Epi4Dogs

Thanks for your support and well wishes for my boy! His poop started declining as soon as I stopped the supplements (probiotic, slippery elm and or changed his food to the hydrolyzed food) as the Cornell vet suggested prior to surgery. She didnt want me to start again until we knew what was going on with the liver and small intestine. So not sure what could be the one thing that is making him slip back to such bad poop. Maybe it is a combination of the liver problem and the SIDs coming back. It is weird as he is hungry and eating well but not pooping much. I keep walking him around and no poop. I have to admit I hate to see his bright yellow diarrhea but I hope nothing is blocking him up either. Thankfully he seems so happy and is acting his normal playful self with no pain so I am hanging on to hope that whatever the liver problem is it can be repaired easily and fully! I am trying to be patient but this waiting is hard and it crushed me to see his poop get so bad. I am hoping to hear something this week.
Nothing is close where I live ...a benefit of living in a beautiful wild part of the country but health facilities and stores are all quite a ways from me. Even so, I would travel even farther or any distance to bring my babies back to perfect health...they are the world to me!
Lets hope 2022 brings peace and perfect health to all those we love!
Take good care,
Elizabeth

ahh Elisabeth.... i am so sorry to hear this,,,,i wish you could just start the slippery elm again...and then add back the probiotics... because with the yellow poo.... to me it sounds like more of a SID issue than a liver issue,,,,, BUT,..... i understand completely that your vet doesn't want to add any of these things back until she sees what is going on via the results.

So.... what i can suggest and shouldn't interfere with what the vet is doing is try increasing the enzymes for a few days and see if that helps. If not, the other thing i can suggest is go back to adding the B12 pill... maybe start with 1 pill 3 days a week. Some dogs just do not hold or respond as well as expected to the B12 shots... this doesn't happen very often, but it does happen.... and let us know if you see any hint of improvment...................

As always try these two adjustments one at a time...............

Hopefully you will hear back from the vet sooner rather than later so that she can advise you on the slippery elm and probiotics.....................
Gosh... i sure hope 2022 is MUCH better year for WHiskey than 2021.....................

Thanks for the suggestions. How much should I increase his enzymes per cup? He hasn't pooped anything since yesterday at 9 am and it was yellow diarrhea so I am hoping tomorrow brings a regular poop.. always the optimist!
We are going to my local vet on Wednesday to check his stitches so he can be released from the cone! He hasn't really bothered the incision so I only keep it on him if I am not able to watch him closely or at night while we sleep. The incision looks good to me but the Cornell wanted me to have him checked so I made an appointment.
Thanks again!

try just a tiny bit increase....1/8 tsp more per cup and then really scrutinize the poo to see if you notice any tiny improvement.... if you think you see a little change for the better... then you can try upping the enzymes even more by 1/4 tsp per one of the cups in a meal.... and again,..watch the poos closely......this is a back end way of sometimes handling SID.... when you are in the process of trying to figure out what triggered it to get out of control... whether not enough enzymes or food that is not optimal....doesn't always work. but sometimes it does help give some answers as to what is going on.............

Please keep us posted.

Thanks, I will give it a try!

Just heard back from the Cornell vet tonight. I am attaching her report and the biopsy report. As she thought the biopsy reported he has a combination of Copper Hepatopathy and Inflammatory Bowel Disease. So 6-12 months of chelating medicine to remove the copper and a home cooked diet for the IMD for life. I put in a request for a Cornell nutrition department Dr to develop a diet that will help the liver and IBD. I hope it also works well with his EPI! It is a good thing I like to cook and will do anything for my sweet boy. His 5 siblings might be jealous!
He did have a more formed poop since my last post but he really isnt pooping much which is odd to me. The vet didn't seem too concerned as she felt he has been through a lot with many meds over the last few weeks. She put him back on denamarin, probiotics and will add b12, b6 and vit E and medication to help prevent fibrosis of the liver. I am just glad we have a concrete diagnosis and plan to bring him back to good health. I have ordered all the suggested meds and supplements so I am hoping next week to have him on his healing protocol! It seems like a lot of changes but hopefully his body will be able to adjust. He still seems happy and I hope it continues.
Happy New Year everyone!

Thank you Elisabeth for sharing these test results with us. I am so relieved and thrilled for you and WHiskey that it is confirmed that he does not have cancer. That is a HUGE relief.

The IBD diagnosis is fairly common among EPI patients. But the Copper Hepatopathy is not something i have really heard much of.... so it is good that you will consult with a vet to help you with a home-made diet to cover the Copper Hepatopathy aspect, along with EPI and IBD. Just be sure when they put the diet together if they include fiber, like quinoa (Cornell has done this in the past with EPI dog diets) please let them know to not include quinoa as it doesn't agree with the majority of EPI dogs. Most (although not all) EPI dogs do not do well with many fibers in their foods.... although sometimes some EPI dogs actually need some. If this is required then white rice seems to be better tolerated in very small doses... if a fiber is going to be tolerated at all. With the EPI aspect, you will just have to "try" to see how well or not Whiskey will do with it.

Regarding the Vitamin E.... Please share with your vet that EPI dogs are greatly depleted in the fat soluble vitamins (one of them being Vitamin E) and if this is part of the treatment .. WHiskey is starting at a deficit with vitamin E much more so than the typical dog... please share this research on it done by Dr. Patrick Barko & David A. Williams in ACVIM June 2018 Journal titled " SERUM CONCENTRATIONS OF LIPID-SOLUBLE VITAMINS IN DOGS WITH EXOCRINE PANCREATIC INSUFFICIENCY TREATED WITH PANCREATIC ENZYMES"..... located on this page: https://epi4dogs.com/epi-research/ .... after reading this research your vet may determine that a higher concentration of vitamin E may be needed (or not) to help with manage the oxidative stress from the copper hepatopathy.... since they are using vitamin E as one of the antioxidants to decrease the free-radical formation from copper... I honestly don't know if this is important for your vet to know or not, but it probably would be best to share this report with her and let her decide.

Please keep us posted on how WHiskey does with his new protocol... i am glad that he seems happy... cause if he is happy and doing well..., i know that you will be happy too

Thanks as always for your advice and support. I will pass on the article to the vet. I spoke to the nutritionist today and she will get me a meal plan next week. It looks like it will be tilapia and white rice with supplements. I will know amounts next week and send it along for you to check out the amounts . For now she wants me to just add small amounts to acclimate him to the new foods. I am excited to get him started on the meal plan and drugs to get rid of the copper ... to start the healing !!.

great! Looking forward to seeing the diet.
I read where white rice helps with copper storage.... and although typically many EPI dogs have trouble with grain... if there is a grain that "might" be tolerable by some EPI dogs, it usually is a small amount of white rice. You will just have to try a little bit and see how it goes and slowly increase the amount to see how well (or not) whiskey handles it.

What i have noticed over the years though is when there is a commercial food (kibble) with grain in it... it usually (although not with every single EPI dog) is difficult for an EPI dog to digest. Reason is that fiber reduces the efficacy of the enzymes ... but the iffy part is that it can reduce the efficacy from anywhere between 0% to 50%... and we have no way of knowing which dog is affected by how much until we try a food. Please feel free to share this with the nutritionist who is preparing the diet for you.

what i have also noticed is that "some" EPI dogs cannot handle commercial food with grain in it.... BUT if you home prepare the food.... amazingly they can handle some of the grain or fiber that they couldn't when you buy a commercial product that includes it. Also, ask the nutritionist if it would be okay for you to double rinse the white rice after it has been cooked to remove some of the starch... or if doing this would mess up the diet......

So looking forward to hearing that Whiskey is getting this copper condition under good control. Please keep us posted !

Well Whiskey is doing well. Today is his first day completely on home made tilapia and white rice. I had been weaning him off the other food for a week now. I will be adding supplements (Balance IT® Canine-Cu, FLORA Sunflower oil, Nordic Naturals Pet Omega-3 oil) slowly over the next couple weeks. I am attaching the correspondence and diet plan made for him. At this point he is on the tylan, penicillamine(liver), denamarin, elevate 500(water soluble vit E), pyridoxine hcl (B6), Phosphatidylcholine (anti-fibrotic agent), & B12. I am excited to have him on his healing path! So far he likes the food but didn't finish his morning meal which I see as a good sign. While on the hydrolyzed food he was hungry more than usual and at least now he seems full. It is a lot of food (I am buying out all of the frozen tilapia in the area, and purchased a 20 lb bag of rice lol) but I know that it is to help him gain some weight. I will be keeping an eye on his poop to watch for improvements. His diarrhea had lessened but now his last poop was small soft formed yellow poops. I am attaching a photo of yesterdays poop. I might be desperate and looking for any sign of improvement but he was doing "crazy dog" (a big play bow and then run like a crazy dog all over the yard or the furniture in the house) with his older sister Willow (another Shepherd) and he hadn't done that in a long time.... so fingers crossed that he is on the mend and all of this will work to give him a long life with me and his pack!
Wishing you all the best on this beautiful day!
Elizabeth