Epi4Dogs

Suggestions Please!
I am on day three for giving my newly diagnosed EPI GSD her powdered enzymes. I am using Biocase. For the first two days I gave her two cups CANIDAE® Grain Free PURE Ridge™ Dog Dry Formula with Real Chicken (which is what she was already used too), two teaspoons powder, 1/2 cup warm water, incubated between 30-60 minutes two times a day. In the last 48 hours she has had two poops that were completly formed and somewhat darker in color and then all the others were more EPI typical stools, yellow, grainy, soft, mushy, cow-patty, with some mixture of soft formed. My biggest concern is that five times since starting the enzymes, in two days, she has "spit-up" clear liquid. She just opens her mouth, doesn't make any retching sounds, bends over and clear liquid comes out. Sometimes almost like a light spray of just a few drops, other times the size of a silver dollar to a large pancake of liquid on the ground. One time she made a kind of belching sound and then a few drops of clear liquid hit the ground. She has gotten one B-12 shot and I have ordered the Pet Factor B-12 and will start that orally daily once I get it. Her B-12 level was 279 and TLI was 1.3. I know there are many recommendations from antibiotics to probiotics etc, but I wanted to be methodical and start the fewest things first to see how she responded. What do you think the spitting up of clear liquid is a sign of? My best guess is acid reflux from the enzyme powder as this is the only new thing at this point and she has never done this before. Should I continue on or change formulas? Should I continue the same dose even though her poops haven't changed that much yet and just give it more time? Still pooping frequently (11 times total after two days of enzymes), about the same or a little less frequent than before.

I am wondering if SID is playing a role in the spit up. Was Zoe treated with Tylan or Metronidazole?

No. Not yet.

That does sound like acid....
We have recently discovered that all EPI dogs have bile and SID isues. With some dog we notice there is a problem and yet with other dogs, we do not see any signs. Another thing with these EPI dogs is that every thing is connected..... SID itself can trigger acid reflux. Sometimes it is a real acid reflux issue where nothing helps until your vet will prescribe an acid reducer like Pepcid AC (only give this under the guidance of your vet) ... but you don't want to keep a dog on an acid reducer forever... too much can lower the B12.... acid reducers should be taken as needed.

BUT.... more times than not, the acid in an EPI dog is from SID which doesn't need an acid reducer cause it is not because of too much acid, but rather from not enough of the right kind of acid..... in this case, usually SLippery Elm, which is a prebiotic & mucilage it has jsut the right amount of the right kind of fiber with SCFAs (short chain fatty acids) specifically Butyrate, that actually battles SID and this often takes care of the acid without resorting to chemicals like Pepcid AC.

The theory behind this is, if this acid is because of SID that your dog is experiencing acid reflux, you need to alter the gut flora. EPI dogs do not have enough bacteria nor do they have enough of a variety of bacterial strains. Prebiotics feed bacteria which is needed by an EPI dog.

So.... one of my suggestion would be to go on the SLippery Elm page,
https://epi4dogs.com/slippery-elm/
get some powder (not the capsules) you can get it from Amazon.com, NOW puts out a SLippery Elm powder, 4oz for about $8. Give a little less than what is recommended (too much SCFA will also give loose stools- -so sometimes less is better).... and i would try Slippery Elm powder sprinkled in the food with every meal... if you do not see an improvement in a couple of days, then you most likely need to bring out the big guns and i would ask your vet for Tylan antibiotic powder/45 days/twice a day.... this should address the SID and in turn address the acid.............

There are more tricks to handle this, but with an EPI dog, you only want to try one thing at a time.

Let us know how things go ... and if you need more suggestions.

OH..... while i am thinking of it.... there is another thing.... if you are seeing this clear acid in the morning... that is from an empty stomach... many of us have fixed this by giving a little snack just before bedtime.... but.... jsut reading your post, it sounds like the white acid is happening throughout the day- - and if so, then this is not from just an empty stomach......

my Kara had this

she just openned her mouth and spit out liquid, and froth

the vets approach, and he had dealt with EPI for 20 + years was

its acid reflux, probably caused by a change in enzymes,

so we gave Kara Ranitadine, (Zantac ) 30 mins before food, it coats the gut, and if as Olesia says, its first thing in the morning, give a small meal before bedtime, with enzymes

you should be able to buy Ranitadine over the counter in USA, Zantac is expensive in comparison, we used the 75 mg pack, but maybe run that, and anything else past your vet

we were lucky, we could give Kara a digestive biscuit, I am not sure you have them in USA

https://en.wikipedia.org/wiki/Digestive_biscuit

I had no idea they originated in Scotland, you live and learn, but Scotland is a very different world to us in Liverpool, and its only 200 miles ish,,,,,,,

But you could maybe give some mashed potato and a scrambled egg

we no longer have this issue, but have the pills in her medicine cupboard, just in case, she still has her digestive biscuits at night, not all EPI dogs could tolerate them

its all good fun, and they are worth everything you do

one thing, keep a journal of anything, and everything you do, I still have mine 8 years down the line, a huge note book with pictures and print outs, I suppose its like a scrap book !

a life history!

jean UK

Thanks Jean..... i looked it up on Wikipedia and this is the description..... i suspect it is the sodium biocarbonate in these biscuits that do the trick

https://en.wikipedia.org/wiki/Digestive_biscuit

"The term "digestive" is derived from the belief that they had antacid properties due to the use of sodium bicarbonate when they were first developed.[2] Historically, some producers used diastatic malt extract to "digest" some of the starch that existed in flour prior to baking.[3][4]"

I also did a search on digestive biscuits for dogs... and what popped up were Probiotic treats here in the US (which is not the same) .... SO.... my guess is that maybe we can just try baking our own little biscuits, try a few and see if they help.... might have to tweak some of the ingredients- -to make it more appetizing&appropriate for a pup ..... but here is a basic recipe:

https://www.wikihow.com/Make-Baking-Soda-Biscuits

However.... i did find this doggie charcoal biscuit recipe that i thought might also be a possibility
https://www.lubrisyn.com/homemade-charc ... -biscuits/

Wouldn't any treat have to be treated with the enzymes first, even these?

over here if you have a gastric issue, the doctors will say

eat digestives, and, or Arrowroot biscuits, no food, no dairy, just water and juice

so there you go

jx

yes and no.... we have many ways of covering treats with enzymes.... a lot of times... if we cannot include enzymes in the treat (you have to be careful not to include enzymes and then bake with anything over 130 degrees or that will kill the enzymes included in the batter)

SO..... one way to get around this is to feed a meal with enzymes per usual.... and just give the non-enzymed treat within 1 hour of that enzymed meal

Hi and welcome to our group. The B12 is extremely low and if you've only had one shot it probably is still not at the level needed for EPI dogs - 600+. Glad you ordered the B12 pills from WonderLabs. It could be SID as the B12 is so low. Once you get the pills I would start them right away. In the meantime, I would try Slippery Elm Bark Powder - here's the link to our Slippery Elm Page https://epi4dogs.com/slippery-elm/. If the symptoms continue, then I would talk to your vet about a course of Tylan.

Please keep us posted on how things go.