Timothy's EPI story began in the fall of 2011, when he abruptly began acting very sick. My five year old Siamese mix, who had always been very playful and a great eater, suddenly refused his food and became extremely lethargic. He had severe diarrhea and some vomiting, and waddled around the house as if it was very painful to move. After a couple of vet visits and an ultrasound, he was diagnosed with acute pancreatitis and I took him home with subcutaneous fluids and injectable medications to support him as he recovered. I had worked at a veterinary hospital for seven years back before I left to start a business of my own, so I was able to do all the necessary treatments without hospitalizing him, which was great as it was less stressful for him and less expensive for me. Thankfully he pulled through the severe episode of pancreatitis, and a couple of less severe recurrences thereafter.

Even though he had survived the pancreatitis, Tim didn't really return to normal.

His stools remained soft, were a clay-like grey color rather than brown, and smelled truly horrible. The stench was so intense that if he passed a stool at night, the smell would wake me up even though the litter box was located on another floor at the opposite end of the house from my bedroom!

Around February, I noticed that Timothy was behaving oddly. He had always been extremely interested in food, but that interest began to morph into an absolute obsession with anything even remotely edible. Nothing was safe in our house. He would open the pantry and eat uncooked pasta and whole wheat bread. He raided our fruit bowl for peaches and avocados. He also began to lose weight rapidly. His pre-pancreatitis weight had been about eight pounds. Between February and April, he went from seven pounds to just barely over five pounds. As Tim's sixth birthday rolled around, I began seriously doubting that he would survive to see seven.

At some point, as I stood in the vet's office at yet another visit talking about awful things that it could be, one of us said, "Do cats get EPI?" I can't remember which of us brought up the subject. I had seen cases of EPI over the years in dogs, and so had the vet. Neither of us had seen it in a cat, but the symptoms that Tim was exhibiting were uncannily familiar. She left the room, and came back a few minutes later practically beaming as she declared that we would start him on enzymes right away. I was so relieved to finally have something concrete to pursue, even if it was a condition that would require lifelong management. I knew that EPI could be frustrating and expensive, but I also knew that it was treatable!

Tim's EPI is currently being managed with one teaspoon of EPI-Pro 6x enzyme powder mixed into each of his meals. I had him on a probiotic for a while as well, but it didn’t seem to make much of a difference and he wasn’t especially pleased with his food when the probiotic was present, so we eventually discontinued it.

Finding a food that works for Tim has been a bit of a struggle. He isn’t a fussy eater by any means, but it seemed as though I just could not get his diarrhea under control as long as he was on a normal canned diet, even if the canned diet was a very respectable brand like Innova EVO, Weruva, or Wellness. For the last few months, I have been feeding The Honest Kitchen’s dehydrated “Prowl” diet, and that seems to be working very well. He gets ¼ cup of the dehydrated food mixed with ½ cup of water and his enzymes twice per day. The food looks kind of like a soup when made with that much water. After mixing things up, I let everything sit for five minutes before feeding Tim. So far, his stools have been pretty consistently firm on this diet plan. It may be that the enzymes end up better mixed in his food now than they were previously, or that one of the ingredients in canned diets was not working well for Tim. Whatever the cause of the improvement may be, I am glad for it.

I give him weekly subcutaneous injections of 250mcg of vitamin B12. I noticed dramatic improvements in his energy level after beginning the B12 injections, and his stools seem to be approaching closer to normal as well. The hope is that we may be able to reduce the frequency of the injections in the future, but we aren't to that point yet; every few months, I will try to space the injections out a little bit further, but doing so has so far resulted in a return to loose stools. Tim is generally pretty good about his injections and allows me to give them without putting up much of a fight, though I do occasionally have to fall back on the "kitty burrito" method of wrapping the cat in a towel while giving the injection. He loves his food, so if I give him the injection while he is eating, he often does not notice that I have done anything!