Exocrine pancreatic insufficiency (EPI) is a genetic condition where the pancreas does not produce the necessary enzymes required to digest food and absorb nutrients causing starvation regardless of the amount of food taken in. For further information and other resources on EPI I highly recommend visiting epi4dogs.com because my knowledge comes entirely through my experiences with Yara. Much of which has been chronicled here on my blog.
EPI is highly treatable, thankfully, but to say the entire thing was a struggle is truly an understatement. Yara has a penchant for stubbornness and from practically the moment she entered my life her choice method to showcase this was refusing to eat. Looking back it’s hard not to focus on all the mistakes that I made. Signs of her EPI were present from the moment she entered my life; her bowel movements were a tan color and always disproportionately large in comparison to how much she ate. Our instructor assured me that this was normal and so I never gave much thought to it. At her first annual checkup she got a clean bill of health, but had dropped an alarming twelve pounds! The weight loss continued steadily over the next three months, which was certainly baffling but not exactly alarming. Other than a noticeable increase in her bowel movements and an occasional bout of diarrhea or vomiting Yara seemed fine.
Throughout this I was in constant contact with Yara’s school, Fidelco. They were very sympathetic, but hardly alarmed by the weight loss. They offered a bunch of suggestions that included adding everything from vitamin supplements and probiotics to canned dog food and raw beef to her daily meals. At her peak Yara was eating what amounted to more than nine cups of food a day! The addition of the raw beef ignited the first undeniable symptoms of EPI; Yara’s stools morphed into a bright yellow “cow plop” and she started vomiting almost daily. It was exactly the worst thing she could have had in her diet, but I’m strangely grateful that we did because it alerted everyone to how serious things were. Still, it would take nearly two months before she was formally diagnosed. She had a battery of different tests run and they all returned normal results; in fact, the GI test that determined her EPI diagnosis initially showed that she was “marginally” in the range.
By that point I was fully on board with whatever the vet told me. Yara was clearly sick! She never was as ravaged as some EPI dogs I’ve seen, but her ribs were clearly visible at the height of her weight loss. (This photo is the best example I could find.) A fact that the general public made me aware of almost constantly. In fact, there was even a formal complaint made to Fidelco! I tried not to take it as a personal offense when they sent a trainer out within a few days to check on things while for months before they were made aware of the entire situation at every interval and had been completely nonplussed.
The resounding memory of these six months is the amount of stress I was under. I felt pressure from Fidelco to take their advice against my own better judgment or that of my vet’s. This greatly influenced the length of time it took to diagnosis Yara. On the rare occasion that I didn’t side with the school it was made abundantly clear they felt that decision was the root of the problem. I had changed her food, for instance, so that might be the culprit because she was used to the other food. Admittedly, I took a substantial amount of time off because of Yara, but my superiors at work were largely unsympathetic. The level of passive aggression and outright punishment directed towards me probably only furthered my own health issues with chronic migraines. So, when I needed time off because I was sick it was a Big Problem. And I got no respite because everyone from my family and friends to outright strangers made it known how bad things were. People made a point to remark about how thin Yara was and suggest ways to offset this. (“I think you need to feed her more.”) On countless occasions I was accosted in public about my “obvious” abuse; one woman actually dragged me by the arm while literally in the middle of crossing a street to yell at me!
Worst of all was my own personal struggle. I scoured every possible resource for anything that might help. Perhaps she was sensitive to chemicals and so along with her various food alterations she drank only purified water. For months. I changed all of my cleaning and laundry supplies to green products, which I admit I had wanted to do anyway because of my migraines. I went so far as to replace all of her bedding, including a very expensive bed, thinking that she might have an allergy (which she does but that’s a whole other story) and began a long process of eliminating things one by one to determine the cause. But with every change that netted no resolution I kept coming back to one constant: me.
Part of me couldn’t believe that this was possible. I rejected the notion that I was the problem by reminding myself of her nearly flawless work in harness. But every time she refused a morsel of food or had an accident in the house I became just a bit more convinced that she was stressed out by her job. I felt like a rotten human being; I was selfish to want to keep working her and cruel to continue to do so if she wasn’t cut out for this life. Mostly, I felt like a failure. The partnership was faltering and I couldn’t fix it. I was increasingly convinced I was doing something wrong, but proud enough that I wouldn’t dare admit it. Friends tell me they guessed as much, but I never told anyone how bad it really was for me or how close I came to calling Fidelco to take Yara back. To this day I can’t tell you what stopped me. I could say I didn’t want to give up, but I did. I could say that I didn’t want to be parted from her, but that’s hard to believe when every room in the house is covered in dog sick.
Obviously it wasn’t all for naught and we made it through all of this. Yara’s recovery was very swift and though I did eventually retire her because of her health issues it actually had very little to do with any of this or the fact she has EPI. I’ve since remarked on how profoundly she impacted my life in her short working career even though we had more than our fair share of “downs.” Not that I want to repeat it, but I don’t regret the struggle. For all I know it only made the bond we shared even stronger. Mostly, it made me appreciate all the positives we had. Sometimes it was a way to distract myself from how miserable things were and other times that focus was the driving force behind figuring it all out. Together, we accomplished so much!