New diagnosis, need some help with diet and treatment.

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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Dsmulders
Member
Posts: 3
Country: Canada
Pet name: Luna
My name: David

New diagnosis, need some help with diet and treatment.

Post by Dsmulders » 29 Apr 2021, 11:53

Luna(GSD,62lbs normal 70lbs) 4 years, had some history as a pup. When we got her she had Corona-virus and Giardia which resulted in her belly being distended from her lymph system being swollen and from a blocked GI. Over the past 3 years her bowel movements and weight we're relatively normal, besides the occasional bouts of diarrhea. Which seemed a little abnormal but not worrisome. Until this February where she lost around 10 lbs in just over a month. Her cowpie diarrhea never got better. I had her fecal samples and blood tests done through a lab with fasting. Her blood test came back (uploaded), we're still awaiting fecal sample tests.

Victoria(GSD,100lbs normal 90lbs) 7 years, a rescue who was bred twice. Nearly starved the 2nd time. She has an inclination to eat feces. Especially Lunas, obviously since it is so high in nutrients. Which is a problem because of Lunas intestinal bacteria overgrowth. She has bouts of diarrhea when I notice she has consumed feces. I have tried so hard to stop her, nothing seems to work. She will wake up in the night poo on the floor and consume right away.

My situation currently is:
-Vet is currently away sick until next week(tues)
-Vet tech called me yesterday and told me she had pancreatitis, I got upset and went to the office and asked for the blood test results. Which I have attached.
-Pancrelipase USP (brand Pank-Aid?) Is ordered for friday, with instructions from vet coming tuesday.
-No B12 recommendations
-No recommendations for Tylosen? antibacterial. she was previously on metronidazole, about 1.5 weeks ago.
-After I got upset with vet tech(1) tech (2) contacted me to say the vet recommends low fat diet with the enzyme, which I believe is the Hills I/D low fat.
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Tuckaboo Pam
Member
Posts: 1345
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: New diagnosis, need some help with diet and treatment.

Post by Tuckaboo Pam » 29 Apr 2021, 14:11

Hi there. Looks like I'm the first one to see this, so I'm going to go ahead & respond. WELCOME to you and you Shepherd Girls! You will hear from others, who will have more knowledge than I have, but I will share what I know.

I can understand why you are so frustrated! This group will hold your hand, though, and help get you and Luna through this.

For starters, EPI dogs do not need lowfat food. They do, however, need grain-free (preferred) & low fiber, less than 4%. Sport Dog Elite & Taste of the Wild offer some varieties, and they are pea-free, which is good.

Another member from Canada ordered Wonderlabs Intrinsic Pet Factor B12 from Amazon, and it took awhile to arrive, so you may want to go ahead & order that, since Luna clearly needs it. Perhaps your vet will want to start her on B12 injections when she gets back, but you will need the capsules eventually. Amazon is also where I get my Sport Dog food, but you can order from the company & I believe from Chewy, if you want to try it.

Ask the vet for Tylan (tylosin tartrate), but in the meantime if you can get some slippery elm powder, human grade, that may also help. All of these things combined, will help get Luna on the road to better poos. Dosage info is on the Managing EPI page.

While you wait for a staff member to respond, I suggest reading the Managing EPI pages. They are full of useful information.

As for your poo-eating Victoria, this was the first symptom of EPI that sent me over the edge, and before official diagnosis my vet had me start giving Tucker B12, so maybe try that for her, as well. It can't hurt. Take Care, and stay in touch----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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Olesia711
Founder & Research Director
Posts: 3857
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: New diagnosis, need some help with diet and treatment.

Post by Olesia711 » 29 Apr 2021, 22:45

Hi and welcome to our EPI family.... although i am sure this not something you were looking forward to being a part of.

Based on the actual blood test results attached..... i am assuming these tests are Luna's ?.... anyway... she does NOT have pancreatitis, but rather does have EPI. Since the TLI results are 0.6 !

Also, based on her extremely low B12 levels.... no matter how well you follow the EPI treatment protocol, until the B12 is addressed ... Luna will never really fully heal. She needs B12 supplementation started ASAP.

Since you vet is out sick, you really are kind of stuck to get his/her appropriate recommendations.... so, like Pam said, i would order the oral B12 called "Pet Factor B12" from WOnderlabs ...
https://www.wonderlabs.com/itemleft.php?itemnum=K9688
many, MANY of our EPI dogs with B12 issues use this and sometimes it even works better than the B12 injections.... but...it will take a little time to order from the USA.... so in the meantime... go to your pharmacist and ask for 1000mcg B12 pills.... they should have some made with cyanocobalamin B12 with folate included.

SInce Luna is 62 lbs right now.... Give her 1+1/4 pills (capsules) a day...(be sure to share what we are recommending to you with your vet, when your vet is feeling better and back at work.. If the pharmacist gives you capsules, you can give them whole or open them up and serve them mixed in with the food.

Next... do NOT let your vet prescribe anymore Metronidazole... Since Luna is confirmed with EPI, she has SID (small intestinal dysbiosis) formerly referred to as SIBO. All dogs with EPI have SID to one degree or another, whether you see signs or not. Currently our protocol is to keep it in good control. there i now a set path of how to do this.
1. try a prebiotic (slippery ELm powder is a mucilage and has prebiotic properties. this will NOT permanentaly damage gut flora like Metro can and will.
2. If a prebiotic doesn't help or doesn't help enough to stop the loose stools.... then get a probiotic. these are the 3 that we are currently recommending: Visbiome, Proviable, VetriScience Mega Probiotic. VERY IMPORTANT though, when starting a probiotic, start with less than 1/2 dose and work your way up to a full dose within a week or two.
3. IF after a couple of weeks you are still not seeing improvement from the probiotics, THEN tell you vet that you want Luna started on Tylan (Tylosin Tartrate antibiotic powder) for a 45 day/twice daily course... NO METRO/Flagly!!! Metronidazole KILL all bacteria where as Tylan just inhibits the reproduction of more bacteria. With EPI dogs they not only do not have enough bacteria in the gut, they also do not have enough of a variety of bacteria in the gut. WHen Metro kills the bacteria in the gut, some of those strains can never ever be replaced even if you stuff the dog with lots of probiotics... Metro can permanently alter the gut flora. :(

And the most important thing... start adding the enzymes to every meal. No cheating, no treats, nothing without enzymes.
THe Pancrelipase USP (brand Pank-Aid?) is the right product. Start with 1 level tsp of these enzymes per 1 cup of food (kibble) add a liquid. (room temp water if fine) to wet the dry food so that you can thoroughly mix in the enzymes and let it sit in the food for about 20 minutes prior to feeding. If you are feeding canned (wet ) food... then start with 3/3 tsp of enzymes per 1 cup of wet food... mix well, let sit for 20 minutes, then serve.

Like Pam said though, since this is EPI,,,, you do not need to limit the fat, but rather, to begin with limit the fiber content. Fiber can destroy the efficacy from anywhere between0% to 50%.... we just don't know from one dog to the next how much they will be affected... this is why we tell everyone to start with a low fiber food.... and avoid food stuffed with lots of peas/legumes, etc.... one or two of these ingredients (peas/legumes) as the 4 or 5th item in the description is okay... but if a food lists peas etc multiple times or if it is the first, 2nd or 3rd ingredient.... AVOID!!! these dogs do not do well at all with peas and legume!

And that delightful poo eating habit (NOT!!!) what you can try is putting 1 tsp of canned crushed pineapple in the food... it supposedly tastes good going out but is not so appetizing when it comes out the other end. THis actually worked for my dog when she was starving , eating her own poo when first diagnosed with EPI. You also can try sprinkling a little pinch of ACCENT meat tenderizer on her meal... that also seems to work with many of these dogs. Usually this habit will subside, once they are not longer starving........... which will get better once they get the proper treatment

Hope this helps you get started!
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.........

Dsmulders
Member
Posts: 3
Country: Canada
Pet name: Luna
My name: David

Re: New diagnosis, need some help with diet and treatment.

Post by Dsmulders » 30 Apr 2021, 11:18

Thank you So much for responding so quickly.
I went ahead and ordered:
https://www.organictraditions.com/produ ... ark-powder - on amazon in canada it was only $31 and had one day shipping.
https://www.wonderlabs.com/itemleft.php?itemnum=K96882 -wonderlabs pet factor B12 with intrinsic(180)
https://www.naturesrecipe.ca/En/Product ... kin-Recipe
the nature's recipe dry kibble was the best I could find in Canada, it still lists peas as the 3rd-4th ingredient, and the Crude Fibre is 4.5% which is a bit high but that was the best I could find available. I'm open to suggestions, however, finances are a bit limited at the moment. we spent over 2000$ for the testing/vet bills and we are currently in the process of applying for a mortgage(going through conditions). I had her on wet food for a while but 4.25$ a can with how much she eats is really starting to hurt.

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Olesia711
Founder & Research Director
Posts: 3857
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: New diagnosis, need some help with diet and treatment.

Post by Olesia711 » 30 Apr 2021, 20:31

You are very welcome,... but OMG.... they charged you $36 for 7 ounces of Slippery Elm. YIKES! That's a lot.

Next time, if there are any wholistic or herbal stores near you, get some loose powder from there.... i used to pay $2 for about 4 ounces.

Here is the USA, you can order 4 ounces of SLippery Elm powder from Wonderlabs for $13... but then by the time you add in all the shipping charges for shipping from USA to Canada... i am guessing it makes it expensive doing it that way too.

Please keep us posted and let us know how things go.................
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.........

Dsmulders
Member
Posts: 3
Country: Canada
Pet name: Luna
My name: David

Re: New diagnosis, need some help with diet and treatment.

Post by Dsmulders » 01 May 2021, 22:08

The vet charged me 90$ for 4oz of Pank Aid =O...I'll be ordering off wonderlabs for enzymes and Elm bark once I get ahead a bit with bills.

And 24hours after I started 1 TSP enzyme per 1 Cup food x3-4 a day, she had her first mostly solid poop. 2 actually today. I'm so excited I can't believe how much help this website has been.
I'm just waiting on B12 this Wed-Fri, I live in Alberta so it's a bit harder than most Canadians who probably live in Ontario. Luna's also been playing and the most active I have seen her in a month. For ref she's been pooping orange like a garden hose for 2+ weeks with no respite.
Whoever hosts this website and puts in the work, Thank you so much!

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Olesia711
Founder & Research Director
Posts: 3857
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: New diagnosis, need some help with diet and treatment.

Post by Olesia711 » 01 May 2021, 23:12

Hi DAvid,

You are very welcome and thanks for the great update on Luna.... So glad to hear that you are seeing a difference so quickly !
But... jsut fair warning..... if... in a few weeks you start seeing sloppy poos again... don't freak out... that will just be SID acting up.... all dogs with EPI also have SID (small intestinal dysbiosis) and we will help you get that under control too, if need be .

Also... with regards to the enzymes..... you are currently using the right stuff.... but the brand names are VERY expensive.
What i suggest you do is contact EnzymeDiane ... she sells generic enzymes that many of us use for our dogs to save on enzyme expense (more than a 60% savings over brand name enzymes in the USA) However.... although she is based in the USA.. I know she ships to Canada, but sometimes there is/was an issue with customs.... so contact her and ask her how long would it take and if there are any issues anymore shipping to Canada and how much more this adds to the cost. This is her website:

https://enzymediane.com/product-category/pancreatin-6x/
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.........

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