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Forum Home > General Discussion > My Dog was just diagnosed with EPI

LelaAdelman
Member
Posts: 12

We brought Tula home on August 1st of last year. She is an 11 month old Springer Spanial.

 

In October she began to have GI issues and we finally diagnosed her with a case of Giardia and Coccidia. Despite several rounds of antibiotics it would not go away. Finally in February she had several clear fecal tests. I think we had a week or two of a truly healthy pup and then she began to have serious GI issues. Increased and frequent bowl movements. She lost 6lbs in a week and you could tell she was starving. Nothing was staying in her system. She became agressive and started eating her stool. I begain reading and self diagnosed her with EPI, switched vets as ours was not proactive and requested testing. Unfortunatly I was correct in my assumption.

 

Here are her results from Texas A&M:

 

Cobalamin Fasting 385 ng/L | ref is 251-908

 

Folate Fasting 18.3 pg/L | ref is 7.7-24.4

 

TLI Fasting <1.0 pg/L | ref is 5.7-45.2

 

Interpertation diagnostic for EPI

 

Currently we have her on PaniKare but I plan on re-ordering enzymes through enzymediane.com. She is also on Tylan 1 teaspoon 1x a day. She has gained her weight back and seems to be evening out a bit.

 

My immediate questions and concerns are:

 

Did she get EPI from having Giardia and Coccidia infections that would not clear? Was she born with EPI?

 

She has always eaten everything! Especially anything that is green (grass, twigs, plants, flowers etc..). Is this a sign that there were always EPI issues? Is there something we can do to supplement so this behavior lessens?

 

The PaniKare does create a unique body order. Is there anything we can do to minimize this? Should we order in a pill form?

 

Is there anything else we can be doing for her to help her get back on track?

 

I was so relieved to come across this site as there is so much to learn and this site has already helped us feel less overwhelmed.

 

 

--

Lela, Steven, and Tula

April 17, 2017 at 12:24 AM Flag Quote & Reply

Jean and Kara
Administrator
Posts: 7233

good morning to all of you from UK


And a huge welcome, i know you are stressed and worried, but this is manageable


firstly, your questions


there is no definitive answer as to why they get EPI,but I reckon we can all go back to a certain occurance, but no proof !


she could have been born with EPI . if there is a breeder out there , it would be as well if you tell them, as there could be a litter mate that may have it too, but that is a huge MAY,  


the eating of anything, and everything is a puppy thing, and you tend to take no notice, but when it gets out of hand, it becomes an issue, it sounds like she has always had GI issues, and probably EPI from a very early age , and starving hungry, as she was not digesting food


as to supplements, its best to keep things simple to start with


and agression, can you be more specific


So, her cobalamin (b12) levels are low, she should be on a course of generic b12 injections weekly, for at least 6 weeks, not the multi vitamin type, it is a dull pink in colour, this is essential to digestion, and animals can be agressive if its low, but more so if they are hungry


Tylan is weight dosed, how heavy is she ?


FOOD, what are you feeding, how much, and how often , the recommendation is 150% of the food for the weight the animal SHOULD be over several meals 


keep a diary, log or whatever, record everything you do, and only change one thing at a time so you know what works   


so I look forward to your answers and the US folk will help with the smell of enzymes, we dont have that over here, as our enzymes are different


please dont panic, we have been at this for nearly 7 years and you have down days. but mostly, I forget there is anything amiss with Kara


jean


UK Admin

--



 

 

Kara

 

From Liverpool England


born 21st July 2009


Adopted at five months old 26th December 2009

 

EPI dx August 2010


tli<1.00 folate 8.3 cobalimin 611

Antibiotics  2 Oxytet antibiotics 3 times a day also if we cannot fit the Oxytet in she has Tylan 1/8th teaspoon before her meals as a maintenanance dose

Food- Ashenbank Lamb Casserole  twice daily equalling 3 cups per day possibly more

Zantac (ranitadine) 75 mg 30 minutes before each meal as too much acid was being produced, causing shedding of bowel lining

Enzymes-Panzym 3 gram per meal twice daily ( 3/4 teaspoon ) 

B12 injection once every three weeks

One Chemeyes B12 with intrinsic factor of 40 daily

One Antepsin before bedtime

Allergies to beef, pork, chicken. and white fish confirmed by blood test

33.6 kilos in weight as of 5th May 2013

37 kilos as of 10th June 2014

40.65 kilos, 89.6 pounds as of 3rd March 2015

Vet says she is now processing her food correctly

Very proud of all of us


 

"UNCONDITIONAL LOVE WAS INVENTED BY DOGS"


I am not a vet, nor have veterinary experience, but have lived and breathed EPI for 51/2 years, and hope I can bring some support to others, as others have to me.

 

 

 





our favourite man Uncle Ian

April 17, 2017 at 2:40 AM Flag Quote & Reply

Patsy
Member
Posts: 916

Hello, sorry to hear another springer has got Epi.   My beautiful Marti, a springer , lived with Epi for eight years till she was twelve, with unrelated issues. She regained all her weight, and energy,    She did have the enzyme odour,  but  I changed enzymes to capsules in the UK.  The causes of Epi are vague. I've not found out about any kennel mates of Marti, unless yours has  uk imports in the pedigree?  Sadly all breeds of dog are represented Epi.  This may be due to the fact that the condition wasn't considered for any but GSDs, and other breeds with it  were misdiagnosed and  untreated.  It took my vet a couple of months ,  as Marti became critically ill. 

It takes a while to get to grips with it, but life will get back to normal,  and coping with ups and downs becomes easier. We've all been at rock bottom, so do keep in touch, vets don't always know best !



--

Marti  Springer Spaniel, owned by Patsy, Sheffield, England.  She died age 12yrs 6mths  on 27/11/14 from heart failure. Diagnosed after three months, when she was 4 years old,she dropped from 24 kilos to 17 kg.  initially she also had protein losing enteropathy, treated with steroids, ,raw sores on back, obsessive thirst, bursting bowels and biadder, then stable after 2 years.   Developed another autoimmune problem with muscular myositis on head ( muscles wasted away, leaving gaunt hollows.)  She also suffered sometimes from  bottom end thrush, anal  gland infections, and recurrent SIBO treated with 4 weeks of oxytetracycline each time. 

Enzymes: Panzym caused mouth problems, resulting in tooth removal , as I didn't know at the time how caustic it was. I changed to one Lypex  then used VetUk Pancreatic Nutrient tablets, and one Chemeyes because it is half the strength, and I didn't need to use two vet uk ones. Then 3 Chemeyes or  2 pancreatic Nutrient  per meal. 

B12 injection monthly.  Trinfac B12 + intrinsic factor capsules from Chemeyes daily. Metacam for knee joints.  Also used Yumpro Bio pre/probiotics.

Food: picky eater,tinned  Chappie saved her life  till she would eat kibble again.  Eden Holistic, Millies Wolfheart and Lily's Kitchen all good,chicken and grain free.

Vets, one caring learner, who had  nervous breakdown, replaced by obnoxious vet , so I rang round  interviewing them to find someone I trusted and would work with us. Since losing Marti and Bob, I have changed again since the good vet us retired.

RIP Bobby the cocker , from PLN.  Present pet, Tinker the fluffy little grey Greek rescue dog. New addition, Jack ,  a neglected rescue terrier, looks like a fox cub and so happy to to be healthy and loved.

 


April 17, 2017 at 5:24 PM Flag Quote & Reply

Jill
Administrator
Posts: 3571

Hi and welcome to the forum.


It is usually advised here to give Tylan two times per day instead of 1.  Here is the chart you can look up the dose to give her for her weight:


http://www.epi4dogs.com/sidsibo.htm



After the dogs start the enzymes they just seem to smell(not particularly good either) for awhile.  It might last quite awhile but usually subsides. 


You might want to print the Tylan table out for your vet and run by her/him the 2x/day dosing instead of 1.




--

   Jill-  Washington State

Mickey 6/21/99 - 8/29/2014 

17.5 lb  jack russell, chronic pancreatitis, hyperuricosuria,high blood pressure, hypothyroid, spinal stenosis

diet of  hard boiled eggs, macaroni,  RC Hepatic, mashed potato

2 #2 Dianes enzymes 6x premeal

 2.5 mg Amlodipine, .15mg soloxine am/pm, 100mg ursodiol started for gall bladder thinning

arthritis:  6.25mg tramadol 1x/day, 12.5mg gabapentin every 12 hrs,  Assisi soft loop used on back and elbow, 1- 540meq potassium citrate nightly

Denamarin once a day, 1/16 t tylan (150mg)  2x/day ,  Senilife started 12/14/13, Trixsyn sirup for arthritis, .1mg Adequan weekly by shot. 75mg Tylan 2x./day for SIBO

Optimmune for Dry eyes

 Kiya is Mickeys sister, 3/4 aussie, 1/4 blue heeler born 9/2006.  She thinks she is a 44 lb jack russell who tries to heel Mickey!!

TJ is the newest addition.  He is in the bottom picture with Kiya.  He was born 7/05/2015. 

I am not a vet, just a pet owner sharing what experiences I have had in helping my dogs with other pet owners.  If you have an emergency please call your vet.





April 17, 2017 at 8:48 PM Flag Quote & Reply

Epi4Dogs
Site Owner
Posts: 16651

Hi Lela and welcome to our EPI family... Sorry you have to be here with Tula but at least you ahve an answer on what in the world is wrong and YES!!!!!   once you find the right balance of the EPI protocol  Tula will be back on track :)


EPI is not as devastating as first thought once you find the right balance of things.....  My pup Izzy was diagnosed at 1+ 1/2 yrs old  and she is now 12 years old ,,, and if you met her you'd think she was not more than a mayber 4 yrs old..... she is doing GREAT!  ONce we got her EPI under control, her EPI was very manageable.  Over the years we had a few set backs with SID (most often treated with Tylan,.. but twice a day according to weight, recommended to give with food so easiest to give with breakfast and dinner ... however, better to encapsulate the right dose of powder (according to weight) in empty gel caps cause Tylan is NASTY tasting and some dogs won't eat food with TYlan in it.... but should also be given for 30-45 days.  PLEASE share this with your vet and please also print the SID/SIBO page   http://www.epi4dogs.com/sidsibo.htm

for your vet that has the supporting research and correct dosing recommendations on giving TYlan to EPI dogs with SID.  

To answer your question.... they really don't know why EPI happens, there is some evidence of genetics in play, BUT... not in every case, hence why there is an EPI Metabolomic Research study going on now with the Univ of Ill/Drs. David A. WIlliams (developed of the TLI test) and Patrick Barko .... Epi4Dogs is also collaborating on this research ... we now suspect that EPI is a combination of possible genetics and environmental causes.... exactly what, thoough, we just don't know.

That stench you smell is (we strongly suspect)  putrefication.  It usually eventually goes away.... but until then it does indeed stink!  I think (and this is only my personal guess) when you get the gut flora  in a good place and all the bad old stuff is finally expelled... that is when the stench goes away.  of course this is just my personal opinion........BUt it jstu appears that the stick stays until you find the right does/product and or amount of food, enzymes, and antibiotic, B12 if needed... in other words the right balance of the recommended protocol.  

Looking forward to hearing more about Tula so that hopefully we can better help you help Tula!!

--

Olesia, owned by Izzy, a 35lb SWD, Diagnosed at 1.5 years old - TLI results 1.3, Stable 9+ yrs! Once stable, was able to reduce enzymes to only 1/2 tsp of Enzymes (use EnzymeDiane's 6x) with each meal, but after almost 4 years of stabilization... had to increase the amount of enzymes to 3/4 teaspoon with each meal. Fed various grain-free kibble+real meat, 6x pancreatin enzymes from EnzymeDiane., gave 1 tsp of coconut oil one day and 1 tsp salmon oil next day, and also give canned sardines packed without salt or canned herring for extra omega oils.... until she developed Diabetes and now cannot tolerate higher fat foods.

In Feb 2013, Izzy developed a very serious condition called IMHA which she (thankfully) beat and is now in remission. We also discovered that now, at 8+ years old, she not only has EPI, but also Diabetes, Low Thyroid and High Cholesterol.  Izzy was able to receive excellent care because of the kindness of so many here on epi4dogs and  is currently  doing extra-ordinarily well. If anyone could spend a day with Izzy, they would never guess that she has any health problems!  Because of Izzy's concurrent conditions of Diabetes and High Cholesterol we had to make changes to our daily EPI routine. We had to alter the fiber, type of fiber and the fat content her diet. She is now on an all home-made diet which she does best on and has even been able to reduce the insuline (Vetsulin:pork-based insulin) . Because of the diet change to all home-made i no longer worry about hypoglycemia or hyperglycemia- -she is much more even-keeled with a diet of sweet potato, a lean meat/fish, sometimes a free range egg, cottage cheese,  fish oil+vitamins and bone meal. We tried Novolin N a human synthetic RNA insulin.... but Izzy did not do well on it. aside from all of Izzy's health issues.... she continues to wake up every day full of joy and a great sense of humor!

I am not a vet.  All of my suggestions/recommendations are based on personal expereinces, observations, information gleaned from EPI research, and information shared with me by EPI researchers....that hopefully may help others. Please always share anything and everything recommended on this forum with your vet.

April 18, 2017 at 12:03 PM Flag Quote & Reply

Doc's Mom
Administrator
Posts: 2802

Hi and welcome to the Group!!  You've been given great advice but one thing stood out - you stated you are giving 1tsp of Tylan 1x a day?  Is that correct?  How much does your dog weigh as that's a big dose of Tylan.  The other thing is that Tylan should be given twice a day usually with breakfast and dinner - about 12hrs apart.  There is information on dosing on our SIBO tab above that you can share with your vet.  It seems overwhelming in the beginning but we are here to help guide you along the way.

Madelon

--

MADELON and DOC aka "BUBBY WUBBY"

Nashville, Tennessee

DOB: 4/3/2014 - Diagnosed EPI and SIBO: 5/22/2015
EPI Test Results: 1st test 7/2014 = TLI 16.5, B12 894, Folate > 24; 
2nd test 5/2015 = TLI < .4, B12 406; Folate >24; 3rd test 10/2015   TLI < .4; B12 >1000; Folate 14.4

Weight: 95 (highest 1/2015) - 76 (lowest 5/2015) - goal met 100lb (7/23/15) - 101.8LBS 12/3/15 - CHUNKY MONKEY

History prior to DX:  May/June 2014 (2mos old) - DX coccidia and bladder infection; July 2014 (3mos old) 1st EPI test = TLI 16.5, B12 894, Folate >24 - Diagnosed SIBO not EPI; Feb 2015 thru May 2015 - weight loss only; May  2015 vomitted several times, diarrhea and eating poop.

History since DX: has maintained weight between 95-101lbs since July 2015; extreme yeast and rod infection in ears; yeast infection paws (ongoing); bacterial eye infection; bacterial skin infection on legs; poops LIVE fly larvae; diagnosed with mild, focal superficial pyoderma (bacterial infection) - rare lesions on inner thighs; bacterial and yeast overgrowth lip folds; yeast overgrowth feet and left ear; metacarpal/metatarsal draining tracts/fistulae (infection and/or immune mediated disease; probable underlying allergy (food vs. environmental ); staphylococcus pseudintermedius infection in sores on paws; recurring metatarsal fistula - all issues resolved after NutriScan Food Sensitivity Test and switching foods.

NUTRISCAN Food Sensitivity Test (12/2015): reactive to chicken, turkey, white fish, wheat, white potato (mild), venison, soy (mild), pork (mild), duck (mild), corn - switching food based on test resolved all skin issues.

Serum Allergy Test (5/2016): Too many to mention

CURRENTLY :  6 cups Forza10 Legend Skin - Diane 6x 1tsp per cup; 1 WonderLab PetFactor B12 2x day; 2 scoops TotalBiotics 1x day; 600mg vitamin E; 1 Zyrtec 10mg 2x day; Milk Thistle during heartworm/flea/tick meds

I am not a vet.  All of my suggestions are based on my personal experiences, information gleaned from EPI research and information from other EPI owners.  Please always share anything and everything recommended on this forum with your vet

SO THANKfUL FOR OUR EPI4DOGS GUARDIAN ANGELS!!!!!!!!

YOUR PAWS LEFT PRINTS ON MY HEART (in loving memory of Bugsy aka Boo Boo - Boston Terrier 14yrs - not EPI but medically challenging and totally worth it)


April 18, 2017 at 12:57 PM Flag Quote & Reply

LelaAdelman
Member
Posts: 12

Wow! Thank you all for responding so quickly with such amazing information.

Based on your questions here is a bit more information and more questions! I'll go down the line but let me know if I missed anyone.

JEAN-

Agression-At Tula's rock bottom she was so hungry and started eating her poo. We were out for a 2am potty and she lunged for her poo and I pushed her off and she bite me. This was the second time in a short period where she had become agressive around food. The first time she had grabbed some meat off the counter and when I went after her she growled and snapped at me. Now that she has enzymes in her she is back to her normal self. I'm fairly certian that it was situational. 

B12- Based on the numbers you stated that she should be recieving B12 shots. The vet stated that her B12 was fine?  Can you tell me which of the below refers to B12?

Cobalamin Fasting 385 ng/L | ref is 251-908

Folate Fasting 18.3 pg/L | ref is 7.7-24.4

TLI Fasting <1.0 pg/L | ref is 5.7-45.2

Tylan- She is right around 45lbs and the vet prescribed 1/4 teaspoon 1x a day. Based on the chart I can give her 1/8 2x day? The taste doesn't seem to be bothering her as she eats her food without any issues. Should I still do capsules? Now I feel bad and don't want her food to taste awful?

She is currenlty on a vet prescribed food (Royal Canine Hydrolized protein kibble). We give her 1 1/2 cups in the am and pm.  I hate the ingredients in this food (they are all processed and don't even resemble food)> I plan on changing it to something with more nutrients after we get her balanced out.

PATSY-

I'm so sorry to hear about all the hardships that you and Marti experienced. It sounds heartbreaking but it's nice to hear that there was another springer out there that went through what our Tula is going through. 

Tylan-Should I be concerned about her teeth and PanaKare???  Has anyone else experienced teeth problems with enzymes? Is this a thing?

JILL and MADELON

Tylan- She is right around 45lbs and the vet prescribed 1/4 teaspoon 1x a day. Based on the chart I can give her 1/8 2x day? The taste doesn't seem to be bothering her as she eats her food without any issues. Should I still do capsules. Now I feel bad and don't want her food to taste awful

Group Question!

Are all he enzymes from Enzyme Diane the same kind or do I have to figure out what to get Tula?  If they are different how do I make sure that it is similiar to the PanaKare Plus Powder that she is currently taking?

What are the pros and cons of enzymes in capsule form vs. powder? Does it still work the same in a capsule form?  


Thanks again for all of your valued insight!


--

Lela, Steven, and Tula

April 18, 2017 at 10:47 PM Flag Quote & Reply

Epi4Dogs
Site Owner
Posts: 16651

Hi Lela and Steven and Tula,

If Tula is eating her food with the Tylan sprinkled in it.... consider yourself lucky!!!!! That means the taste doesn't bother her and i would just continue doing what you are doing :)


Regarding the Tylan.... i would contact your vet and ask her if  she has a specific reason for giving  1/4 tsp once a day, please let her know that we at Epi4Dogs suggest twice a day (every 12 hours) , and for her weight 1/8 of a tsp with breakfast and 1/8 of a tsp with dinner (which works out to the 1/4 tsp)... but......  Please share with her the SID/SIBO page (which appears to be down at the moment :() that the reason why we suggest this is because this is what Dr. Jorg Steiner at TAMU has recommended regarding Tylan and treat SID in EPI dogs.   


Why are you worried about her teeth and Panakare or any enzyme???  i don't think there is a problem with it, if there is i have not yet heard of it.


Before you change the Hydrolyzed kibble and yea, the ingredients sound awful, eh?!  BUT... hydrolysed food is processed in such a manner so the body will not recognize any offending protein.  Did you vet put Tula on this for a reason??? Does your vet also suspect possible IBD??? If so i wouldn't change or at least not until you get Tula stable (consecutivelyputting out normal poos a normal amount of times a day for at least a month or even two months.)  If your vet doesn't have Tula on special Hydrolysed food for a possible food sensitivity, then i would try OTC low fiber foods found in the grain free section.... but besure to read the ingredients and analysis, what they claim on the front of the package is not always what is actually in the package.........


EnzymeDiane has 6x which is equivalent to the ewll known brand-name enzymes such as Pancrezyme, Viokase, PanaKare, etc.  Anytime you change an enzyme brand, use the Lipase USP units as your main "ingredient" guide. Enzyme Diane also carries 8x, but that is stronger so you use less. I personally like the 6x just because it's less math to figure out :).


If you put enzyme powder in capsules how well it will work varies from dog to dog.  Usually you serve the powder loose in the food with a little room temp water added, mix, let sit for 20 minutes to mostly avoid mouth sores, and then serve. However, some people have had difficulty getting their dogs to eat their meals with the powder mixed in and have tried putting the powder in empty gel caps... as i said, success with this method is variable.  


The Cobalamin level at 385 is in the normal but low range.... with EPI dogs it is better to have the B12 level be in the upper mid range. Anything below and it is suggested to receive shots to bring up the B12 level and then (this is important) you and your vet will need to figure out how often going forward Tula will need B12 to maintain nice upper mid range levels (500-600).  Reason why we suggest this is because their B12 may be low normal now, but in time if not supplemented, it usualy drops to low. Over 80% of all EPI dogs end up needing supplementation... so it is a concern.  Please share the B12 page with your vet, as again, we follow the TAMU gastrointestinal lab B12 recommendations with EPI dogs.


Yea, that aggression thing can happen and it's jsut that they are starving at that point. Glad she stopped once she started receiving the proper treatment....thankfully it did not develop into a bad habit.  And if it helps any, my gal, just before she was diagnosed did almost the same thing, started eating her own poo... and she was FAST about it too, i couldn't stop her, but the poor thing was literally starving......once we started the enzymes she stopped that habit too.


--

Olesia, owned by Izzy, a 35lb SWD, Diagnosed at 1.5 years old - TLI results 1.3, Stable 9+ yrs! Once stable, was able to reduce enzymes to only 1/2 tsp of Enzymes (use EnzymeDiane's 6x) with each meal, but after almost 4 years of stabilization... had to increase the amount of enzymes to 3/4 teaspoon with each meal. Fed various grain-free kibble+real meat, 6x pancreatin enzymes from EnzymeDiane., gave 1 tsp of coconut oil one day and 1 tsp salmon oil next day, and also give canned sardines packed without salt or canned herring for extra omega oils.... until she developed Diabetes and now cannot tolerate higher fat foods.

In Feb 2013, Izzy developed a very serious condition called IMHA which she (thankfully) beat and is now in remission. We also discovered that now, at 8+ years old, she not only has EPI, but also Diabetes, Low Thyroid and High Cholesterol.  Izzy was able to receive excellent care because of the kindness of so many here on epi4dogs and  is currently  doing extra-ordinarily well. If anyone could spend a day with Izzy, they would never guess that she has any health problems!  Because of Izzy's concurrent conditions of Diabetes and High Cholesterol we had to make changes to our daily EPI routine. We had to alter the fiber, type of fiber and the fat content her diet. She is now on an all home-made diet which she does best on and has even been able to reduce the insuline (Vetsulin:pork-based insulin) . Because of the diet change to all home-made i no longer worry about hypoglycemia or hyperglycemia- -she is much more even-keeled with a diet of sweet potato, a lean meat/fish, sometimes a free range egg, cottage cheese,  fish oil+vitamins and bone meal. We tried Novolin N a human synthetic RNA insulin.... but Izzy did not do well on it. aside from all of Izzy's health issues.... she continues to wake up every day full of joy and a great sense of humor!

I am not a vet.  All of my suggestions/recommendations are based on personal expereinces, observations, information gleaned from EPI research, and information shared with me by EPI researchers....that hopefully may help others. Please always share anything and everything recommended on this forum with your vet.

April 18, 2017 at 11:15 PM Flag Quote & Reply

LelaAdelman
Member
Posts: 12

After all she has been through she is still a very happy good dog! Which makes all of this so much harder. 

This morning I started her on 1/8 teaspoon of Tylan 2x a day. I will be sure to discuss it with the vet as well. I will also talk to the vet about b12 shots. Makes perfect sense to me and maybe why she still doesn't seem 100%.

Patsy mentioned that Marti had teeth problems from the Enzymes but sounds like it isn't something that I should typically be concerned about?

Before Tula was diagnosed with EPI my old vet thought it might be food sensitivities so had me put her on the Royal Canine. Since we got her it seemed we couldn't find a food that really worked for her. She was going to the bathroom alot but her poops were solid until it escalated out of control and we had her tested for EPI. How do I know if it is food or the EPI? I don't plan on changing until I feel that she is back to normal. 

We also use the Royal Canine treats for training. Obviously we can't put enzymes on her treats? Also she eats an insane amount of plants. Anything green, even the foxtails! :o I feel like this is a strong indication that she is still missing some sort of plant based nutrient. Can we feed her green beans? How does that work without enzymes? Not suggested or??? 

I will plan on ordering the 6x enzymes form Diane too. Thank you for clarifying for me!

I'm thrilled to hear that we have a little luck on our side. Tula seems to handle the powdered Tylan and PanaKare like a champ. We mix the food with warm water, pumpkin enzymes, and wait 20 mintues. So so far so good! Are we in the clear or can she still possibly get sores in her mouth?

I think we might have also escaped the agression. She still wants to eat her poo but we are on her and she knows that it is a no no! 



--

Lela, Steven, and Tula

April 19, 2017 at 10:16 PM Flag Quote & Reply

Epi4Dogs
Site Owner
Posts: 16651

As long as you are mixinb the enzymes IN the food with a pinch of room temp water and letting it sit, then she should be fine and not get any


Definitely talk to your vet about the B12 (share the B12 page here on this website s it has the Texas A&M Gastro Labe research and prtocol recommendations.  


Regarding the Tylan, you are still giving the same dose daily, just giving the right amount every 12 hours vs. once every 24 hours.  This is also Texas A&M's  protocol in treating SID .. but please show your vet and make sure she is okay with it.  Your vet is not the only one, periodically we have come across other EPI pet owners who's vet suggested the Tylan just once a day and the EPI dog still has difficulty getting SID under control.... so not only the research, but also via our anecdotal observation, it appears that the twice daily dose works better on these dogs.


Diet... UGH..... can be a lot of trial and error.  Since you don't really know (yet) if Tula does or doesn't also have food sensitivities.... my thought would be to give the Tylan, the Enzymes and get some B12... give all of this a chance to work... so that you can determine if the Royal Canin prescription Hydrolysed food is necessary or not............if after trying the recommended protocol for a few weeks and you don't really see major improvement.... THEN i would discuss with your vet that maybe it is time to try a different food... in which case.. then i would look at low fiber content food with the fiber from plants not grain. Check in the "grain-free" food section, but like i said read the label. Start with foods that are 4% or less fiber content.... Even less fiber content is better... if this is what you end up doing.  BUt for now, i'd stay on the Hydrolyzed food your vet put Tula on.... and jsut keep us posted and we will work with you and your vet :)


Ahhh... treats..... well/// this is going to be hard... for YOU... Tula will adjust quicker then you. THe best thing you can do for her is NO treats until she is stable with her EPI....and then we will work with you how to intriduce some treats, when and what kind, but for now... it is a big "No-No....


Regarding the teeth.... usually there are not any problems with the enzymes deterioatting the teeth... Patsy's dog had issues with it and there was one other dog, but other than that, i don't recall any others  having issues...........

--

Olesia, owned by Izzy, a 35lb SWD, Diagnosed at 1.5 years old - TLI results 1.3, Stable 9+ yrs! Once stable, was able to reduce enzymes to only 1/2 tsp of Enzymes (use EnzymeDiane's 6x) with each meal, but after almost 4 years of stabilization... had to increase the amount of enzymes to 3/4 teaspoon with each meal. Fed various grain-free kibble+real meat, 6x pancreatin enzymes from EnzymeDiane., gave 1 tsp of coconut oil one day and 1 tsp salmon oil next day, and also give canned sardines packed without salt or canned herring for extra omega oils.... until she developed Diabetes and now cannot tolerate higher fat foods.

In Feb 2013, Izzy developed a very serious condition called IMHA which she (thankfully) beat and is now in remission. We also discovered that now, at 8+ years old, she not only has EPI, but also Diabetes, Low Thyroid and High Cholesterol.  Izzy was able to receive excellent care because of the kindness of so many here on epi4dogs and  is currently  doing extra-ordinarily well. If anyone could spend a day with Izzy, they would never guess that she has any health problems!  Because of Izzy's concurrent conditions of Diabetes and High Cholesterol we had to make changes to our daily EPI routine. We had to alter the fiber, type of fiber and the fat content her diet. She is now on an all home-made diet which she does best on and has even been able to reduce the insuline (Vetsulin:pork-based insulin) . Because of the diet change to all home-made i no longer worry about hypoglycemia or hyperglycemia- -she is much more even-keeled with a diet of sweet potato, a lean meat/fish, sometimes a free range egg, cottage cheese,  fish oil+vitamins and bone meal. We tried Novolin N a human synthetic RNA insulin.... but Izzy did not do well on it. aside from all of Izzy's health issues.... she continues to wake up every day full of joy and a great sense of humor!

I am not a vet.  All of my suggestions/recommendations are based on personal expereinces, observations, information gleaned from EPI research, and information shared with me by EPI researchers....that hopefully may help others. Please always share anything and everything recommended on this forum with your vet.

April 19, 2017 at 10:35 PM Flag Quote & Reply

LelaAdelman
Member
Posts: 12

Oh one last thing her stomach is growling all the time now? Is that a good thing? She doesn't seem too uncomfortable...

--

Lela, Steven, and Tula

April 19, 2017 at 10:43 PM Flag Quote & Reply

Patsy
Member
Posts: 916

Marti had powdered UK enzymes,that didn't need soaking. At the time ,before EPI4dogs, I had no way of knowing that it is caustic , and with dogs with floppy cheeks like spaniels, saliva gets stuck all over the place. This is why they are prone to lip fold infections. The preventative solution is to try to wash their mouth with water after feeding, , giving them a drink then. Some people are able to squirt water round the gums. Then wipe clean.

 

Of course the tooth trouble may have had other reasons, she was a rehomed show dog ,two years old, when I got her. She wouldn't have had sweet treats at the breeders. However, my latest rescue dog, non Epi, has had 15 teeth out and he's only about six, very neglected. Maybe Marti's Epi malabsorption with Epi had some issues with gum health?

Usually the urge to eat green stuff is because they feel sick. Oddly, Marti would zoom to Forget me Not plants, little blue flowers. I couldn't find it in herbal remedy books!   Maybe it's a spaniel thing.  

Rumbling is SIBO/Sid .  It comes before the room clearing fart stage!  Using the suggested antibiotic course is necessary. 




--

Marti  Springer Spaniel, owned by Patsy, Sheffield, England.  She died age 12yrs 6mths  on 27/11/14 from heart failure. Diagnosed after three months, when she was 4 years old,she dropped from 24 kilos to 17 kg.  initially she also had protein losing enteropathy, treated with steroids, ,raw sores on back, obsessive thirst, bursting bowels and biadder, then stable after 2 years.   Developed another autoimmune problem with muscular myositis on head ( muscles wasted away, leaving gaunt hollows.)  She also suffered sometimes from  bottom end thrush, anal  gland infections, and recurrent SIBO treated with 4 weeks of oxytetracycline each time. 

Enzymes: Panzym caused mouth problems, resulting in tooth removal , as I didn't know at the time how caustic it was. I changed to one Lypex  then used VetUk Pancreatic Nutrient tablets, and one Chemeyes because it is half the strength, and I didn't need to use two vet uk ones. Then 3 Chemeyes or  2 pancreatic Nutrient  per meal. 

B12 injection monthly.  Trinfac B12 + intrinsic factor capsules from Chemeyes daily. Metacam for knee joints.  Also used Yumpro Bio pre/probiotics.

Food: picky eater,tinned  Chappie saved her life  till she would eat kibble again.  Eden Holistic, Millies Wolfheart and Lily's Kitchen all good,chicken and grain free.

Vets, one caring learner, who had  nervous breakdown, replaced by obnoxious vet , so I rang round  interviewing them to find someone I trusted and would work with us. Since losing Marti and Bob, I have changed again since the good vet us retired.

RIP Bobby the cocker , from PLN.  Present pet, Tinker the fluffy little grey Greek rescue dog. New addition, Jack ,  a neglected rescue terrier, looks like a fox cub and so happy to to be healthy and loved.

 


April 20, 2017 at 4:20 AM Flag Quote & Reply

LelaAdelman
Member
Posts: 12

Thanks for clarifying Patsy! All information is important at this point. I would rather be over educated in this case then miss something I should be paying attention to. I can't wait for the next phase...room clearing gas! :mad:

--

Lela, Steven, and Tula

April 20, 2017 at 10:34 AM Flag Quote & Reply

Epi4Dogs
Site Owner
Posts: 16651

Tummy grumbling and stinky gas = SID / SIBO..... call the vet and ask if they would be fine with you switching the Tylan dose to twice a day.  One thing great about Tylan is that you do not have to be exact with the dose you jsut don't want to under-dose.


Oh... and definitely talk to your vet and start the B12 :)


Also.... keep a journal record EVERYTHING  what you give, amount , brand name AND the results (poop, gas burping, etc)


Either this is the initial SID and has not cleared up yet ...... you need to try giving the TYlan twice a day dose 7-10 days....to see if dosing was the problem....... BUT.... if you do not see /hear/smell any improvement in the 7-10 days... then this is when we recommend to ask the vet to change the anti (next in line is Metronidazole... although "usually" Tylan works MUCH better most of the time)..... but in Tula's case there are still too many protocol variables still not completely addressed... so i would not yet do the anti change... but rather.....


... it is more likely that the Tylan IS working but that the diet you have is perpetuating it.... and in the beginning it is difficult to ascertain which is which....(it's enough to make you head spin, eh?!!!!!..........SO my suggestion (and please share with your vet) .... is to give the TYlan twice daily at least a week tor two at the most...  to see if you notice ANY improvement.... and let us know about it.... if no improvement whatsoever..... then at that point i would stay on the Tylan twice a day as you are doingand switch the food.  (1) try an extremely low fiber food (in the grain free section) or (2) a grain -free home-prepared meal for about 3 days... to see if you see ANY improvement or not.... if not.... then we can assume it is probably the Tylan that is not working.... BUT if you see ANY improvement with the food change at this juncture... then i suspect that the Tylan was trying to do it's job but the food was not agreeing with Tula and instead was perpetuating the SID......


When you get to this point, we will help you with the diet change :)


It's a real trial and balancing act and it is best to test things one a a time.....  but well worth finding out what you need to adjust to help Tula have optimal results from her EPI treatment.   

--

Olesia, owned by Izzy, a 35lb SWD, Diagnosed at 1.5 years old - TLI results 1.3, Stable 9+ yrs! Once stable, was able to reduce enzymes to only 1/2 tsp of Enzymes (use EnzymeDiane's 6x) with each meal, but after almost 4 years of stabilization... had to increase the amount of enzymes to 3/4 teaspoon with each meal. Fed various grain-free kibble+real meat, 6x pancreatin enzymes from EnzymeDiane., gave 1 tsp of coconut oil one day and 1 tsp salmon oil next day, and also give canned sardines packed without salt or canned herring for extra omega oils.... until she developed Diabetes and now cannot tolerate higher fat foods.

In Feb 2013, Izzy developed a very serious condition called IMHA which she (thankfully) beat and is now in remission. We also discovered that now, at 8+ years old, she not only has EPI, but also Diabetes, Low Thyroid and High Cholesterol.  Izzy was able to receive excellent care because of the kindness of so many here on epi4dogs and  is currently  doing extra-ordinarily well. If anyone could spend a day with Izzy, they would never guess that she has any health problems!  Because of Izzy's concurrent conditions of Diabetes and High Cholesterol we had to make changes to our daily EPI routine. We had to alter the fiber, type of fiber and the fat content her diet. She is now on an all home-made diet which she does best on and has even been able to reduce the insuline (Vetsulin:pork-based insulin) . Because of the diet change to all home-made i no longer worry about hypoglycemia or hyperglycemia- -she is much more even-keeled with a diet of sweet potato, a lean meat/fish, sometimes a free range egg, cottage cheese,  fish oil+vitamins and bone meal. We tried Novolin N a human synthetic RNA insulin.... but Izzy did not do well on it. aside from all of Izzy's health issues.... she continues to wake up every day full of joy and a great sense of humor!

I am not a vet.  All of my suggestions/recommendations are based on personal expereinces, observations, information gleaned from EPI research, and information shared with me by EPI researchers....that hopefully may help others. Please always share anything and everything recommended on this forum with your vet.

April 20, 2017 at 12:17 PM Flag Quote & Reply

LelaAdelman
Member
Posts: 12
Thank you! We have an appointment with the vet on Monday and will discuss the b12 and Tylan adjustments. Then we will see how she does.
--

Lela, Steven, and Tula

April 22, 2017 at 11:47 AM Flag Quote & Reply

Epi4Dogs
Site Owner
Posts: 16651

good!  looking forward to hearing that your vet got Tula back on track :)


Please do keep us psoted!

--

Olesia, owned by Izzy, a 35lb SWD, Diagnosed at 1.5 years old - TLI results 1.3, Stable 9+ yrs! Once stable, was able to reduce enzymes to only 1/2 tsp of Enzymes (use EnzymeDiane's 6x) with each meal, but after almost 4 years of stabilization... had to increase the amount of enzymes to 3/4 teaspoon with each meal. Fed various grain-free kibble+real meat, 6x pancreatin enzymes from EnzymeDiane., gave 1 tsp of coconut oil one day and 1 tsp salmon oil next day, and also give canned sardines packed without salt or canned herring for extra omega oils.... until she developed Diabetes and now cannot tolerate higher fat foods.

In Feb 2013, Izzy developed a very serious condition called IMHA which she (thankfully) beat and is now in remission. We also discovered that now, at 8+ years old, she not only has EPI, but also Diabetes, Low Thyroid and High Cholesterol.  Izzy was able to receive excellent care because of the kindness of so many here on epi4dogs and  is currently  doing extra-ordinarily well. If anyone could spend a day with Izzy, they would never guess that she has any health problems!  Because of Izzy's concurrent conditions of Diabetes and High Cholesterol we had to make changes to our daily EPI routine. We had to alter the fiber, type of fiber and the fat content her diet. She is now on an all home-made diet which she does best on and has even been able to reduce the insuline (Vetsulin:pork-based insulin) . Because of the diet change to all home-made i no longer worry about hypoglycemia or hyperglycemia- -she is much more even-keeled with a diet of sweet potato, a lean meat/fish, sometimes a free range egg, cottage cheese,  fish oil+vitamins and bone meal. We tried Novolin N a human synthetic RNA insulin.... but Izzy did not do well on it. aside from all of Izzy's health issues.... she continues to wake up every day full of joy and a great sense of humor!

I am not a vet.  All of my suggestions/recommendations are based on personal expereinces, observations, information gleaned from EPI research, and information shared with me by EPI researchers....that hopefully may help others. Please always share anything and everything recommended on this forum with your vet.

April 22, 2017 at 12:14 PM Flag Quote & Reply

LelaAdelman
Member
Posts: 12
It's been a couple months now and Tula is doing much better. We have done all the key pieces. She is just finishing the Tylan round (2x a day), we have her on PanaKare. She is also on her 3rd week of B12 shots. She is still on the royal canine hydorlized kibble. I would like to switch her to another food but Ian waiting for consistancy in her BMs. They have gotten smaller and less frequent. The color and consistency seems to vary. In the last 4days it seems to have gotten softer larger and more yellow in color. The yellow color has never completely gone away but has been better up until now. She is also burping a lot and her stomach is very gurgly. Is this the SIBO? Is it typical to see these setbacks? Is there something we can do to get her bms under control again? Do I need to request another round of Tylan? She had a foxtail removed and was put on antibiotics for 2wks? She has been fine on them until now. Her last one was today. Any thoughts or suggestions would be appreciated!
--

Lela, Steven, and Tula

May 16, 2017 at 11:40 AM Flag Quote & Reply

Doc's Mom
Administrator
Posts: 2802
Hi there - sorry you're still having some issues. I just looked back to some of the posts and I agree with Olesia - if you saw some improvement with Tylan but are still having SIBO symptoms it might be time to switch food. Look for grain free with 4% fiber or less. Unfortunately with EPI until you get everything balanced you won't have perfect poop. Also, when you are done with the 45days of Tylan remember to slowly wean off - don't quit cold turkey as that sometimes causes a set back. And with B12 - when you are done with the protocol I would start using the WonderLab PetFactor pills for B12 supplementing or you can continue with shots but what you don't want to do is stop supplementing B12. Hang in there - we're here with you :)
--

MADELON and DOC aka "BUBBY WUBBY"

Nashville, Tennessee

DOB: 4/3/2014 - Diagnosed EPI and SIBO: 5/22/2015
EPI Test Results: 1st test 7/2014 = TLI 16.5, B12 894, Folate > 24; 
2nd test 5/2015 = TLI < .4, B12 406; Folate >24; 3rd test 10/2015   TLI < .4; B12 >1000; Folate 14.4

Weight: 95 (highest 1/2015) - 76 (lowest 5/2015) - goal met 100lb (7/23/15) - 101.8LBS 12/3/15 - CHUNKY MONKEY

History prior to DX:  May/June 2014 (2mos old) - DX coccidia and bladder infection; July 2014 (3mos old) 1st EPI test = TLI 16.5, B12 894, Folate >24 - Diagnosed SIBO not EPI; Feb 2015 thru May 2015 - weight loss only; May  2015 vomitted several times, diarrhea and eating poop.

History since DX: has maintained weight between 95-101lbs since July 2015; extreme yeast and rod infection in ears; yeast infection paws (ongoing); bacterial eye infection; bacterial skin infection on legs; poops LIVE fly larvae; diagnosed with mild, focal superficial pyoderma (bacterial infection) - rare lesions on inner thighs; bacterial and yeast overgrowth lip folds; yeast overgrowth feet and left ear; metacarpal/metatarsal draining tracts/fistulae (infection and/or immune mediated disease; probable underlying allergy (food vs. environmental ); staphylococcus pseudintermedius infection in sores on paws; recurring metatarsal fistula - all issues resolved after NutriScan Food Sensitivity Test and switching foods.

NUTRISCAN Food Sensitivity Test (12/2015): reactive to chicken, turkey, white fish, wheat, white potato (mild), venison, soy (mild), pork (mild), duck (mild), corn - switching food based on test resolved all skin issues.

Serum Allergy Test (5/2016): Too many to mention

CURRENTLY :  6 cups Forza10 Legend Skin - Diane 6x 1tsp per cup; 1 WonderLab PetFactor B12 2x day; 2 scoops TotalBiotics 1x day; 600mg vitamin E; 1 Zyrtec 10mg 2x day; Milk Thistle during heartworm/flea/tick meds

I am not a vet.  All of my suggestions are based on my personal experiences, information gleaned from EPI research and information from other EPI owners.  Please always share anything and everything recommended on this forum with your vet

SO THANKfUL FOR OUR EPI4DOGS GUARDIAN ANGELS!!!!!!!!

YOUR PAWS LEFT PRINTS ON MY HEART (in loving memory of Bugsy aka Boo Boo - Boston Terrier 14yrs - not EPI but medically challenging and totally worth it)


May 16, 2017 at 2:12 PM Flag Quote & Reply

Epi4Dogs
Site Owner
Posts: 16651

Hi Lela,


Yea.. that sounds like SID bubbling up again :(.. with the color of the poo, softer consistency and burping..and gurgly tummy.   How many days has she been on Tylan?  45? 


Also... just curious.... What was the name of the other antibiotic that she was on for the foxtail? 


My "guess" is that either she has not been on Tylan long enough, and needs a repeat session, or... the Tylan was working, but something in her regimen is triggering the SID to not go away completely... and usually  the food is the culprit. ........  

 

i checked back on your posts.... and if i have the trail of events correctly... your vet put Tula on prescription hydrolyzed food because they suspected possible food sensitivities which really was the next right thing to do... owever... after you got the EPI diagnosis... the hydrolysed food may not be needed and may be perpetuating SID... of course we are just guessing at this, but it's the best we can do when trying to figure out what is perpetuating SID... and like i said, it often is the food.


SO..........what you can do is give a pinch more enzymes while you think about and research possible food changes.

You can check out the Dog Food Options page look at the foods that have low fiber content from carbs not grain... for now, when testing new foods, first start with foods that do not have any grain in them like rice, wheat, barley, quinona, oats, etc, etcstay . Look for foods that list Fiber Content at 4% or less (sometimes 3.5% is much better tolerated) Also... in the beginning .. stay away from foods that have "peas" in the ingredient multiple times (like 3 times or more, like peas, pea protein, pea flour), yadda yadda......

And jsut buy a SMALL bag.... just in case whatever food you are trying doesn't work.. you don't want to waste a lot of money...


Once you do find a food that works (keep notes on what you try and how she responds... this will save you from going crazy later... honest :D....)  then you can try "other" types of composition.


Hope this helps and keep us posted!

--

Olesia, owned by Izzy, a 35lb SWD, Diagnosed at 1.5 years old - TLI results 1.3, Stable 9+ yrs! Once stable, was able to reduce enzymes to only 1/2 tsp of Enzymes (use EnzymeDiane's 6x) with each meal, but after almost 4 years of stabilization... had to increase the amount of enzymes to 3/4 teaspoon with each meal. Fed various grain-free kibble+real meat, 6x pancreatin enzymes from EnzymeDiane., gave 1 tsp of coconut oil one day and 1 tsp salmon oil next day, and also give canned sardines packed without salt or canned herring for extra omega oils.... until she developed Diabetes and now cannot tolerate higher fat foods.

In Feb 2013, Izzy developed a very serious condition called IMHA which she (thankfully) beat and is now in remission. We also discovered that now, at 8+ years old, she not only has EPI, but also Diabetes, Low Thyroid and High Cholesterol.  Izzy was able to receive excellent care because of the kindness of so many here on epi4dogs and  is currently  doing extra-ordinarily well. If anyone could spend a day with Izzy, they would never guess that she has any health problems!  Because of Izzy's concurrent conditions of Diabetes and High Cholesterol we had to make changes to our daily EPI routine. We had to alter the fiber, type of fiber and the fat content her diet. She is now on an all home-made diet which she does best on and has even been able to reduce the insuline (Vetsulin:pork-based insulin) . Because of the diet change to all home-made i no longer worry about hypoglycemia or hyperglycemia- -she is much more even-keeled with a diet of sweet potato, a lean meat/fish, sometimes a free range egg, cottage cheese,  fish oil+vitamins and bone meal. We tried Novolin N a human synthetic RNA insulin.... but Izzy did not do well on it. aside from all of Izzy's health issues.... she continues to wake up every day full of joy and a great sense of humor!

I am not a vet.  All of my suggestions/recommendations are based on personal expereinces, observations, information gleaned from EPI research, and information shared with me by EPI researchers....that hopefully may help others. Please always share anything and everything recommended on this forum with your vet.

May 16, 2017 at 5:08 PM Flag Quote & Reply

LelaAdelman
Member
Posts: 12

Epi4Dogs at May 16, 2017 at 5:08 PM

Hi Lela,


Yea.. that sounds like SID bubbling up again :(.. with the color of the poo, softer consistency and burping..and gurgly tummy.   How many days has she been on Tylan?  45? 


Also... just curious.... What was the name of the other antibiotic that she was on for the foxtail? 


My "guess" is that either she has not been on Tylan long enough, and needs a repeat session, or... the Tylan was working, but something in her regimen is triggering the SID to not go away completely... and usually  the food is the culprit. ........  

 

i checked back on your posts.... and if i have the trail of events correctly... your vet put Tula on prescription hydrolyzed food because they suspected possible food sensitivities which really was the next right thing to do... owever... after you got the EPI diagnosis... the hydrolysed food may not be needed and may be perpetuating SID... of course we are just guessing at this, but it's the best we can do when trying to figure out what is perpetuating SID... and like i said, it often is the food.


SO..........what you can do is give a pinch more enzymes while you think about and research possible food changes.

You can check out the Dog Food Options page look at the foods that have low fiber content from carbs not grain... for now, when testing new foods, first start with foods that do not have any grain in them like rice, wheat, barley, quinona, oats, etc, etcstay . Look for foods that list Fiber Content at 4% or less (sometimes 3.5% is much better tolerated) Also... in the beginning .. stay away from foods that have "peas" in the ingredient multiple times (like 3 times or more, like peas, pea protein, pea flour), yadda yadda......

And jsut buy a SMALL bag.... just in case whatever food you are trying doesn't work.. you don't want to waste a lot of money...


Once you do find a food that works (keep notes on what you try and how she responds... this will save you from going crazy later... honest :D....)  then you can try "other" types of composition.


Hope this helps and keep us posted!

I request and received another round of Tylan. She was on it for almost 45 days. We went a day and 1/2 without Tylan but we are now back to 2x a day. When she had the foxtail removed they had her on 14 days of Simpliceff and then 5 days of Deramaxx for pain control. The thing I don't understand is she has been fine and we haven't changed anything. The only exception has been the foxtail stuff and she was fine up until the last few days. Things have not improved. In fact I think it might be getting worse. I will start to blend in a new food tomorrow (will look at the list). Is this type of setback normal? When switching food should we blend old and new? Thank you!
--

Lela, Steven, and Tula

May 19, 2017 at 12:26 AM Flag Quote & Reply

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