Title

Subtitle

Forum

Post Reply
Forum Home > General Discussion > Kobe

Samantha
Member
Posts: 683

Wow, it has been a long, long time and I'm back seeking advice from my fellow EPI owners.

Kobe has been mostly stable over the past 4 years. He has had a few bouts of SIBO which each time has been taken care of with Tylan. Most recently, I thought I was battling the same thing so started Tylan. No better. He has been having monthly B12 injections and still gets a daily Wonderlabs B12. Kibble of Canidae GF Bison & Lamb. No other changes, nothing to explain the sudden change.


The quality of poo changed from firm to slop/mushy/explosive. Volume also increase and frequency (usually once a day, increased to 3). Tummy gurgling, farts, the usual signs that I thought indicated SIBO. But no response to Tylan for the first time.


I took him to the vet this week and requested a full CBC, B12 & folate. Which showed the following:

  1. Amylase: 345U/L and in January it was high 400's - he had surgery to remove a torn dewclaw
  2. B12: 2,007 ng/L when the poo degraded I started weekly injections so he has had 2 in the past 2 weeks
  3. Folate: 15.5 ug/L
  4. Urea: 2.0 (low) - possibly going to look into this pending on how the next few weeks go
  5. EOS: 0.5 (low WBC) - I'm waiting for a copy of the last bloods done in January, but I do know they were also low.

My vet recommended increasing Creon, which I have done. In doing so I have seen an improvement in the volume, quality and quantity of poos, but it's still not as it was. I increased the Creon with Monday dinner and the feeding and poo diary following that is:

  • Tuesday meals: Brekkie & dinner - 2 cups of Canidae with 3 Creon (no lunch).
  • Tuesday morning poo: formed but soft. Darker in colour but no gas or gurgling noticed.
  • Wednesday meals: Brekkie, lunch & dinner - Brekkie & dinner same as above, but 1 cup with 2 Creon for lunch.
  • Wednesday morning poo - same as Tuesday.
  • Wednesday evening poo - diarrhea. Not much, not slimy or smelly and it was dark brown, not dark yellowish as it has been. Also noticed wind following on from his dinner.

I'm putting the diarrhea down to the lunch meal considering it had improved, so once again I am stopping his lunch until I can get the balance right. I called Canidae yesterday and there have been no changes to the formula, but I do know that enzyme requirements can change in EPI dogs and they may need more. My questions.. 

  • Am I missing anything? Is there anything standing out for you?
  • Should I keep the increase of Creon for the next 7 days and if no improvements should I a) start Tylan and see if that helps or b) try give an extra Creon so it's 4 Creon per 2 cups?
  • The vet has recommended doing the increase for the next 7 days and touching base. She wants to ensure that it's EPI related before exploring other options such as IBD, etc which makes sense to me. And, with the change that I've seen I am inclined to think it is EPI related.
  • She also suggested possibly changing his diet to see whether that is the cause for the sudden deterioration. I will look at that depending on how the next few weeks ago.
  • He has lost 2.5kgs, so is 35.2kgs at the moment.

Thanks,

Sam x

--

Kobe - 9yo GSD diagnosed with EPI in October 2009 (19 months old). 2 cups of Canidae Bison & Lamb Grain Free, fed 3 times daily,  2 Creon 25,000 per meal. Weekly B12 injections at home & daily Wonderlab Trinfac-B in between. Inner Health Plus Probiotic once a week.. EPI weight 33.5kgs, current weight 40kgs. Original blood results - TLi: 1.2, B12: 306, Folate: 15.6.

Blood results April 2013 - B12: 596, Folate: >20.

Read Kobe's journal that was started the day he was diagnosed here.

May 17, 2017 at 11:06 PM Flag Quote & Reply

Epi4Dogs
Site Owner
Posts: 16992

Hi Sam... wow.... long time no chat... glad that Kobe has been doing well for so long!!! And although nice chatting with you.so sorry you have to be here cuase Kobe has an issue.....


First i agree with your vet increase the Creon a bit- -see if that helps with the poo quality.

Okay... this is what jumps out at me..... BUT.... i need you to run this by your vet to for her to assess if i am on the right path..... look at the low UREA.... this usually means the kidneys are not processing the waste properly.  Back off on the b12... and cut out any extra vitamin A or vitamin D.   Talk to your vet about the possibility that this might be a kidney issue... and if your vet thinks maybe.... first thing i would do is really reduce the B12 amount (don't stop, good to give but not good to over-give) and have your vet help you with a more "kidney friendly" diet....and whatever else she recommends for a kidney issue..


The high Amylase can also kind of point in this direction (kidney) ...BUT... the amylase reading is only a snapshot in time... and usually not very useful reading unless coupled with other blood abnormalities... your vet will have to look at the whole picture and decide how and "if" the Amylase value has any bearing on what is gong on with Kobe or not.


Do ya'll have tick in Australia??? like Erlichea????  i know it sounds crazy..... but if you have ticks there, i'd ask the vet to run a tick panel....


Please 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 17, 2017 at 11:28 PM Flag Quote & Reply

Samantha
Member
Posts: 683

Hi Olesia.. it sure has, I'm sorry that I've been so absent and it's lovely to speak to you again!


Do you think I should try going to 4 capsules, if 3 doesn't make it spick and speck?

As for the UREA. Since posting that, I have gotten the previous CBC reports and they are:


May 2017: 2.0mmol/L

January 2017: 2.6mmol/L

July 2016: 3.8mmol/L


So it looks as though it has slowly been decreasing over the past 12 months. I did mention to her about kidneys/diabetes combined with EPI, she said that his glucose was fine so they weren't inclined to think that at the minute but of course that doesn't mean the kidneys are functioning correctly. Especially considering the UREA being the way that it is and has been going. It's just difficult to know if this is EPI related or something else at play.


The vet also suggested stopping the B12 injections so I will be. I might also cut back on the Wonderlabs to every 2nd day instead while his levels are sky high.


I also looked at the Amylase results for the same time period as above. There isn't a huge change and last year they were in the 300's as well. But anyway they are:


May 2017: 345

January 2017: 411

July 2016: 380


We do have ticks, but not where I live and I don't have lawn or plants in my backyard (its artificial law and Kobe likes to eat plants so I don't even have a potted one!). In saying that though, I moved house in July 2016 and now live next door to a man that has chickens. And I just checked the product that I give to the children each month, Panoramis, and it doesn't look like it controls ticks.


--

Kobe - 9yo GSD diagnosed with EPI in October 2009 (19 months old). 2 cups of Canidae Bison & Lamb Grain Free, fed 3 times daily,  2 Creon 25,000 per meal. Weekly B12 injections at home & daily Wonderlab Trinfac-B in between. Inner Health Plus Probiotic once a week.. EPI weight 33.5kgs, current weight 40kgs. Original blood results - TLi: 1.2, B12: 306, Folate: 15.6.

Blood results April 2013 - B12: 596, Folate: >20.

Read Kobe's journal that was started the day he was diagnosed here.

May 17, 2017 at 11:49 PM Flag Quote & Reply

Patsy
Member
Posts: 941

When my non Epi dog had kidney issues, his poop became dark, he lost weight, and his coat lost condition. And his breath stank.   If you have any concerns , do go to the vet, with a morning urine sample, ask for blood tests to be repeated to check the urea again,   Your gut instinct is telling you to follow this course, otherwise you wouldn't be asking us to confirm your worries!  Go!!

--

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.

 


May 19, 2017 at 3:12 AM Flag Quote & Reply

Epi4Dogs
Site Owner
Posts: 16992

Well said Patsy!!!!!   ALWAYS  listen to your gut... sometimes we can't exactly verbalize what we think is wrong, just that we know something is not right.


Samantha... YES... back off on the B12... just in case, just don't stop B12 supplementation - -your plan sounds like a good one....  


And YES... based on the declining UREA numbers and your gut feeling that something is not right.... i would ask the vet to pursue checking the kidneys... and taking into consideration the move/neighbors, chickens ... all environmental things.... i definitely would run a tick panel... just in case also.  For us in the USA, checking the kidney and doing a tick panel is not an outrageous expense. I hope it is reasonable for you in AUS.


Also.... because you moved to a new place... is it possible that Kobe got into something in the yard, or around the premises, some kind of chemical (yard/soil/home) treatment that you might not be aware of???  As "toxins" of some sort could be what triggered the low WBC count.....as usually the 2 main causes of low WBC is tick disease and/or toxins......or (and i am just thinking out loud here) ... i wonder if there could be a toxin build up if the kidneys are not flushing things properly... i honestly don't know if this could be a possibility with environmental toxins... but if it is a possibility.... that also might be what is going on... or not......... 



--

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 19, 2017 at 9:26 AM Flag Quote & Reply

Jill
Administrator
Posts: 3614
Sam, was there any protein found in the urine specimen or was one submitted? Thanks, good to hear from you.
--

   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.





May 19, 2017 at 9:44 AM Flag Quote & Reply

Samantha
Member
Posts: 683

Hello hello,


I had a lengthy chat with my vet on Thursday evening regarding the blood results. She went through each of them with me and explained the possible causes of each of them. The difficulty is that because he has lost weight and is clearly not absorbing correctly, that can also throw a few of the tests off. My plan was to wait a few more days with the increase in Creon and see how it went. Last night I increased again by one, so he had 4 with his dinner. A few hours later he did the best poo he has done in weeks. Colour and texture wise - it wasn't perfect but it was better. I gave the same dose this morning and it was mushy again, so must have been a fluke last night however I will keep on giving 4.


There is nothing in the yard that he can get into that could cause any issues. It's very bare as they can get up to mischief!


Unfortunately this morning I woke up to a big big wee in the house. He had gone on his bed and near the door. He then went and did a big wee had brekkie and did another wee. I called the vet and have made another appointment for tomorrow for a urine test and further bloods as I am not happy with how he is progressing. There are too many what ifs and I'm not ok just waiting to see if they are related or not. As I said to the nurse this morning.. is he drinking more because he is weeing more or is he weeing more because he is drinking more. His poos aren't loose enough in my mind and experience, to explain either of them. I could be wrong. When I spoke to the vet on Thursday she said they could do specific tests for adrenal glands and functions, to be more specific.


I know this isn't 100% related to EPI, but does anyone have any suggestions on specific kidney and/or liver tests that I should be requesting apart from the adrenal glands that aren't included in a normal CBC? He seems a lot more interested in my food as well and although I have cut his daily meals down by one cup, he has never really shown this much attention to what I am cooking and eating. Coincidental or part of the larger picture..


Two of Kobe's brothers have passed away this year from Hemangiosarcoma (my mums dog and my sisters dog). Nothng at all points to that from what's been going on with him, but to say that it doesn't concern me would be a lie.


--

Kobe - 9yo GSD diagnosed with EPI in October 2009 (19 months old). 2 cups of Canidae Bison & Lamb Grain Free, fed 3 times daily,  2 Creon 25,000 per meal. Weekly B12 injections at home & daily Wonderlab Trinfac-B in between. Inner Health Plus Probiotic once a week.. EPI weight 33.5kgs, current weight 40kgs. Original blood results - TLi: 1.2, B12: 306, Folate: 15.6.

Blood results April 2013 - B12: 596, Folate: >20.

Read Kobe's journal that was started the day he was diagnosed here.

May 20, 2017 at 10:05 PM Flag Quote & Reply

Epi4Dogs
Site Owner
Posts: 16992

Ahhh Sam... this bits big time.......... i get so frustrated when you KNOW something is not right but you jsut don't know where to look first.


I honestly don't know whaspecific kidney testsyou should ask the vet to look into- - but ask what they suggest and why and then decide what you feel is best for Kobe......


Regarding the Adrenal tests... i do not have any experience with Addisons... but i do have experience with Cushings.....when checking for Cushings... ask for the ACTH test... that is the full big time test that is the best... OR.... might want to ask your vet if there is a new Cushings test out there that is as good as the ACTH but not as expensive... not positive... but i think i read something about this recently....


A little background....They thought my Rico had EPI.... but when they tested him, he did not... but he too started peeing everywhere, has loose stools (Tylan did not clear it up ) and issue (or kidney).  Cushings without teatment just gets worse and worse... HOWEVEr... with treatment... (they put Rico on Lysodren) within a week he was almost back to normal... he improved real quick.  My Rico was diagnosed with A-Typical Cushings.


So glad you went to the vet and had a long conversation..... and glad you are staying on top of this.  

Please keep us posted! Hope they figure out what is going on and soon, so you can get Kobe feeling better soon 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.

May 20, 2017 at 11:14 PM Flag Quote & Reply

Samantha
Member
Posts: 683
We had followup today and a urine sample. His urine is diluted, because he is drinking excessively. His poos still aren't normal and I've increased to 4 capsules. Unfortunately he has also lost another 700grams, so is basically his EPI diagnosis weight of 34.5kgs. The vet opted not to do further bloods but instead has ordered an abdo ultrasound which is happening tomorrow afternoon. If all is well with that, I will look at some different kibble to try. Have there been any changes with the diet or is grain free/ low fiber still the key elements? The vet showed me a prescription one I could try, Hills I/D, which was low fat.. but low fat isn't a concern anymore from what I remember although I'm rusty. I was just going to try find something with similar analysis of protein/fat and fiber like his current Canidae? Thoughts or suggestions?
--

Kobe - 9yo GSD diagnosed with EPI in October 2009 (19 months old). 2 cups of Canidae Bison & Lamb Grain Free, fed 3 times daily,  2 Creon 25,000 per meal. Weekly B12 injections at home & daily Wonderlab Trinfac-B in between. Inner Health Plus Probiotic once a week.. EPI weight 33.5kgs, current weight 40kgs. Original blood results - TLi: 1.2, B12: 306, Folate: 15.6.

Blood results April 2013 - B12: 596, Folate: >20.

Read Kobe's journal that was started the day he was diagnosed here.

May 23, 2017 at 5:43 AM Flag Quote & Reply

Epi4Dogs
Site Owner
Posts: 16992

hi SAm..... no..... the deal is still the same with the fat.- -fat in moderation is tgeh best way to go UNLESS...another conditions requires  limited fat in the diet....


HOWEVER... Texas A&M has been digging into this and does have a few studies out there.......suggesting super low fat diets for certain conditions

http://vetmed.tamu.edu/gilab/research

.....maybe you might want to go to thier site (go to above link) browse around and see if any of it "might" apply to Kobe>   Did your vet say why he/she didn't agree with further pursing possible adrenal condition ?

--

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 23, 2017 at 12:40 PM Flag Quote & Reply

Barb
Member
Posts: 3893

Hi Sam,   I hope you can get to the bottom of what is going on with Kobe.   I know how frustrating and worrisome this can be.   


Please let us know what you find out.


Thinking of you, sending hugs.


Barb

--


May 23, 2017 at 1:14 PM Flag Quote & Reply

Samantha
Member
Posts: 683

Thanks Barb, hope you're all well x


Hi Olesia,


I asked the vet about that specifically (thyroid, further bloods etc). She said symptomatically he isn't presenting that way and the blood work that was done last week, doesn't indicate that either. She said the results in which he is low in, if there was one of those being the root cause, they would be elevated and not lower. Last night I gave him 5 Creon with his dinner and this morning's poo was the best that it's been - but he did have some gurgling tummy noises last night. Which with his increase in water, could be the cause of that.


The plan at the moment is to get the ultrasound today. I am hopeful it will all show clear and that this is just a sudden change in his requirements or intolerance to the Canidae, resulting in a need for a higher Creon dose.


I have been reading about alternative kibble and have come across an Australian one called BlackHawk (Grain free). The analysis seems quite good - 28% min. protein, 18% min. fat, 2% max fiber. A lot of the other ones that I was reading about have fiber of 5%+, which I am reluctant to try as his current Canidae is 25% protein, 15% fat and 4% max fiber. The only problem that I do have with the BlackHawk is that all their grain free products have chicken meal and chicken fat. He has never had an intolerance to it before, but I recall in 2013 when I changed from Holistic Select to Canidae it was because they changed something in their kibble and for the life of me I cannot remember what it was, I thought it had something to do with Chicken (he was on duck and had been for a few years) but I can't be 101% certain.


BlackHawk have different flavours of Chicken, Lamb, Salmon & Kangaroo. I don't like that they are all made up of 'meal' however. He has been having lamb with his current Canidae - should I stay away from lamb or is it better to give something else? Canidae Bison & Lamb has very limited ingredients which I liked, as opposed to all the others I've read that contain tomato, beets, etc.


What would be the lesser of the two evils? So. many. questions.

--

Kobe - 9yo GSD diagnosed with EPI in October 2009 (19 months old). 2 cups of Canidae Bison & Lamb Grain Free, fed 3 times daily,  2 Creon 25,000 per meal. Weekly B12 injections at home & daily Wonderlab Trinfac-B in between. Inner Health Plus Probiotic once a week.. EPI weight 33.5kgs, current weight 40kgs. Original blood results - TLi: 1.2, B12: 306, Folate: 15.6.

Blood results April 2013 - B12: 596, Folate: >20.

Read Kobe's journal that was started the day he was diagnosed here.

May 23, 2017 at 10:20 PM Flag Quote & Reply

Epi4Dogs
Site Owner
Posts: 16992

Hi Sam.... that's enough ot make your head spin... eh?!  The only thing i can sthink of is maybe just go ahead and buy the smallest bag possible of the Black Hawk... just to see if it even works with Kobe.... and if it does YEAH!!!  if not... :( thenatleast you will not have spent a tone of money on it................. 


thanks for letting me know what your vet said ... i really appreciate..  Hopefully Kobe will start feeling better...............SOON!!!!!


Please do 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 24, 2017 at 8:55 AM Flag Quote & Reply

Samantha
Member
Posts: 683
Thanks Olesia. He vomited this morning, all water. Didn't think much of it. He had an ultrasound today and it showed his adrenals are moderately enlarged and the stomach contained a moderate amount of fluid. He was heavily sedated so is pretty well out of it, had a few sips of water and just resting. But he just woke me up by loud retching and did two huge.. and I mean huge, water/bile vomits. He hasn't eaten at all today and the radiologist said the fluid is in the small intestine but no other abnormalities were noted apart from that and the adrenals. I'll speak to my vet tomorrow and will ask her about the blood test you recommended and also these very sudden fountain vomits and the tummy fluid. He's not a vomit kind of dog, very very rare. Arghhhhh
--

Kobe - 9yo GSD diagnosed with EPI in October 2009 (19 months old). 2 cups of Canidae Bison & Lamb Grain Free, fed 3 times daily,  2 Creon 25,000 per meal. Weekly B12 injections at home & daily Wonderlab Trinfac-B in between. Inner Health Plus Probiotic once a week.. EPI weight 33.5kgs, current weight 40kgs. Original blood results - TLi: 1.2, B12: 306, Folate: 15.6.

Blood results April 2013 - B12: 596, Folate: >20.

Read Kobe's journal that was started the day he was diagnosed here.

May 24, 2017 at 9:56 AM Flag Quote & Reply

Judith
Member
Posts: 408

Hi. I'm sorry you are having issues and Kobe is not feelig well. I would as your vet to run an ACTH stimulation test to rule out any issues with his adrenals. It is the diagnositic test for Addison's disease and Cushing's syndrome. Hope you get some answers soon

--

Nate 2 year old Pembroke Welsh Corgi. DOB 5/5/2014 

EPI and Addison's Disease and Idopathic Epilepsy

TLi 2.1 June 13, 2016 TLi 2.0

Coblamin and folate could not be done

Clinically diagnosed with Addison's disease on June 23, 2016

Diet 1.25 cup Royal Canin Ultamino every 12 hours 

2 Chemeyes capsules given with each meal

.45ml hydroxocobalamin (B12) once a week

.33ml Percorten-V every 28 days Addison's Disease

.5mg prednisolone in the morning for Addison's Disease

100mg Zonisamide every 12 hours for seizures

May 24, 2017 at 1:13 PM Flag Quote & Reply

Donna
Member
Posts: 910

Hi Sam,

Great to hear from you, although sorry its because Koby is doing poorly... :(

You have been given some great suggestions as I too believe what's going on probably isn't related to EPI.

Ive had two Chushionoid dogs and the first we caught pretty early, so the bloodwork didn't show much to lead them there, but the peeing, OMG! She would drink and pee at the same time! The second had uncontrolled Cushings for a while before I got her as a rescue, so the bloodwork DEFINATELY pointed us in that direction... Besides the ATCH test, there is another your vet may suggest called a LDDST. If they believe it is Cushings, this test will differentiate between adrenal vs pituitory...

Please keep us informed!

Hugs and healing vibes to you and Koby!

Donna

May 24, 2017 at 8:11 PM Flag Quote & Reply

Samantha
Member
Posts: 683

Hi Donna, it sure has been a while eh!


That sounds so full on, peeing and drinking at the same time, poor love. Earlier this week at a guess he would have had at least 5 litres of water. I have a vet appointment this afternoon and have told them already I want him thoroughouly tested for Cushings. I'll find out what test they use and recommend but will write down what everyone has suggested with the ATCH and LDDST. The radiologists report states it's possibly "pituitory dependent" and recommended further testing and possibly a low dose of dexamethasone, which I'm assuming is a drug for the Cushings.


Is it a common symptom with Cushings to see the vomiting or fluid in the small intestines? He is urinating fine, so I don't really understand why there would be fluid in his belly. One of my many questions for this afternoon, the receptionists must cringe when they hear my voice first thing in the morning.

--

Kobe - 9yo GSD diagnosed with EPI in October 2009 (19 months old). 2 cups of Canidae Bison & Lamb Grain Free, fed 3 times daily,  2 Creon 25,000 per meal. Weekly B12 injections at home & daily Wonderlab Trinfac-B in between. Inner Health Plus Probiotic once a week.. EPI weight 33.5kgs, current weight 40kgs. Original blood results - TLi: 1.2, B12: 306, Folate: 15.6.

Blood results April 2013 - B12: 596, Folate: >20.

Read Kobe's journal that was started the day he was diagnosed here.

May 24, 2017 at 8:29 PM Flag Quote & Reply

Donna
Member
Posts: 910

Hi Sam,

The LDDST = low dowse dextrose suppression test.

Keep in mind this blood  draw needs to be done fasted and over a period of time. They do several at different intervals, so Koby will spend some time there.

Donna

May 24, 2017 at 8:47 PM Flag Quote & Reply

Donna
Member
Posts: 910

Also, that isn't the treatment, but the diagnostic. There are various treatment options and I'm not sure what's available where you're at, but here in the US, Lysodren is pretty much the go to drug, in Europe Trylostain <sp> seems to be the go to drug.

Either one is pretty much a chemo type drug to shrink a tumor.  Keep in mind the gland rumors are almost always benign....

My last Cushionoid dog came to me at 14 and had never been treated. I thought I'd give her a couple of months, but that couple of months ended up a couple of years!

Keep us posted!

Donna

May 24, 2017 at 9:01 PM Flag Quote & Reply

Samantha
Member
Posts: 683

Hi Donna,


I was literally just reading about it and then saw your post and then called the vet. They said it will be an all day test, made up of 3 blood tests done over 4 hourly periods. So it sounds like LDDST. On that note and considering it's almost mid-morning here, I have booked it in for tomorrow. And scheduled a telephone call with my vet for this afternoon to go over everything else in report.


I'm not sure what we have here for Cushing's in terms of treatment. Are the tumours normally seen on the glands themselves? I did read something about them being on the brain. Nothing was seen on the glands themselves, apart from them being mildly enlarged (7.7mm & 8.9mm) - should be <7mm apparently. A couple of months turned into a couple of years, what an amazing story and for her to come to you when she was 14 years young, amazing!!

--

Kobe - 9yo GSD diagnosed with EPI in October 2009 (19 months old). 2 cups of Canidae Bison & Lamb Grain Free, fed 3 times daily,  2 Creon 25,000 per meal. Weekly B12 injections at home & daily Wonderlab Trinfac-B in between. Inner Health Plus Probiotic once a week.. EPI weight 33.5kgs, current weight 40kgs. Original blood results - TLi: 1.2, B12: 306, Folate: 15.6.

Blood results April 2013 - B12: 596, Folate: >20.

Read Kobe's journal that was started the day he was diagnosed here.

May 24, 2017 at 9:27 PM Flag Quote & Reply

You must login to post.