Any Tips on Enzyme Dosage?

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.
Barb
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Re: Any Tips on Enzyme Dosage?

Post by Barb » 13 Jun 2021, 23:29

A warm welcome to you and Hana, Andy. She is certainly a lucky girl to have landed in your care.

I am glad you are going to look at the amount of enzymes you are using with the canned food. We used Royal Canin for many years with Kolby, but at one point he started refusing, so we tried the canned version. We settled on 1 teaspoon per can as his dose and it worked very well. As Olesia suggested, you can start with a 1/2 teaspoon and work up and then see if the dose is the problem.

I also heartily endorse keeping a log/journal. It absolutely saved our sanity. We recorded everything we gave Kolby and the amounts on a daily basis, then watched the resulting poos. This gave us a lot of information that we wouldn't have had if we had not seen it inwriting. And as you said, if you only change one thing at a time, you will know what works and what doesn't.

You are doing an amazing job already with all of Hana's challenges. She is so fortunate to have you.

Barb

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Patsy
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Re: Any Tips on Enzyme Dosage?

Post by Patsy » 14 Jun 2021, 16:27

You’ve had lots of great advice, so I can just chime in to say that my dog Marti had MMM. She could still open her mouth wide, but the muscles on her head wasted rapidly and she had hollows that made her head gaunt. Luckily I could grow her hair to cover them, but everyone who stroked her commented on how bony her head felt. I fed her from a raised bowl. She was on prednisone for a year for this other autoimmune issues . Epi can leave a dog open to these. These conditions all resolved to existing without any medication for them. She lived till she was 11, a great age considering her problems, succumbing to heart failure.
You must feel things are difficult now, but being patient and taking care of the most life threatening issues first is a logical way to go. If your pet is gaining weight, the body will be fixing itself as it heals.
As you can see from my avatar, my dog got through it.
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.

afairbairn
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Posts: 32
Country: United States
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Pet name: Hana
My name: Andy

Re: Any Tips on Enzyme Dosage?

Post by afairbairn » 15 Jun 2021, 23:17

Thanks everybody for chiming in. I appreciate everyones time to try to help out and offer suggestions as well as encouragement. One piece of advice we have taken and have been doing for a while is keeping a good journal of everything going in and out. It is definitely helpful to look back and see what changed and when. And I just did a little study of some past events and its making me wonder about something that maybe someone has some knowledge about.

But first a quick update. We are on day 3 of going back to everything we were giving Hana before we tried different food and a different enzyme amount. I was thinking maybe the poo would be getting back to what it was before but it is still pretty much liquid. But we probably still need to watch for a few more days to know for sure. The good news is that even with bad poo, she has put on a pound in the last few days. Right now the only thing that is different from before is the amount of prednisone. We are down to 15mg per day from 60mg. One thing our journal noted was when we started on the 60mg of prednisone there was a significant increase in the volume of water Hana was drinking which sounds like a common side effect of prednisone. We had been worried how little water she was drinking prior to that and the vets told us that there was so much moisture in the hydrolyzed protein food that we shouldn't worry because she really didn't need much water. After starting the prednisone there was an increase in the quality of poo so we thought great. But it sounds like prednisone can help with diarrhea in some cases. So maybe prednisone was helping?

So now that we are on less prednisone but Hana is still drinking a lot of water its making me wonder if the amount of water in a dogs stomach can have an effect on the efficiency of the enzymes and the overall digestion process? Does anybody have any thoughts or opinions on how lots of water affects EPI dogs?

And a prednisone question for Patsy. Hana is experiencing the bony head issues that Marti had. Its definitely a little shocking when you pet her head. Our general vet seemed to think that the MMM was the culprit and was why we needed so much prednisone, but the internist seemed to think that so much prednisone was contributing to the muscle wasting. I'm curious what amounts of prednisone you guys used? The mouth opening issues are definitely resolved which is good news.
Hana is a 1 year old golden doodle who was recently diagnosed with EPI on top of Myasthenia Gravis and Megaesophogus.

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Patsy
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Re: Any Tips on Enzyme Dosage?

Post by Patsy » 16 Jun 2021, 13:49

The highest dose was 25, but she was taking it for a year. She was also affected by blisters that rapidly emerged, burst and coalesced into raw patches, so steroids were to possibly help with that. She had ointment and wore a t- shirt for months. I haven’t any idea about causes and effects, and the vet was was just using the few trusted drugs that might help. We agreed that her recovery depended on normalising her digestive system and then her organs would get what they needed. Her immune system has crashed. Her bony head stayed, but all other muscle wastage was improved. She would drink gallons if I let her. She needed to wee a lot too, and couldn’t be left for more than two hours or she’d wet the floor. Oh the joys of an epi dog! It’s a steep learning curve, chaotic for a couple of years.
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.

afairbairn
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Posts: 32
Country: United States
State: Colorado
Pet name: Hana
My name: Andy

Re: Any Tips on Enzyme Dosage?

Post by afairbairn » 20 Jun 2021, 23:06

Okay, so here's an interesting update that has me a little confused. We checked with the internist and she didn't have a real strong opinion one way or the other on trying the slippery elm. So a couple of days ago after a few days of really bad poo, we figured what the heck. We stopped with the Syncacore pro/pre biotic and gave her 1/2 teaspoon of wonderland slippery elm with breakfast. That afternoon she had two different poo's that looked like they came from a normal dog! We are now doing 1/2 teaspoon of S/E twice a day. But since then we're kind of hit and miss, and mostly miss. Every now and then we have some good ones, but mostly they're not super great. We figured maybe its something with the pre/pro biotics so we also stopped giving her pills with a spoonful of yogurt and instead are using some wet food from the previous meal that was mixed with enzymes.

Anybody have any thoughts on how the slippery elm could make such an instant impact but then have kind of mixed results?
Hana is a 1 year old golden doodle who was recently diagnosed with EPI on top of Myasthenia Gravis and Megaesophogus.

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jilbert57
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Re: Any Tips on Enzyme Dosage?

Post by jilbert57 » 22 Jun 2021, 09:33

Am I reading right that you stopped the pre/probiotic and gave SE that you had better poops?
If so I would try the SE only for a few days.
I had a dog once that I never could find a probiotic thst worked.
Just a thought.

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.

Barb
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Re: Any Tips on Enzyme Dosage?

Post by Barb » 22 Jun 2021, 15:36

I agree with Jill because I, too, had a dog who always got diarrhea whenever I tried a probiotic.

Barb

Tuckaboo Pam
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My name: Pam H.

Re: Any Tips on Enzyme Dosage?

Post by Tuckaboo Pam » 22 Jun 2021, 17:01

Tucker did well on Proviable, but we started it very gradually, to keep it from giving him diarrhea. I stopped because it was so expensive, on top of all his other needs. It didn't seem to hurt.---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.

afairbairn
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Posts: 32
Country: United States
State: Colorado
Pet name: Hana
My name: Andy

Re: Any Tips on Enzyme Dosage?

Post by afairbairn » 08 Jul 2021, 21:48

Not sure if anyone is still checking this thread but thought I'd give an update and hit folks up with a question as well. Hana generally seems to be doing better. The weight gain is still happening and she is up to 41.5 lbs from a low of about 34, but still has a way to get back to her pre epi weight of 47. But overall she just looks and feels better so that is encouraging. We have been keeping a journal like everyone suggested and there definitely is a trend that we're seeing. Morning and afternoon poops seem pretty darn okay, a little soft, but they are shaped right. But at night they generally get bad. So the current mystery is what happens during the day to make them go wonky? I don't think we are doing anything different at the end of the day to make it change but who knows.....

Any ideas what would be causing a difference between morning and nighttime?

I'll give a bit of refresher of our current regime:

Breakfast
1.5 cans wet hydrolyzed protein
1-7/8 teaspoons enzyme diane 6x
1/8 teaspoon tylan
1/2 teaspoon slippery elm
10mg prednisone
30mg pyrodstigmine
20mg omeprazole (about 30 minutes before)

Lunch
1.5 cans wet hydrolyzed protein
1-7/8 teaspoons enzyme diane 6x

Mid Afternoon
30mg pyrodstigmine

Dinner
1.5 cans wet hydrolyzed protein
1-7/8 teaspoons enzyme diane 6x
1/8 teaspoon tylan
1/2 teaspoon slippery elm
20mg omeprazole (about 30 minutes before)

Bedtime
30mg pyrodstigmine
Hana is a 1 year old golden doodle who was recently diagnosed with EPI on top of Myasthenia Gravis and Megaesophogus.

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