24 Hour Sick Flare Ups? 2 Year Old GSD w/ EPI

Epi4Dogs Foundation Inc.’s mission is the advancement of science and education relating to EPI (Exocrine Pancreatic Insufficiency), yielding useful insights and positive outcomes in better managing EPI in dogs and cats. Our goals are to support and/or collaborate with veterinary EPI research and researchers, and to promote EPI awareness by educating the general public, pet owners, pet organizations, rescue and shelter organizations, veterinary schools and veterinarians.
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Maverick26

24 Hour Sick Flare Ups? 2 Year Old GSD w/ EPI

Post by Maverick26 » 23 Feb 2021, 11:10

Hello Everyone!

I've been a quiet member for about a year now, and I appreciate all of the information located here. It has been a tremendous help! However, unfortunately there are still some nagging EPI symptoms I am having a hard time eliminating/treating.

Background: My pup Maverick (2 year old GSD), was officially diagnosed with EPI about 10 months ago. Unfortunately it took quite some time to diagnose him, given the vet was unknowledgeable about EPI. It was actually thanks to this site that I was able to suggest EPI as a possible culprit. However, by that time, he had been experiencing horrible diarrhea/vomiting episodes on an almost constant basis, and was about 30-40 lbs underweight (He looked like he could have been in the "In the arms of the angels" rescue shelter commercials).

Here were his test results:
TLI: 1.8 ug/L (Low)
Cobalamin: 293 ng/L (Low)
Folate: 12.9 ug/L (Mid)
SPEC cPL: 48 ug/L (Low)

Since then, I have thankfully managed to get him mostly stable on enzymes and probiotics. Now he is at a solid 75 lbs, although he has room for more meat on his bones, thus I have kept him to a high daily calorie count. Here is his daily routine:

Breakfast: 3 Scoops Food, 3 Scoops Wonderlabs Enzymes, 1/2 scoop Wonderlabs slippery elm powder, 2 Wonderlabs B12 pills, Chicken Broth
Lunch: 3 Scoops Food, 3 Scoops Enzymes, 2 B12 Pills, Fortiflora Probiotic, Chicken Broth
Dinner: 2 Scoops Food, 2 Scoops Enzymes, Chicken Broth

His food is Merrick Grain Free Full Source Freeze Dried Raw Coated Kibble (Beef & Bison). Here are the stats on it:
Protein: 32%
Fat: 16%
Fiber: 3.5%

This is the most recent food choice, as we have probably tried over 10 different brands, etc throughout this process. I have been slowly weaning him onto it for the past two weeks. Trying to finally find one he accepts, is willing to eat, and meets the standards for EPI. He is a very picky eater, so the chicken broth has seemed to be the only way to get him excited about meal time. Which is important because of his need to continue putting weight back on. This food is one of the few grain free's that were also Pea/Legume free as well.

The Issue: As mentioned, he has stabilized for the past 4 months or so, and we've eliminated most of the EPI difficulties. More or less, he has been a healthy happy pup. The only remaining issue is 24 hour flare ups of what seems to be like SID. His stomach will start rumbling vehemently, so much I can hear it across the room, he will vomit phlegm once in the morning, then have diarrhea throughout the day. It seems like every other week, sometimes longer, he will have this 24 hour flare up. After the 24 hours passes without eating, he is right back to normal, and solid stools for the next couple weeks. For that reason, I have been holding him off taking him to the vet, simply because it always passes by the end of the day. Does anyone know anything else I can try? I understand this may be SID showing its face, and Tylan may be a solution, but I would prefer to try alternative solutions first. Am I not giving enough Slippery elm?

He does not get any treats, and I have not noticed any dietary changes that would be causing the episodes. It seems to be every other Monday morning (or less). So it almost feels like the bacteria build up all week, until the SID flares up on Monday, and only goes down because of his lack of food intake for the day. Then repeat cycle. This has been consistent for the past 4 months or so, regardless of the brand of food, or broth, etc.

Sorry for the book, but I've noticed the more experienced members having the same questions to most new posts, so I wanted to try to cover as much of it as I could for you! Perhaps there is something I am overlooking that may be easy to notice for a more experienced member.

Thanks for the help ahead of time!

Ty - Mav's Dad

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jilbert57
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Re: 24 Hour Sick Flare Ups? 2 Year Old GSD w/ EPI

Post by jilbert57 » 23 Feb 2021, 16:46

Hi Ty and welcome to you and Maverick. You are doing a great job!
Will you give me a link to the Wonderlabs enzymes? When you say 3 scoops enzymes how much is in a scoop? How much is in a scoop of food you use? We recommend 1 level teaspoon enzyme to 1 cup food, so just wondering if you are over or under enzyme.
The SE is usually am and pm.
If it is not doing the trick I would ask your vet for Tylan, a 45 day course dosed 2 times a day to deal with SID.

Jill
My name is Jill and we live on the Hood Canal in Washington State. We currently have 2 Jack russells, TJ is 8 and Sadie is 2.

Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.

Maverick26

Re: 24 Hour Sick Flare Ups? 2 Year Old GSD w/ EPI

Post by Maverick26 » 23 Feb 2021, 17:15

Hey Jill, thanks for the response!

My mistake, the enzymes are not Wonderlabs, they are Panakare Plus Powder https://www.chewy.com/panakare-plus-pow ... are%20Plus

1 Scoop is 1 tsp of Enzymes, and 1 scoop of food is 1 cup. So I have been doing 1 tsp enzymes per cup of food, as suggested. I apologize for not clarifying that. And I've been following the 15-20 minute incubation instructions as well.

I am going to up the SE to twice daily as suggested, and see if that decreases the frequency of these episodes. If not, Tylan may be the only other option I can think of. Hoping not to go that route if possible though!

Thanks for your help!

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jilbert57
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Re: 24 Hour Sick Flare Ups? 2 Year Old GSD w/ EPI

Post by jilbert57 » 23 Feb 2021, 17:38

Thanks for clarification!
Just for future the Tylan is gentler on the system and kills the bad bugs while leaving the good bugs intact. Some dogs are on the minimum dose Tylan for life as they need it.
Try 1/4-1/2 t SE 2 times a day for a few days to see if that helps.
Keep in touch.

Jill
My name is Jill and we live on the Hood Canal in Washington State. We currently have 2 Jack russells, TJ is 8 and Sadie is 2.

Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.

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Olesia711
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Posts: 3858
Location: North Carolina
Country: United States
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Pet name: Izzy
My name: olesia

Re: 24 Hour Sick Flare Ups? 2 Year Old GSD w/ EPI

Post by Olesia711 » 23 Feb 2021, 20:25

Hi Ty,

So sorry that Maverick is having periodic set backs ....... Anyway... Tylan just might be the next step.... .
I respect your feeling about wanting to try everything and anything BEFORE resorting to an antibiotic..... and i agree with you... but sometimes, you just have to try it. .......... Now Metronidazole i would 100% stay away from for any chronic gastrointestinal condition.

So, something jumped out at me... why are you giving so much B12... 2 pills with breakfast and 2 pills with lunch???? THat is too much!
Basically your dog should be getting 1 WOnderlabs B12 pill a day.
First thing i would do is stop giving so much B12..... drop down to 1 pill a day. And see if this might have been the problem.

If not......................... then

REgarding SLippery ELm... do try it twice a day.... however.... if that doesn't help and you want to increase the SE dose.... try it but watch the poos, Sometimes if you give too much SLippery Elm it can actually trigger loose stools, etc.

The other thing is that you can try a small amounts of EnzymeDiane's enzymes... just to see if a different bran enzymes appears to work better, maybe 250 grams? which would last enough for you to see if it works better https://enzymediane.com/product/sample- ... 250-grams/. This technically shouldn't make a difference, but for whatever reason, sometimes it does.


SO........ the only other thing i can think of trying a little bit of alfalfa.... see if you can get fresh alfalfa from the grocery store, if not... (and please don't laugh) is try some rabbit pellets... but only a brand that has Alfalfa as the 1st ingredient.... specifically like Purina Rabbit Chow (maybe just 10 little pellets)
http://wabbitwiki.com/wiki/File:Purina- ... mplete.jpg
....of course, i would buy the smallest bag possible in case this is a bust. Alfafa is a prebiotic, you just don't want to use too much..........this actually worked for one lady with her dog's loose stools from SID- -she too tried SE and it helped but not enough.....but whenever the dog got into the Purina Rabbit Chow.... stools firmed up... it was the Alfalfa.! i personally have never tried it..... but it is an alternative that can be tried first before resorting to Tylan..... or there is of course chicory or Jerusalem Artichoke. I know you can buy these as powder on the internet, but i don't know how much should/could be used for dogs......
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

Tuckaboo Pam
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Posts: 1346
Country: United States
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Pet name: Tucker
My name: Pam H.

Re: 24 Hour Sick Flare Ups? 2 Year Old GSD w/ EPI

Post by Tuckaboo Pam » 24 Feb 2021, 18:16

I am ordering rabbit pellets, right now.
Tucker was a shepherd/lab mix--- TLI 1.3, Folate 9.7, Cobalamin 666, Lipase 38. Took Diane's Enzymes 4 teaspoons/day, Wonderlabs B12 one capsule per day, and Tylan 1/16 teaspoon/ morning (to hold SID at bay). Taste of the Wild High Prairie, 1 1/2 cups/day, with a total of 4 cups of Fresh Pet. Stopped eating everything in sight, and went from 60 to 85 pounds! Tucker was my boyfriend, and my husband was OK with that. Tucker succumbed to hemangiosarcoma, but we cherished every day we had with that wonderful, beautiful boy. I will always, always miss my sweet big boy.

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jilbert57
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Re: 24 Hour Sick Flare Ups? 2 Year Old GSD w/ EPI

Post by jilbert57 » 24 Feb 2021, 22:09

There are specific alfalfa supplements for dogs.
One:

https://seapet.com/using-alfalfa-nutrie ... -for-pets/

Jill
My name is Jill and we live on the Hood Canal in Washington State. We currently have 2 Jack russells, TJ is 8 and Sadie is 2.

Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.

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Madelon
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Pet name: Doc

Re: 24 Hour Sick Flare Ups? 2 Year Old GSD w/ EPI

Post by Madelon » 25 Feb 2021, 18:57

Interesting about the rabbit pellets Olesia! Thanks for the information as always.
Madelon, owned by DOC. DOC dx EPI 5/2015 = TLI < .4, B12 406; Folate >24. DOC taught me so much and together we battled and overcame EPI, food sensitivies, environmental allergies but we lost the cancer battle. DOC was dx with hemangiosarcoma 5/2022 and crossed the rainbow bridge July 24, 2022. He is and always will be the love of my life, my soulmate, my heart dog.

Maverick26

Re: 24 Hour Sick Flare Ups? 2 Year Old GSD w/ EPI

Post by Maverick26 » 01 Mar 2021, 11:19

Thanks everyone for the feedback!

Olesia, sorry for the confusion, I mistyped the original post. He gets ONE wonderlabs B12 pill for both breakfast, and lunch (Total of two B12 pills PER DAY). My mistake!

I will look into both the Tylan and perhaps even the alfalfa solutions once I see if upping his Slippery Elm powder to twice per day gets the job done.

Last question, and it is regarding the Fortiflora Probiotic. I believe I've read on here that prebiotics should be prioritized over probiotics in the case of EPI, but has anyone seen any adverse affects of giving both? I'm just trying to narrow down each aspect of his routine to see if anything can be eliminated or is having negative results.

Tuckaboo Pam
Member
Posts: 1346
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: 24 Hour Sick Flare Ups? 2 Year Old GSD w/ EPI

Post by Tuckaboo Pam » 01 Mar 2021, 13:29

Hi there---I give Tucker both slippery elm and proviable, and since starting this practice, he is better than ever.---Pam
Tucker was a shepherd/lab mix--- TLI 1.3, Folate 9.7, Cobalamin 666, Lipase 38. Took Diane's Enzymes 4 teaspoons/day, Wonderlabs B12 one capsule per day, and Tylan 1/16 teaspoon/ morning (to hold SID at bay). Taste of the Wild High Prairie, 1 1/2 cups/day, with a total of 4 cups of Fresh Pet. Stopped eating everything in sight, and went from 60 to 85 pounds! Tucker was my boyfriend, and my husband was OK with that. Tucker succumbed to hemangiosarcoma, but we cherished every day we had with that wonderful, beautiful boy. I will always, always miss my sweet big boy.

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