracious appetite
• Eliminating more frequently with voluminous yellowish cow-plops (sometimes grayish)
• Eating their own stools, or other inappropriate substances
• Increased rumbling sounds from the abdomen
• Increased passing amounts of flatulence
• Some dogs do not show any typical signs
• Some experience intermittent watery diarrhea or vomiting

These symptoms are not exhibited until
85% -90% of the pancreas is destroyed.

Testing
A trypsin-like immunoreativity (cTLI) blood test (Texas A & M University labs are most widely used) will show the dog's ability to produce digestive enzymes (lipase, protease, amylase). The normal range is between 5.0 – 35.0. The dog must fast 12 hours prior to blood test. cTLI tests range approximately $100.

Treatment
Treatment of EPI may be regulated after some trial and error with enzyme replacement. It is usually necessary for life. Most dogs with EPI respond well to pancreatic enzyme replacement with every meal, antibiotics to reduce the SIBO (small intestinal bacterial overgrowth) condition and a change in diet to a low fiber and some cases also a low-fat diet. Raw diets are also being met with success. Grains need to be avoided. Not every vet recognizes the symptoms or realizes that breeds other than GSD can have EPI. Misdiagnosed, these dogs eventually die a painful death. Many are surrendered out of frustration or euthanized because of enzyme expense. But there are other reasonable alternatives!

For EPI Support
Contact the EPI Global Group community:
k9-EPIGLOBAL@yahoogroups.com

Where does EPI come from???
Previously EPI was suspected to be caused by autosomal recessive genes. In preliminary data from November 2008 research at Texas A&M and Clemson University it is now strongly suspected that EPI is not autosomal recessive but rather more complex, having multiple genetic and environmental factors. A larger study is currently underway at these universities. With EPI traits may vary in degrees of severity and symptoms may be exacerbated by physical or emotional stress.

What we can do!
There are most likely unidentified carriers everywhere and in every breed. At this point in time we can only test to confirm an EPI diagnosis, so it is imperative that we identify the genetic markers and stressors to eliminate this horrible disease.

A large research study is underway at Texas A&M Medical University along with Clemson University in SC to identify the genetic markers. They are working with the latest technology, SNP, to handle the complexities of multi-loci genes and working with EPI. The following scientists, known for their expertise in EPI is conducting a breed-specific study with the German Shepherd Dog since EPI is most prevalent in GSDs hence, more data is available for testing. Once the GSD markers are identified, other breed markers will be easily noted. EPI is surfacing everywhere - - if we don’t get a handle on this, all of our dogs will be at risk.

If you have a GSD, please consider being part of the study, contact Dr. Leigh Anne Clark at:
lclark@cvm.tamu.edu or visit EPI Research

For more information about EPI:
Visit: EPI * Exocrine Pancreatic Insufficiency - Overview or
EPI Research Fund
for further information about this devastating disease and how you can help.

The Researchers
• Keith Murphy, PhD, Prof & Chair of Genetics, Dept of Genetics & Biochemistry, Clemson University, Clemson SC. TAMU College of Veterinary Medicine
2004-2005 Grant for PAA from the CHF:
Murphy, K.E. and L.A. Clark (Co-Is). Analysis of a candidate gene for pancreatic acinar atrophy in the German Shepherd Dog. Canine Health Foundation.
• Leigh Ann Clark, PhD in EPI
Research Ass't Professor, Dept of Pathobiology
Dr. Clark studied under Dr. Murphy for her PhD and continues to work with him. She received the Texas A&M University College of Veterinary Medicine Fisher Institute Medical Research Award, 2004, for her dissertation, titled: Transmission genetics of pancreatic acinar atrophy in the German Shepherd Dog.
• Kate Tsai, Ph.D.,
Assistant Research Scientist in the Dept of Pathobiology
Texas A&M University, College of Veterinary Medicine and Biomedical Sciences
• Jörg M. Steiner, Med.Vet., Dr.Med.Vet., PhD, DACVIM, DECVIM-CA
Associate Professor with the Department of Small Animal Medicine and Surgery
Texas A&M University, College of Veterinary Medicine and Biomedical Sciences
• And with special collaboration of:
David A. Williams MA VetMB PhD
Diplomate ACVIM, ECVIM-CA
honored developer of the cTLI test

twilson28 · 04-26-2010, 09:57 AM

Thank you! Wow - ok - so this kinda sounds like Sparky. He's thin, though he eats alot and he's always hungry. He seems to poop all the time - though I'm giving him probiotics and I wonder if they might not be the cause of his poops. Prior to the whole pancreatitis incident (or that's what I diagnosed it cause the Vets said - "don't worry about it - just give water and pepcid") he did have the soft serve ice cream poops. I was feeding him high fat, high protein Innova at that time. He also always had VERY bad gas and his stomach rumbled alot....

After that whole incident with pancreatitis, I switched him to a low protein, low fat food (like 14 grams protein, 6 grams fat) and his poops are formed and soft, but no longer like ice cream and are long logs like they should be. I also started him on the VSL#3 I give Chewy to get some healthy probiotics in his system and I give him pediasure with his food cause he loves it and I figure the extra vitamins are good for him. Overall - from these changes, he seems completely normal (and my hubby says I'm nuts) other than being thin and always hungry and peeing alot.

He does seem hungry all the time - and yet he's very fit and thin. At the same time, he is also a HIGH ENERGY Yorkie and he never stops running - and playing and exercising....if I ran like that all day, I would be thinner too.

I've also been adding water to all his meals too - just figuring since I do it for Chewy, I will do it for him, and he likes it. He does pee often - from the time I get home from work (6:30) til I got to bed at 10:30-11:00 he pees at least 3-4 times. I don't know how much he pees on the wee wee pads during the day - but I see him pee at least 3 times between those hours every night. IS that normal, or excessive? Never owned a Yorkie - so I just don't know...

What do you think? Should I bring him in? Get the test done to be sure he doesn't have this? Like I said - after changing his food and giving him the VSL#3 - most of the symptoms I was concerned about have stopped.

Would love to get anyone advice on this...
<3Tania, Chewy & Sparky
P.S. I ask because I know after Chewy, I'm a big of a hypochondriac for my dogs....

RONLYNN · 04-26-2010, 10:09 AM

Quote:

Originally Posted by Deegan's mom

Hi everyone,

As some of might know, the new lil' guy Trooper that I recently adopted had liver shunt surgery in the summer. The vet said he has a clean bill of health now and recommended to his foster family that he can be fed a normal diet, and they have him on Wellness (dry & wet). I checked with my vet and she agreed, but when I joined the LS Group on Yahoo I was told that he should still be eating a low protien diet like Royal Canin Hepatic LS 14 so that he doesn't have anymore attacks/complications later in life. Now I'm torn and don't know what direction to go... I'm still feeding him Wellness, but does anyone have any suggestions/opinions/experiance with liver shunt babies. If you have a liver shunt baby, what have you been feeding them since their surgery???

I appreciate the help.

My Teddi had her surgery 2 1/2 years ago and she has been eating RC Hepatic food ever since. Dr. Tobias (the leading authority and Doctor who invented the Ameroid Constrictor) recommends you still feed them a low protein diet even though they are completely fixed so I figure why take chances.

Deegan's mom · 04-26-2010, 10:29 AM

Tania - I totally understand your concern. From the symptoms you said that he displayed, they seem alot like what Deegan had too. The only thing different is I didn't give Deegan any probiotics until after he was diagnosed. He was losing weight no matter how much or what I fed him, and every bm was like a cow pie. He didn't really pee execively though until after he was on the enzymes, but that's because the emzymes make them thirsty and so he drinks ALOT of water through the day and night. If he's not losing weight and his poops are formed like tootsie rolls, my guess would be that he doens't have it, but I don't know if the probiotics would help without the enzymes cause I'm not a vet.

But if it were me, I would have him tested just for piece of mind. Knowing what test you want them to run shouldn't really cost that much. You can even call your vet and ask them how much a cTLI test would be. The $100 or so would be worth me feeling confident that he doens't have any under lying issues.

Let me know what you decide and if you get him tested.

twilson28 · 04-26-2010, 10:42 AM

Hi Jayne,

We've decided to get it. It's not worth worrying about and Sparky is fully covered under petplan pet insurance, which covers all testing and covers all congenital and hereditary defects (the only pet insurance that does!). So we're just going to get the special blood test, and I think I will have a regular blood test run too just to be sure everything is looking good. Why not check if we now know what to ask for.

Thanks again for all the info - I'll keep you posted on how things go!

<3Tania, Chewy & Sparky

Deegan's mom · 04-26-2010, 11:39 AM

Quote:

Originally Posted by RONLYNN

My Teddi had her surgery 2 1/2 years ago and she has been eating RC Hepatic food ever since. Dr. Tobias (the leading authority and Doctor who invented the Ameroid Constrictor) recommends you still feed them a low protein diet even though they are completely fixed so I figure why take chances.

Hi Ronda - This is a very old post. I posted it when I first got Trooper. Since then I've learn an enormous amount and I agree with not taking any chances!

Tania - So good to hear that you've decided to get him tested. Better to be safe, than sorry. I would do the same thing, cause like you, I'm now very hypocondiracish since I have to fubabies with health issues.

DAB · 06-10-2012, 05:07 PM

Just posted a reply and question but it does not appear. When I submitted it the screen switched to the log in page. But, I already had logged in! How annoying!

TammyV · 06-09-2018, 12:07 PM

My 3 1/2 year old Yorkie had surgery 4 days ago. She is normally very active and wild, I understand this was a major surgery and that’s why she isn’t quite herself. But every time I feed her or give her meds her body shakes for a good 30 minutes, has this been normal for other yorkies that have had this surgery? I watch her sleep and her little body just twitches, Ive called my vet with my concerns and the answer I got is “oh its probably normal”. My baby is picky and has been very sick so all my vet and i could get her to eat is Gerber chicken and apples, the surgeon told me to continue with that. I really need advice from those whom have been through this with their babies. I’m very worried about her.

KatysMom · 06-10-2018, 06:04 AM

Quote:

Originally Posted by TammyV

My 3 1/2 year old Yorkie had surgery 4 days ago. She is normally very active and wild, I understand this was a major surgery and that’s why she isn’t quite herself. But every time I feed her or give her meds her body shakes for a good 30 minutes, has this been normal for other yorkies that have had this surgery? I watch her sleep and her little body just twitches, Ive called my vet with my concerns and the answer I got is “oh its probably normal”. My baby is picky and has been very sick so all my vet and i could get her to eat is Gerber chicken and apples, the surgeon told me to continue with that. I really need advice from those whom have been through this with their babies. I’m very worried about her.

Worrying with you.

Hope you'll take your little one to an ER so her vitals can be checked. (Perhaps take some food with you so they can see her reaction.)

It wouldn't matter to me what her vet or specialist said to me via a phone call--if my little one's body was twitching as you described, I'd get her to the ER.

TammyV · 08-08-2018, 07:59 AM

Hoping to get replies to this. Stella’s shaking from my last post after surgery was nothing serious, it was just post surgery adjustments. Stella did so well and I was so excited until we had her first blood work done 8 weeks post surgery. Her bile acid test was bad, 325 after eating when it suppose to be <25. All related liver counts were bad. I cant get any answers what this means from my vet or the specialist just let’s check again in 3 months. Has anyone else experienced this post liver shunt surgery? What do you suggest I do Now? This little dog is my everything and I will do whatever it takes. I’m in Southern California.

04-26-2010, 09:05 AM	#31
TLC Slave to My Rug-Rats Donating Member Join Date: Jun 2005 Location: Long Island Posts: 7,247	Here is a good page for EPI EPI in Dogs __________________ Adopt Donate Foster www.yorkie911rescue.com

04-26-2010, 09:28 AM	#32
Deegan's mom YT 1000 Club Member Join Date: Jun 2005 Location: Windsor, ON Posts: 1,271	Text from EPI Pamphlet EPI - Exocrine Pancreatic Insufficiency Help remove this suffering from all our canine friends. Help our breeders positively identify the EPI carriers so as not to perpetuate this disease. Help maintain quality breeding programs. Help prevent the heartache that families have to endure when faced with this disease Untreated or misdiagnosed dogs with EPI, will either die a painful death by starvation or organ failure. The Disease EPI is an exocrine pancreatic insufficiency disease. The pancreas has two major functions (1) endocrine: to secrete hormones/insulin (2) exocrine: to secrete digestive enzymes. Exocrine pancreatic insufficiency (EPI) is the inability of the pancreas to secrete the necessary digestive enzymes, amylase to digest starches, lipases to digest fats, and trypsin and proteases to digest protein. When these enzymes are not available to help digest nutrients, the nutrients cannot be used by the body. The body in essence starts to starve. In addition, due to the lack of proper digestion of nutrients, exocrine pancreatic insufficiency is usually accompanied by structural and functional changes in the tissue lining of the small intestine that further impairs nutrient absorption called small intestinal bacterial overgrowth (SIBO). Symptoms • Gradual wasting away despite a voracious appetite • Eliminating more frequently with voluminous yellowish cow-plops (sometimes grayish) • Eating their own stools, or other inappropriate substances • Increased rumbling sounds from the abdomen • Increased passing amounts of flatulence • Some dogs do not show any typical signs • Some experience intermittent watery diarrhea or vomiting These symptoms are not exhibited until 85% -90% of the pancreas is destroyed. Testing A trypsin-like immunoreativity (cTLI) blood test (Texas A & M University labs are most widely used) will show the dog's ability to produce digestive enzymes (lipase, protease, amylase). The normal range is between 5.0 – 35.0. The dog must fast 12 hours prior to blood test. cTLI tests range approximately $100. Treatment Treatment of EPI may be regulated after some trial and error with enzyme replacement. It is usually necessary for life. Most dogs with EPI respond well to pancreatic enzyme replacement with every meal, antibiotics to reduce the SIBO (small intestinal bacterial overgrowth) condition and a change in diet to a low fiber and some cases also a low-fat diet. Raw diets are also being met with success. Grains need to be avoided. Not every vet recognizes the symptoms or realizes that breeds other than GSD can have EPI. Misdiagnosed, these dogs eventually die a painful death. Many are surrendered out of frustration or euthanized because of enzyme expense. But there are other reasonable alternatives! For EPI Support Contact the EPI Global Group community: k9-EPIGLOBAL@yahoogroups.com Where does EPI come from??? Previously EPI was suspected to be caused by autosomal recessive genes. In preliminary data from November 2008 research at Texas A&M and Clemson University it is now strongly suspected that EPI is not autosomal recessive but rather more complex, having multiple genetic and environmental factors. A larger study is currently underway at these universities. With EPI traits may vary in degrees of severity and symptoms may be exacerbated by physical or emotional stress. What we can do! There are most likely unidentified carriers everywhere and in every breed. At this point in time we can only test to confirm an EPI diagnosis, so it is imperative that we identify the genetic markers and stressors to eliminate this horrible disease. A large research study is underway at Texas A&M Medical University along with Clemson University in SC to identify the genetic markers. They are working with the latest technology, SNP, to handle the complexities of multi-loci genes and working with EPI. The following scientists, known for their expertise in EPI is conducting a breed-specific study with the German Shepherd Dog since EPI is most prevalent in GSDs hence, more data is available for testing. Once the GSD markers are identified, other breed markers will be easily noted. EPI is surfacing everywhere - - if we don’t get a handle on this, all of our dogs will be at risk. If you have a GSD, please consider being part of the study, contact Dr. Leigh Anne Clark at: lclark@cvm.tamu.edu or visit EPI Research For more information about EPI: Visit: EPI * Exocrine Pancreatic Insufficiency - Overview or EPI Research Fund for further information about this devastating disease and how you can help. The Researchers • Keith Murphy, PhD, Prof & Chair of Genetics, Dept of Genetics & Biochemistry, Clemson University, Clemson SC. TAMU College of Veterinary Medicine 2004-2005 Grant for PAA from the CHF: Murphy, K.E. and L.A. Clark (Co-Is). Analysis of a candidate gene for pancreatic acinar atrophy in the German Shepherd Dog. Canine Health Foundation. • Leigh Ann Clark, PhD in EPI Research Ass't Professor, Dept of Pathobiology Dr. Clark studied under Dr. Murphy for her PhD and continues to work with him. She received the Texas A&M University College of Veterinary Medicine Fisher Institute Medical Research Award, 2004, for her dissertation, titled: Transmission genetics of pancreatic acinar atrophy in the German Shepherd Dog. • Kate Tsai, Ph.D., Assistant Research Scientist in the Dept of Pathobiology Texas A&M University, College of Veterinary Medicine and Biomedical Sciences • Jörg M. Steiner, Med.Vet., Dr.Med.Vet., PhD, DACVIM, DECVIM-CA Associate Professor with the Department of Small Animal Medicine and Surgery Texas A&M University, College of Veterinary Medicine and Biomedical Sciences • And with special collaboration of: David A. Williams MA VetMB PhD Diplomate ACVIM, ECVIM-CA honored developer of the cTLI test __________________ Jayde, Deegan & Trooper ~Be the change you wish to see in the world - Adopt a rescue pet~

04-26-2010, 10:29 AM	#35
Deegan's mom YT 1000 Club Member Join Date: Jun 2005 Location: Windsor, ON Posts: 1,271	Tania - I totally understand your concern. From the symptoms you said that he displayed, they seem alot like what Deegan had too. The only thing different is I didn't give Deegan any probiotics until after he was diagnosed. He was losing weight no matter how much or what I fed him, and every bm was like a cow pie. He didn't really pee execively though until after he was on the enzymes, but that's because the emzymes make them thirsty and so he drinks ALOT of water through the day and night. If he's not losing weight and his poops are formed like tootsie rolls, my guess would be that he doens't have it, but I don't know if the probiotics would help without the enzymes cause I'm not a vet. But if it were me, I would have him tested just for piece of mind. Knowing what test you want them to run shouldn't really cost that much. You can even call your vet and ask them how much a cTLI test would be. The $100 or so would be worth me feeling confident that he doens't have any under lying issues. Let me know what you decide and if you get him tested. __________________ Jayde, Deegan & Trooper ~Be the change you wish to see in the world - Adopt a rescue pet~ Last edited by Deegan's mom; 04-26-2010 at 10:29 AM. Reason: sp

06-10-2012, 05:07 PM	#38
DAB Senior Yorkie Talker Join Date: Dec 2008 Location: Chicopeee, MA Posts: 110	testing Just posted a reply and question but it does not appear. When I submitted it the screen switched to the log in page. But, I already had logged in! How annoying!

06-09-2018, 12:07 PM	#39
TammyV Yorkie Talker Join Date: Sep 2015 Location: Glendora, CA, USA Posts: 10	My 3 1/2 yorkie had surgery 4 days ago, need advice My 3 1/2 year old Yorkie had surgery 4 days ago. She is normally very active and wild, I understand this was a major surgery and that’s why she isn’t quite herself. But every time I feed her or give her meds her body shakes for a good 30 minutes, has this been normal for other yorkies that have had this surgery? I watch her sleep and her little body just twitches, Ive called my vet with my concerns and the answer I got is “oh its probably normal”. My baby is picky and has been very sick so all my vet and i could get her to eat is Gerber chicken and apples, the surgeon told me to continue with that. I really need advice from those whom have been through this with their babies. I’m very worried about her.

04-26-2010, 09:57 AM	#33
twilson28 Yorkie Yakker Join Date: Aug 2009 Location: Ridgefield, NJ Posts: 38	Thank you! Wow - ok - so this kinda sounds like Sparky. He's thin, though he eats alot and he's always hungry. He seems to poop all the time - though I'm giving him probiotics and I wonder if they might not be the cause of his poops. Prior to the whole pancreatitis incident (or that's what I diagnosed it cause the Vets said - "don't worry about it - just give water and pepcid") he did have the soft serve ice cream poops. I was feeding him high fat, high protein Innova at that time. He also always had VERY bad gas and his stomach rumbled alot.... After that whole incident with pancreatitis, I switched him to a low protein, low fat food (like 14 grams protein, 6 grams fat) and his poops are formed and soft, but no longer like ice cream and are long logs like they should be. I also started him on the VSL#3 I give Chewy to get some healthy probiotics in his system and I give him pediasure with his food cause he loves it and I figure the extra vitamins are good for him. Overall - from these changes, he seems completely normal (and my hubby says I'm nuts) other than being thin and always hungry and peeing alot. He does seem hungry all the time - and yet he's very fit and thin. At the same time, he is also a HIGH ENERGY Yorkie and he never stops running - and playing and exercising....if I ran like that all day, I would be thinner too. I've also been adding water to all his meals too - just figuring since I do it for Chewy, I will do it for him, and he likes it. He does pee often - from the time I get home from work (6:30) til I got to bed at 10:30-11:00 he pees at least 3-4 times. I don't know how much he pees on the wee wee pads during the day - but I see him pee at least 3 times between those hours every night. IS that normal, or excessive? Never owned a Yorkie - so I just don't know... What do you think? Should I bring him in? Get the test done to be sure he doesn't have this? Like I said - after changing his food and giving him the VSL#3 - most of the symptoms I was concerned about have stopped. Would love to get anyone advice on this... <3Tania, Chewy & Sparky P.S. I ask because I know after Chewy, I'm a big of a hypochondriac for my dogs....

04-26-2010, 10:42 AM	#36
twilson28 Yorkie Yakker Join Date: Aug 2009 Location: Ridgefield, NJ Posts: 38	Hi Jayne, We've decided to get it. It's not worth worrying about and Sparky is fully covered under petplan pet insurance, which covers all testing and covers all congenital and hereditary defects (the only pet insurance that does!). So we're just going to get the special blood test, and I think I will have a regular blood test run too just to be sure everything is looking good. Why not check if we now know what to ask for. Thanks again for all the info - I'll keep you posted on how things go! <3Tania, Chewy & Sparky

08-08-2018, 07:59 AM	#41
TammyV Yorkie Talker Join Date: Sep 2015 Location: Glendora, CA, USA Posts: 10	My stella Hoping to get replies to this. Stella’s shaking from my last post after surgery was nothing serious, it was just post surgery adjustments. Stella did so well and I was so excited until we had her first blood work done 8 weeks post surgery. Her bile acid test was bad, 325 after eating when it suppose to be <25. All related liver counts were bad. I cant get any answers what this means from my vet or the specialist just let’s check again in 3 months. Has anyone else experienced this post liver shunt surgery? What do you suggest I do Now? This little dog is my everything and I will do whatever it takes. I’m in Southern California.