Thorin advice needed

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.
Post Reply
Miroslava
Member
Posts: 3
Location: Sofia
Country: Bulgaria
Pet name: Thorin
My name: Miroslava

Thorin advice needed

Post by Miroslava » 16 Apr 2021, 07:13

Hello, everyone!

First I want to say that I am so grateful to that site and forum! My dog Thorin has been diagnosed with EPI 2 years ago and i read almost everything here then. He is a shelter dog but looks like from shepherd family- like eastern European or something. He lost so many kilos until he got diagnosed with EPI through TLI test.
He was put on hypoallergenic food Roayl Canin, metronidazole 500mg and as enzymes Creon( sprinkled on the kibbles). In begging he was put on corticosteroids a well (for IBD) and stopped them after 15 days as the vet said that since he is doing fine without them he might not have IBD.
I live in Sofia, Bulgaria and we have no powder enzymes and no Tylan but I can have raw pancreas and I add that to the food.

Everything was OK then, after 5-6 month he was all good and stable, I managed to get off the antibiotic and for more than a year he was OK on the food and creon and/or pancreas alone.
My worries started again in February... I cannot live with myself changing the food as the vet said that he does not need necessarily medical food. I was scared to change anything for over a year as it was a nightmare when he was sick but eventually I changed the food and he got bad after a month or two. He lost weight. I immediately got back to the hypoallergenic food but although his poop was more than excellent the whole time there started the rumbling and gas, he started lying on his stomach (not sidewise as usually does) and he swallows a lot, like hypersalivation(especially through the night).
The vet included metronidazole again and the gas stopped but everything else didn't. The vet also gave esomeprazole as she thought it is something with the stomach. She said that the new food was difficult to digest from him and now it may take some time for the HCL in his stomach to regulate. His poop continued to be great but the hypersalivation and lying front with his head ahead is still ongoing.
Suddenly, out of nothing, 4 days ago his poop got into old yellow water like diarrhea and I cried. It has been 2 months I am trying to get him stable and I have the feeling that it only gets worse with no explanation what so ever. The vet put him back on corticosteroids- Budenofalk- and it has been 3 days. But still no change and I am freaking out..
I included the probiotics between antibiotics intake (Now foods 25 billion and additional Acidophilous) and slippery elm but still his poop is like cow pile ( at least is not watery) ,his hypersalivation continues and again lies on his stomach.

I would really apricate some advice on the saliva and lying position and everything else honestly. My guess is he is in pain and the saliva and lying is bc of that and he has an accompanying IBD to the SIBO and EPI and maybe it will take some time for the IBD to calm down. I am worried that the metronidazole has stopped working.. or the enzymes have stopped working.. I also read that hypersalivation maybe be a cause effect of the antibiotic but 2 years ago he was ok..

I am so lost. Hearing him swallows and all. I feel so desperate and guilty..

It got a little long but thank you for baring with me!

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

Re: Thorin advice needed

Post by Tuckaboo Pam » 16 Apr 2021, 19:52

Miroslava----Hello, and welcome to the forum. I am so sorry your dog is doing poorly right now. Setbacks are so frustrating.

You have a lot going on, so you'll need more advice than I can give. Soon, someone on staff will write you, so do check back. Hopefully, we have another member from Bulgaria, who may be of some help, you never know. Take Care----Pam & Tucker in Florida
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.

User avatar
Patsy
Member
Posts: 266
Country: United Kingdom - England

Re: Thorin advice needed

Post by Patsy » 17 Apr 2021, 08:33

Hello, are you able to get Creon (for humans)? If you can, check back here for how much to use. Otherwise, can you buy dog enzymes from abroad? They certainly have them, and as they are non- prescription should get through customs.
In the UK, try Chemeyes.co.uk, though Brexit may slow delivery down. Otherwise try others!
Springer spaniel Marti had Epi, PLE , MMM just to confuse me. She lived till 12yrs, chubby and happy despite eight years of epi.
Capsule enzymes suited her best. B12 supplements made her into a new dog!
After a cocker with PLN kidney disease, I now have two healthy rescues, a lively, suicidal , small ginger terrier, adopted with pneumonia, and gum disease needing nearly all his teeth out, and a fluffy grey toy poodle/terrier from Greece.

User avatar
Madelon
Staff
Posts: 1317
Location: Nashville, TN
Country: United States
State: Tennessee
Pet name: Doc

Re: Thorin advice needed

Post by Madelon » 17 Apr 2021, 12:20

Hi! I am so sorry you and Thorin are struggling. It definitely sounds like SID (small intestinal dysbiosis) is going on. We recommend a 45 day course of Tylan antibiotic if you can get it and slowly wean off after the 45th day. I know you said you don't have Tylan where you are but I'm putting the link to our page on Tylan and if you scroll to the bottom there is information on various forms of Tylan outside of the US just in case https://epi4dogs.com/antibiotics/. You might also see if you can get Slippery Elm Bark Powder where you are - it's a pre-biotic mucilage that coats the gastrointestinal tract and has proven to be very effective in treating SID. If you can't get it and the only option is Metronidazole then use it but you will likely need about 30 days and please keep an eye out for possible neurological side effects. We now know that all EPI dogs have SID but it's a matter of keeping it under control and not flaring up - so there are a couple of things that could have caused the flare up.

First - you said you originally used Creon but then switched to raw pancreas, may I ask why you stopped Creon? The problem with raw pancreas is that the amount of enzymes in the pancreas varies from organ to organ so it's much more difficult to ensure you're giving the exact right amount. If you can go back to the Creon I would highly recommend it. Also, you might want to check with Suj at Chemeyes - she's been able to ship powder enzymes to lots of countries so you might ask if she can ship to your country https://www.chemeyes.co.uk/.

Second - have you ever supplemented B12 or know what the B12 level was at diagnosis? If not, I highly recommend getting the B12 tested. B12 is critical to properly managing EPI and without the proper supplementing SID can flare up. Again, check with Suj at Chemeyes as she carries the same B12 pills that we recommend to use here in the US - it has intrinsic factor which helps with B12 absorption. If the B12 is low, which it might be if you're not supplementing then I highly recommend starting the B12 shots while you find out if Suj can ship to you.

Third - the food. It's the hardest part of EPI to figure out. If your dog did well on the prescription hydrolyzed food then I would go back to that. Check to be sure that the fiber content is within the range we suggest 4% or less.

If you get the antibiotics for the SID, proper dose of enzymes and B12 and the poop is still not good, then you might consider switching food to a grain free with little or no peas and legumes and 4% fiber or less.

Please keep us posted on how things are going.
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.

Miroslava
Member
Posts: 3
Location: Sofia
Country: Bulgaria
Pet name: Thorin
My name: Miroslava

Re: Thorin advice needed

Post by Miroslava » 20 Apr 2021, 04:49

Hi there!

Thank you for the replies!

I would really want to try another antibiotic but yes, Tylan is not available here. I had a look at the oxytetracycline and will write to the vet to ask to switch it. Hopefully, we have it here, I saw some for pigeons. Will this one do?
My dog is on metronidazole for over 2 months now and get very scared reading about the toxicity.
I am using also Slippery Elm and it does help as well probiotics between antibiotics.
Creon I have never stopped using even when I added the raw pancreas.

The flare up happened because when he was diagnosed with EPI the vet included hypoallergenic food as she doubted for IBD as well.
Later she said that he is doing fine and removed the corticosteroid for it and said that at some point he may go to ordinary EPI food. And after 1 year and a half and I did it. It went all terribly wrong.. hence the flare.
I introduced the whole protocol very quickly - the hypoallergenic food , metronidazole, B12 shots, probiotics. But although he got his kilos back ( and thank God for that) he has that hypersalivation all through that time and suddenly he started pooping yellow diarrhea. The doc put back the corticosteroids and for a week he is doing a bit better but not great and hypersalivation is still a fact.
Could that be a reaction to the antibiotic.. I do not know.

Thank you so much for the guidance. I will definitely insist on trying a new antibiotic.

Post Reply

Who is online

Users browsing this forum: No registered users and 294 guests