When you hear hoof beats, it’s probably a horse, not a zebra.
But what if it is, in fact, a zebra?
Let me start off by saying that this post isn’t easy to write, and it probably won’t be easy to read. There was a lot of uncertainty in this journey, and no small amount of fear. Nevertheless, we persist. I don’t want to forget this. Fair warning, there will be discussions of bodily fluids involved. Proceed at your own risk. We lived it – we totally understand if you don’t want to read it.
Now, with that said.
Bella, our sweet little girl, has Exocrine Pancreatic Insufficiency (EPI).
Before we go any further, let me assure you, dear reader, that it isn’t life threatening. It’s chronic, and she will be on pills and supplements for the rest of her days. It’s serious, but she should be able to have a normal, healthy life, especially now that we have a diagnoses and treatment plan.
So, with all of that said, it’s story time.
When we brought Bella home at the beginning of June 2019, we called our vet to set up a normal, annual check-up. We had all of her vet records from her first family, but we wanted to get her in to ours to get her info into their system. Everything checked out fine. We got her started on the same flea/tick stuff that we have Bear on (Trifexis, for the curious), confirmed that she’s spayed and microchipped, and we went on our merry way. Bella weighed in at 50.5lbs.
Toward the end of July, we noticed that she would disappear about an hour after dinner and come back smelling like vomit. We have cameras in the backyard, so we checked the footage. About the time her food was making it to her stomach (not a vet, so this is an assumption), she was throwing it back up. Not only that, but she was re-ingesting it. Gross, right? We added some pumpkin to her diet, since we’d read that can help settle a pup’s stomach. That didn’t really help, so we made an appointment with our vet.
What was weird is that we didn’t notice a change in her behavior. She was acting just as bouncy and happy and playful as normal. The only indication that we had that something was wrong is her puking. That, and she was losing weight, pretty dramatically. We figured if we got the vomiting under control and let her system get back to normal, she’s put the weight back on.
Bella had lost 23% of her body weight in a couple months.
The vet thought it might’ve been a really bad upset stomach, essentially. We put her on an antibiotic, an anti-emetic, the puppy version of Pepto Bismol, an over-the-counter heartburn medication, and a bland diet. She took all of that like a champ! After all of that, she had stopped vomiting, but her poop was still the consistency of soft-serve. She had also started eating her poop.
Back to the vet we go. This time she weighed in at 38.5lbs.
Let that sink in. She went from 50lbs to 38.5lbs. I’m not a vet, but I can do math. Bella had lost 23% of her body weight in a couple months.
I’m going to pause here for a moment to explain why I’ve been quiet on this until now. Bella had lost a quarter of her body weight, so she looked unhealthily skinny. You could count her ribs just by looking at her. When she jumped in the kiddie pool during a game of fetch, and her fur got wet and not-fluffy, she looked like a skeleton. She might not have acted like she felt bad, but obviously something was wrong. I didn’t post many Bella pictures on their Instagram because of it. The reasons for that are three-fold.
I didn’t want my imagination getting overrun with Google-fueled horror scenarios.
First, as well meaning as they are, I didn’t want the armchair veterinarians weighing in. We were working with a vet we trust, and we were systematically trying to come up with a diagnoses. As soon as friends and family started in with the “well, I had a dog who had those same symptoms and it was X disease!” I knew I wouldn’t be able to resist looking it up, and we all know how well that goes. I trusted that our vet would figure out what’s wrong, and I didn’t want my imagination getting overrun with Google-fueled horror scenarios.
Second, I didn’t want people making the wrong judgement. Bella may be new to our family, but that’s it. She is family. We love her, and we were trying to figure out how to help her get better. Pictures of her taken around this time could’ve been shown with Sarah McLachlan singing in the background, though, so I didn’t want that to be the conclusion people came to.
Third, we didn’t have answers yet. I knew as soon as I shared that we were going through this journey that our friends and family would want updates. A few family members and close friends did know. But I wasn’t ready to share with the general public. I couldn’t handle well-meaning “how is she doing? Do you know what’s going on yet?” repeated a thousand times. I wanted answers before I shared en masse.
Now, back to the story.
She didn’t act sick. She’s still as happy and bouncy and playful as ever.
The vet puts Bella on a grain free diet for a week. Our vet said that normally a grain free diet isn’t necessary, but she had just seen a shepherd with a true grain allergy. It’s worth a try, right? We were told to let Bella eat as much as she wants. So off we go, with another round of antibiotics followed by a probiotic to help re-balance Bella’s gut bacteria.
A week later, we check in with the vet. Bella has gained back a pound. So we kept everything the same, hoping the weight gain would accelerate. She’s now at 39.5lbs.
Keep in mind, there’s still been no change in her behavior. She didn’t act sick. She’s still as happy and bouncy and playful as ever. She’s eating and drinking with alacrity, and she’s eating more than her brother – probably because the poor girl is starving!
After two weeks on the grain free diet, she weighed 40lbs. Still in the right direction, but not exactly what we were hoping for. The vet decided to change tactics, since the gain had slowed down instead of sped up.
We’d ruled out the horses, so it was time to start looking for the zebras.
We switched her to a hypoallergenic food, thinking it might be a different kind of food allergy. Bella was still allowed to eat as much as she wanted. However, she wasn’t a fan of the taste of the hypoallergenic food, so she wasn’t eating quite as much of it. Even though all her fecal tests had come back negative, we put her through a round of de-wormer just to be safe.
We also pulled blood samples for a full GI panel.
Up until this point, we were assuming that the hoof beats we were hearing belonged to horses. Upset stomach, food allergy, etc. are all pretty common ailments, and thus easy enough to diagnose and treat. Since she wasn’t lethargic and hadn’t stopped eating, we had ruled out thyroid issues or diabetes as well. We’d ruled out the horses, so it was time to start looking for the zebras.
The blood work held the answer. Bella has EPI. Her pancreas doesn’t produce enough of the enzymes she needs to break down her food and absorb the nutrients. That’s why she was losing so much weight while eating 8ish cups of food a day (normal for her would be around 4 cups). Her body couldn’t process it. Yes, this is different than diabetes. Diabetes is the endocrine (hormones) function of the pancreas not working. EPI is the exocrine (enzymes) function.
I’m thankful our vet didn’t push [blood work too early] and instead worked through the horses systematically.
She’s now on supplement enzymes, and she will be for life. Thankfully, she can go back to eating the same food as her brother. We have a few types of food to stay away from, but in all honesty, we probably wouldn’t have given our pups that kind of food anyway.
I’m thankful we have a diagnoses. Forgive the dramatic phrasing, but not knowing the name of the monster that has your little one in its clutches is awful. Although we had the option to do the blood work earlier on, and in retrospect we could have and it would’ve been the right call, I’m thankful our vet didn’t push that and instead worked through the horses systematically. That gives us confidence in the diagnoses and treatment. I’m thankful that even though this is a chronic condition, it can be managed easily with a few pills. I’m thankful for my husband, who has been a rock through all of this.
She is now back to the weight she was when we brought her home. She went in a few weeks ago, and she’s right at 50lbs! For a long time, I wasn’t actually sure what she weighed, since we didn’t check in with the vet for a while after the blood work came back and we got her prescription supplements. But I couldn’t see nearly as many of her ribs as I could when we started this journey, so I knew we were going in the right direction.
All that to say, we love our little girl and are so thankful to have a diagnosis, a treatment plan that’s effective and easily manageable, and a vet we trust to work with us for Bella’s well being. It was a long road, but it got us to a good place. We are blessed.
Peace,
Aiden
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