New EPI diagnosis

[CaliGirl]

Madelon- this is amazing! Thank you so much! I truly appreciate it. I just picked up the new probiotic they are recommending, visbiome. She will get one capsule a day, I mix it in her food. I just did it for the first time so we will see. I also just picked up the omeprazole. They are recommending 2 “beads” from capsule 2x a day, I don’t know if you opened a capsule but it’s kind of funny these “beads” are microscopic, so this shall be interesting! I will attempt this at the evening feeding for Cali. Have you heard of this food they are recommending? Purina E/N? I am willing to try anything! So I will go with their attempts and see what happens. Cali was on the slippery elm for a little over two weeks and no changes came from that. I don’t want Cali to endure anything more than she has to, I just want her comfortable and happy! Like I said I am willing to try anything! Let me know your thoughts about trying this food, or if you suggest another? Thank you again for all of this Info, it is so helpful and yes, I will be sending an email!

[Olesia711]

Hi NIcole,
Visbiome is an EXCELLENT probiotic... it was formerly called VSL#3 (the original) and the best on the market!!! There is a back story, that i won't get into, but SOOOooo glad that Visbiome is now being produced and we have access to it.

Regarding the note your vets wrote. SOme of it is very good and some of it is spot on... but some of what they are telling you about EPI is inaccurate and there is current research by Texas A&M Gastrointestinal Lab and some of the premier researchers in the country to back this up.

ANyway... it sounds like your vets are trying to do a good job but that they just aren't as well informed about EPI as they could be.

1. I would ask for the actual Folate and B12 numbers from the Cobalamin test... their comment that it is within reference and very appropriate is NOT good enough. This is YOUR dog, that YOU paid for the test to be run on you have the RIGHT to know what the exact values are.
2. Their comment that primary SIBO is in GSDs which are the only ones can be treated with antibiotics. Is inaccurate. (they no longer refer to it as SIBO anymore they call it SID). ALL dogs with EPI have SID (small intestinal dysbiosis) to one degree or another. Dr. Jan Suchodolski, the nationwide premier researcher in Canine Microbiotics has done multiple studies and has repeatedly proven that all EPI dogs have SID (formerly called SIBO)... it does NOT matter if they are big GSDs or any small breed. PLEASE read the research on the EPI research page. The latest referencing this is from 2019.
3. Your vets are 100% wrong that pancreatin can treat the underlying cause of secondary dysbiosis- -this is dysbiosis because of EPI and is in every EPI case. The recommended treatment (and this has been written ad nauseam is:
(a) 1st treat with prebiotics if that doesn't work
(b) then treat with prebiotics and probiotics
(c) if that doesn't work then treat with TYLAN (do NOT use Metronidazole for any chronic gastrointestinal condition!) Tylan inhibits the reproduction of bacteria. Metronidazole automatically kills ALL bacteria and some of it never comes back. If you keep the dog on Tylan forever, then it too can destroy some bacteria that can never be replaced BUT if you have to keep a dog on Tylan forever, it is because nothing else is working...so you do it. This has been written about by Dr. Westrmarck , Dr. David WiIlliams, and Dr. ANdrew German... all published in the special Pancreatitic edition of "2012 Topics in Companion Animal Medicine"
4. Your vet is 100% correct that antibiotic can wreck havoc with the gut flora......and they are correct in wanting to try probiotics (first) and i think that since they recommended Visbiome, that yes.... this is a good thing to try BEFORE doing Tylan... if it works GREAT.... but if it doesn't work... (and this is why i was pushing for TYlan cause it sounded like this was a desperate situation) and if the loose stools continues even after Visbiome, then you really should do the Tylan. I have spoken with Texas A&M Gastro researchers multiple times, and we go over what i should recommend on this forum because oftentimes when more research is done, we learn new things and protocols change. I just had this conversation with the head of the lab a few weeks ago.... and the current protocol is what i mapped out to try and if one doesn't work, then try the next one (prebiotics, then pre+probiotics, then Tylan) and this is what they recommend.
5. Your vets are also misinformed that SID dos not cause regurgitation. vomiting... it does. Please have your vets READ the issues in EPI dogs with secondary bile acids AND small intestinal dysbiosis... it is ALL connected.

Overall, it sounds like your vets are "trying" to do a good job, and they ARE up-to-date regarding antibiotic use, but they are not up-to-date in their knowledge of current EPI research and protocol.

In short, if the Visbiome works, then no need for the Tylan... BUT..... if it doesn't work....and little Cali continues to have loose stools, they can only have loose stools for so long..... then i would renew the push for Tylan.

Please go to these pages and read/download the Research that maybe you might want to share with your vets:
https://epi4dogs.com/epi-research/
Specifically: "Altered Microbiota, fecal lactate, and fecal bile acids in dogs with gastrointestinal disease"


https://epi4dogs.com/sid-sibo-microbiome-research/
Specifically: Most of the articles in this tab but ESPECIALLY look at the 2 Texas A&M Abstracts that proves that all EPI dog have SID (dysbiosis) and they also do not have enough bacteria, and they do not have enough variations of bacterial strains!
"Fecal D-/L-Lactate concentrations and abundance of lactic acid bacteria in dogs with Exocrine Pancreatic Insufficiency"

Dysbiosis.jpg (39.85 KiB) Viewed 2597 times

Dysbiosis.jpg (39.85 KiB) Viewed 2597 times

[Madelon]

Thanks Olesia - you're the BEST!

[Jane&Clyde]

I'm so happy that even if you didn't get Tylan, you got some things that might help your pup! She's such a cutie.

Regarding the food, if it's the one I looked at, I wouldn't feed that to my dog, but this is just personal opinion. The first three ingredients in the dry food are grain based, two of them being corn. The wet food's first three ingredients are meat by-products, water, and barley. These are very poor quality ingredients for a dog food. Again, just my opinion. Unfortunately a lot of prescription diets are made from ingredients that are not the best. In many cases an appropriate food can be found without prescription diets.

[CaliGirl]

You guys are all the best. I have been feeling like the food could be a problem for a long time, but struggle with what to give her as she is a growing puppy who I know needs certain things! Does anyone have any recommendations for food? She is currently eating Hills science diet puppy kibble and she gets canned wet as well. I have gone back and fourth in my head regarding grain free, as some things are good and bad about it?
I am glad that at least someone knows of the probiotic and thinks it is good. I am still however stuck on the fact that I think Cali needs a boost of something else, I just wish it wasn’t so hard to get tylan. I wish it was something I could get on my own! It stinks! Something is just off. But it is so hard with the fact that Cali has started all of this being so small, and dosing is half the battle with her. Thank you all again for ALL of the info! Couldn’t do this without you all!

[Tuckaboo Pam]

https://epi4dogs.com/dog-food-options/

Hey there. I took a brief look at this page, and right off the bat it looks like Chewy.com has some charts that can help you make your decision. You can click on specific categories & cut to the chase. You got this!!!---Pam

[CaliGirl]

Hi everyone! Just wanted to give an update on Cali. I am still working on things over here to get things right. She is currently getting 1/2c a food 3x a day with 1/2 tsp enzymes. In the morning and evening she is getting 1/8 tsp of slip elm and in the after she gets 1 capsule of visbiome. We still have gas, we still have soft, but formed, (just not logs) of poop, light in color. She hasn’t been eating her poops, this week Hope that stays! I wonder if her poops will ever change from this? Perhaps this is the best? Because Cali is so young and I am trying to teach her so much, and training is SO HARD WITHOUT MOTIVATION. I have taken some treats sprinkled with enzymes and a tiny bit of water and let them sit for incubation. Does anyone know how long the enzymes “last” at room temp? If I put them in a bag and give them to her would they last for days? Or do the enzymes lose effect after a number of hours? Any ideas? Cali is almost 7lbs now!

[Tuckaboo Pam]

The treats would start to grown bacteria after just a little while, so you shouldn't wet them & keep them for hours, even. Sorry. Is she motivated by toys, maybe?

Well, she is a cutie, and you are a hard-working dog momma, so congratulations!

Oh, poo color----is the food light in color? That could be why, I think. ---Pam

[CaliGirl]

She is motivated by food ONLY! She doesn’t listen any other way, trust me I have tried! The food is light in color both her dry food and wet.

[CaliGirl]

Has anyone heard of these? Do we know if they are safe for Epi dogs? Some of the reviews say they have given them to EPI dogs, but I don’t know if I can trust?