Panreatic enzyme supplement

Re: Panreatic enzyme supplement

Noweia — Fri, 22 Nov 2013 14:53:20 GMT

[quote user="John Flynn"]

Most recently had been trying a mix of 2 x capsules of Solgan extra strength and 2 x capsules of ChemEyes per meal.

Should I go back to Lypex for a couple of weeks before tryingt o switch to cheaper version, or is this just postponing the inevitable? What would you do next with pancreatic enzyme mix? I'm thinking of switching to the powdered tub version and this one seems cheapest while having the high lipase proportion: http://www.chemeyes.co.uk/#!bulk/c1b8u

[/quote]

I think worth switching to Lypex if it sorted it before - we have a dog on Chemeyes and it seems to be doing ok on it.

Re: Panreatic enzyme supplement

Dagmar Steele — Fri, 22 Nov 2013 10:46:17 GMT

[quote user="Andrew Kent"]

[quote user="Dagmar Steele"]Ideally one would look into something more expensive than steroids first[/quote]

I'm not sure thats true, steroids are still the most predictable and effective first line drugs short term so wouldn't think there is much indication for anything else at this stage.

[/quote]

You may be very right there, it's just that we've been told other stuff may have less side effects and steroids are very bad these days anyway. Being somewhat of a dinosaur I wouldn't have any problems using them myself to be honest. Definitely not if the dog worsens before my eyes and there is not much money for more tests etc.

Re: Panreatic enzyme supplement

Martin Atkinson — Fri, 22 Nov 2013 10:42:02 GMT

I haven't seen a case of genuine EPI or SIBO in years whereas donkey's years ago it seems every other GSD had one or the other. I am convinced this is due to the advent of decent commercially available diets rather than an improvement in the gene pool and 99% of suspected cases are managed with dietary control. I'm equally convinced that SIBO does not exist as a distinct entity it is the product of malabsorption due to inappropriate diet again.

Re: Panreatic enzyme supplement

Andrew Kent — Fri, 22 Nov 2013 10:34:10 GMT

[quote user="Dagmar Steele"]Ideally one would look into something more expensive than steroids first[/quote]

I'm not sure thats true, steroids are still the most predictable and effective first line drugs short term so wouldn't think there is much indication for anything else at this stage.

Re: Panreatic enzyme supplement

Dagmar Steele — Fri, 22 Nov 2013 10:02:54 GMT

I you are suspecting IBD/SIBO you'll need to add the Metronidazole again, add Tylosin, go for weekly B12 in the beginning and definitely think steroids before it goes further south. Ideally one would look into something more expensive than steroids first but I do get the message that money is the foremost issue in this case? Foodwise I would use at least a low-fat diet (i/d hills or gastro RC) or try food for allergics for 8 weeks. Chappy would defiinitely not be my choice tbh.

Re: Panreatic enzyme supplement

Andrew Kent — Fri, 22 Nov 2013 10:01:15 GMT

Hi John,

I would try to go back to Lypex if possible as I think it is the most predictable in response. Make sure they are opening capsules and sprinkling on food not feeding whole capsule.

There is a website that you can mail order pancreas, see http://www.rawtogo.co.uk

I would then throw everything at this dog to start with to see if you can bring it under control - so weekly VitB injections (yes a lack could lead to a flare up), enzymes, metronidazole and also consider ranitidine - dog's tend to destroy a lot of the enzyme we feed with stomach acid and so an antacid can increase the available enzyme fed.

Diet wise I would go for highly digestible GI diet.

Yes if all else fails a trial on pred in case concurrent IBD.

Andy

Re: Panreatic enzyme supplement

John Flynn — Fri, 22 Nov 2013 09:07:55 GMT

Case update and plea for further advice...

Not going great. Hadn't heard from owners for few months and had hoped no news was good news, but were in yesterday and not so.

Faeces have been inconsistent since last in and didn't sound like was ever great.

Last 2 weeks has worsened and now can be pure water or large pile of soft crap. Has lost 2 kg from when last weighed and owners reckon this has mostly been over last 2 weeks.

Owners have experimented a bit trying to find something both economically sustainable and effective and failed to date and are considering whether will have to euthanase...

Most recently had been trying a mix of 2 x capsules of Solgan extra strength and 2 x capsules of ChemEyes per meal.

They have messed about with food choice a bit, generally unconstructively and fed raw meat whcihc led to vomiting and explosive diarrhoea at one point.

I know that this dog did great on 2 x lypex capsules per meal while fed on a regular food, monthly Vitamin B12 and daily metronidazole. Is about a 28kg husky/malamute-type dog. TLI was very low and suspect SIBO/IBD may be present also. Also gets pruritus in case that's relevant to anyone and is about 2 year old. Plays like a puppy, but can see ribs from far side of room again.

I don't know what to do next, and know that I may only have 1 or 2 more chances to get this right before owners decide that enough is enough for this dog and request euthansia.

Have given vitamin B12 for now and owners to update me in few days whether any response while I think it through.

Questions:

Should I go back to Lypex for a couple of weeks before tryingt o switch to cheaper version, or is this just postponing the inevitable? What would you do next with pancreatic enzyme mix? I'm thinking of switching to the powdered tub version and this one seems cheapest while having the high lipase proportion: http://www.chemeyes.co.uk/#!bulk/c1b8u
Could it just be the lack of VitB12 supplementation over last few months that has led to current crisis?
What would you do feeding wise. I'm thinking just sticking with something consistent and affordable - perhaps dry chappie??
Would you consider adding a steroid it?

PS - were there any results from this study? http://www.vetsurgeon.org/groups/samsoc/wiki/exocrine-pancreatic-insufficiency-epi-treatment-study.aspx

Re: Panreatic enzyme supplement

Chris Barker — Sun, 23 Jun 2013 11:18:05 GMT

Have twice got owners to collect fresh pancreas from local slaughterhouse one for a cat and one for a beagle. The cat ran and hid when ever she saw it and wouldn't even try it and the dog also refused to eat it On Lypex at moment as been unable to get powdered form for a while- Can others get in stock?

Kirsty

Re: Panreatic enzyme supplement

Michael Woodhouse — Sat, 22 Jun 2013 20:09:38 GMT

AI not airport courses. Phone thinks it is clever

Re: Panreatic enzyme supplement

Michael Woodhouse — Sat, 22 Jun 2013 20:07:31 GMT

Our local slaughterhouse are great. Never asked for pancreas, but they have put cows feet aside for foot trimming, uteruses for airport courses and flukey livers for a meeting.

We pay in scotch!

Re: Panreatic enzyme supplement

John Flynn — Sat, 22 Jun 2013 18:05:33 GMT

[quote user="patrick murphy"]I have a client who sources frozen pigs pancreas from Gloucester.[/quote]

Are they local to Gloucester or do they get this delivered?

[quote user="patrick murphy"]does TLI work, this dog was normal TLI[/quote]

The case I'm treating had a very low TLI. I'm not sure I would have thought to supplement otherwise.

Re: Panreatic enzyme supplement

patrick murphy — Sat, 22 Jun 2013 17:05:28 GMT

I have a client who sources frozen pigs pancreas from Gloucester.it seems to work fantastic. cachexic whippet gaining a kilo a weeek. does TLI work, this dog was normal TLI

Re: Panreatic enzyme supplement

John Flynn — Sat, 22 Jun 2013 09:52:36 GMT

Thanks Chris and Michael for suggestions.

I think the powdered one you mention, Chris, is http://www.vetmedsdirect.co.uk/pancreatic-enzyme-for-cats-dogs-formerly-called-pancrex-vet-powder-250g/?gclid=CNKg6YWd97cCFdLLtAoddmwAbA ? For a dog getting 2 lypex capsules per meal (4 capsules daily), how long would you estimate a tub of this would last? I make it a tub might last 6 weeks in which case would be much better value (as long as it worked...)

There are no pig slaughterhouses nearby. Owner is not squeamish in the least, but I'm not sure whether could spot a pancreas out of a pile of offal and would be even more surprised if she was allowed in a slaughterhouse to do this! Have you known a slaughterhouse to allow an owner to do this in the past?

What about http://www.solgaronline.co.uk/Solgar-Pancreatin-tablets-Quadruple-Strength-50-Tablets_p_619.html ? I work that out at about £20 a month giving 4 capsules daily, but obviously a lower lipase content might not work?

Or this "generic" lypex look-a-likey http://www.vetuk.co.uk/dog-supplements-cat-supplements-pancreatic-supplements-c-5_9/vetuk-pancreatic-nutriment-for-dogs-60-tablets-p-9836 ? Doesn't mention concentration of enzymes, but I don't want to write anything off that might both work and be affordable (but prefarably without testing a whole ton of things while the dog in question loses weight etc...

Or this one seems to have the same proportion of enzymes as the lypex, and is a bit cheaper still than the Pancrex/Panzyme? http://www.chemeyes.co.uk/#!bulk/c1b8u Anyone got a recommendation for or against this? How important is the high relative proportion of lipase when treating dogs?

Re: Panreatic enzyme supplement

Michael Woodhouse — Fri, 21 Jun 2013 23:55:05 GMT

Pancreas just pulled out and binned in the slaughterhouse. Won't make it as far as the butchers.

You need to ask the slaughterhouse, if owner not squeamish they can go and collect themselves.

Re: Panreatic enzyme supplement

Anonymous — Thu, 20 Jun 2013 13:48:06 GMT

Hi John,

I use 'pancreatic enzyme supplement for dogs and cats '(branded pfizer but may change soon) still pricey but powdered so goes further available on the centaur suppliers site. seems to work well.

panzyme is another one which is ok but seems more irritant in my experience. the pancrex v types are ok ish tablets were useless(as expected), granules were better but still not great. I just didnt find that tryplase did anything in my own dog.

For my own dog I combine powder as above and lypex, the combination seems to cause less gi irritation than the powder alone although it was fine as far as faeces 'quality' was concerned. Like you I have found that they do need more that the box suggests (sibo and b12 issues aside).

hope this helps.

chris