B-12 shots plus WonderLabs B-12 with IF?

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.
maya193
Member
Posts: 77
Country: United States
State: Rhode Island
Pet name: Maya
My name: Debbie

B-12 shots plus WonderLabs B-12 with IF?

Post by maya193 » 01 Nov 2021, 11:03

Hello all! New EPI mom here. Maya is a 4 year old German Shep/Malinois. Question: Currently the vet has us on weekly B-12 shots for six weeks, then monthly shots (plus enzymes). She is starting week 3 and I haven't been seeing the results I think I should at this point. So purchased the WonderLabs B-12 with IF after reading extensively about it. Thank you Epi4Dogs site! My question is: Since she is getting the B-12 shots weekly should I also give her the capsules daily or less frequently while she is on the weekly schedule? Your experiences are appreciated. Thank you! :)
Maya is a belgian mal/german shep diagnosed with EPI on 10/12/21. TLI 1.2, B-12 196, Folate 4.8. Currently on Maximum K-9 raw diet, beef and vegetable, Enzyme Diane, Wonderlabs B-12 with IF, Proviable and Slippery Elm.

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

Re: B-12 shots plus WonderLabs B-12 with IF?

Post by Olesia711 » 01 Nov 2021, 12:10

Hi Maya's mom, when you say you are not seeing the results you expected.... exactly what results are you referring to?
Is it inappetence, weight gain, anxiousness, loose stools ......or specifically what.

Also..... can you share with us the Cobalamin (B12) blood test results?

Depending on the dog and the issue,,,, like with inappetence, if it is due to low B12, you usually see improvement rather quickly.... (by 3 weeks)
With weight gain.... that can happen fairly soon or take what seems like FOREVER, even with B12 supplementation.
With loose stools.... if it is due to low B12, that too seems to improve within weeks.
With excessive anxiousness... that can take a very long time... and sometmes behavior modification is also needed....but B12 does help.

The B12 protocol your vet has Maya on is the appropriate standard protocol.... But with some dogs, they just don't respond as expected to the cyanocobalamin shots as expected and that is when you switch to either Hydroxycobalamin (shots) or Methylcobalamin (Wonderlabs pills) B12 .....

Since your vet already started Maya on the std B12 protocol.... my suggestion is to follow thru and complete the course- -so you get a valid benchmark.... and THEN decide what to do going forward since one way or another, your dog will need some sort of B12 maintenance going forward.

if the test results are not dramatically improved...then either either switch over completely ... OR..... give a few pills a week in-between continued shots (after B12 re-testing)... HOWEVER.... this cannot be accurately determined until AFTER your dog has completed the standard protocol of exactly what your vet is doing. If you give the pills inbetween the shots at this juncture, you and your vet will not be able to determine if the shots really were working OR if you need to do a combo of shots and pills OR if you should just switch over to the wonderlab pills.

I hope this better explains things.

Looking forward to hearing back from you................
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.........

maya193
Member
Posts: 77
Country: United States
State: Rhode Island
Pet name: Maya
My name: Debbie

Re: B-12 shots plus WonderLabs B-12 with IF?

Post by maya193 » 01 Nov 2021, 13:52

Thank you so much for your reply! So appreciated!

Her B-12 level was 196ng/L (LLN is 284, ULN is 836).

Her appetite is great, even with the supplemental enzymes. They don't bother her at all. I guess I thought her stools would have improved more at this point. And of course it's like I wish she could gain weight quickly.... I'm just a nervous mom I guess. :) This is all new territory for me.

Your information is so helpful and I thank you so much!!! I'm glad I didn't start the supplementation yet!
Maya is a belgian mal/german shep diagnosed with EPI on 10/12/21. TLI 1.2, B-12 196, Folate 4.8. Currently on Maximum K-9 raw diet, beef and vegetable, Enzyme Diane, Wonderlabs B-12 with IF, Proviable and Slippery Elm.

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

Re: B-12 shots plus WonderLabs B-12 with IF?

Post by Olesia711 » 01 Nov 2021, 20:06

ahhh.... now i understand.... unfortunately in addition to adding enzymes, watching the diet, adding B12 in most cases, and keeping SID under good control.... EPI parents also need a HUGE dose of patience ..... and that can be very tough at times!

Yeah, don't give the B12 pills just yet while on the shots and before the retest of the B12.... but do save them for later.... you can always use them for your dog with that kind of low B12 (she is going to need to be supplemented for life... but once you raise her B12 levels, afterwards you only have to give her periodic B12 to maintain the upper B12 levels of 600 or more...........)
Also... these are the same B12 pills that they mfg for people.... so you can take them too :)

Her B12 is very low indeed, but the fact that she is on enzymes, on B12, is happy, has a good appetite, but i my understanding is that her stools are not the best yet.....and she hasn't really gained much weight (yet) ... if so.....

regarding the weight gain... that can start to happen within weeks... or it can take more than a year.
regarding the not optimal stools are most likely due to SID which is not yet under good control. The way to get the stools under good control is to

1. make sure you are giving proper enzymes (pig enzymes) powdered works best. (71,000/+ LIpase USP units, etc....
2. make sure you are giving the right amount of enzymes, rule of thumb to start with 1 level tsp per 1 cup of food, add just liquid to moisten the enzymes in the food (water works) and let sit for approx 20 minutes to avoid any possible mouth sores and this actually does appear to help some dogs digest their food better.
3. Most dogs do better with a low fiber food (4% fiber content or less) since fiber can destroy the efficacy of the enzymes from anywhere between 0% to 50%... and we just don't know which dog will be affected by what %.. so when starting out, best to go with a food with 4% or less fiber content in it, avoid foods with multiple pea ingredients and avoid food (in the beginning) with grains in it.
d. be sure to supplement with B12 if needed (which you are doing)

Once you are doing all of 1 thru 4 and if the stools are STILL not optimal.... this means SID is having a big ol party in the gut and you need to get it under better control.
First you treat and then sometimes you just need to change the food.

SOOoooooooo.... the protocol for SID is:
1. give prebiotics (many of us try SLippery ELm powder https://epi4dogs.com/slippery-elm/ ) first as a prebiotic
2. if a prebiotic helps but not enough.... then talk to your vet about tryin a pre+probioitc,. Currently we are recommending Proviable or Visbiome... many vets prescribe Forti Flora... but we kind of like the other two a little better . WHen giving a probiotic, ALWAYS start with less than half the dose and work your way up to a full dose over the course of a week or two. This helps avoid even more diarrhea with some dogs........
3. If the above does'nt help or doesn't help enough....(over the course of a few weeks).... THEN.... talk to your vet about prescribing Tylan (Tylosin Tartrate soluble powder antibiotic https://epi4dogs.com/antibiotics/ . DO NOT let your vet prescribe Metronidazole https://epi4dogs.com/sid-sibo-microbiome-research/ .... Metro kills ALL the bacteria in the gut flora and some of it will never ever come back in an EPI dog no matter how much probiotics you feed it. EPI dogs not only do not have enough bacteria but they also do not have enough variety.... so this is why you do not want to use Metro... but rather Tylan which is a macrolide antibiotic which means it inhibits bacterial reproduction- - so the EPI dog's gut flora has a much better changed of being repopulated......... Tylan needs to be taken twice a day for 45 days.

This is the SID protocol for EPI dogs set forth by Texas A&M Gastro Lab/Dr. Joerg Steiner & Jan Suchodolski
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.........

maya193
Member
Posts: 77
Country: United States
State: Rhode Island
Pet name: Maya
My name: Debbie

Re: B-12 shots plus WonderLabs B-12 with IF?

Post by maya193 » 02 Nov 2021, 11:10

wow! all of this information is so useful! i am beyond elated that i found your site....i don't think i'm giving her enough enzymes...so i'll change that right away. her stools are becoming more firm but not always....but better than a few weeks ago for sure! she is on raw diet (and has been for about 3 years now because she couldn't tolerate dry kibble as a pup)...and i have recently wondered if the raw diet somehow was like a lifeboat for a few years and perhaps the epi diagnosis would have happened sooner without it..but that's a debate of another sort! lol!

so...a question...i have been giving her omega fish oil support and a joint supplement (has been on it for years)....should i stop those for now until we stabilize?
Maya is a belgian mal/german shep diagnosed with EPI on 10/12/21. TLI 1.2, B-12 196, Folate 4.8. Currently on Maximum K-9 raw diet, beef and vegetable, Enzyme Diane, Wonderlabs B-12 with IF, Proviable and Slippery Elm.

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

Re: B-12 shots plus WonderLabs B-12 with IF?

Post by Olesia711 » 02 Nov 2021, 22:31

Ahhh... not enough enzymes could be the underlying problem.

Effectively managing EPI is all about finding the right balance of the recommended protocol... and that is 4 things you have to juggle. Once you find the right balance of things, you will be amazed at how everything finally comes together.

First you implement the protocol for the 4 aspects of managing EPI: Enzymes, Diet, B12 & SID control
Then if expected results are not happening.... we at Epi4Dogs try to help people figure it out- -what needs "tweaking"...... and we do this one-step at a time....and hopefully this helps the EPI parent best help their EPI dog start feeling good!

REgarding the raw, possibly having staved off you noticing that she was segueing into EPI.... my personal thought on this is maybe. The reason why i feel that this might be a possibility is because we have had dogs in the past that had a lot of difficulty getting on the right diet...... until their pet parent put them on raw.... and that did the trick.. This happened quite a few times. Although this is not to say that all EPI dogs do well on raw... however, i have wondered if it is because natural enzymes are preserved in raw food so maybe this was why it helped some dogs.

REgarding the fish oil.... keep giving it!!!! EPI dogs are especially depleted in fat soluble vitamins.... Fish oil is excellent, needed and well tolerated by EPI dogs. Also, recent research suggests that fish oil does so much more for dogs when included in their diets vs. plant oils.. i'll try to find that research and post here....
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.........

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

Re: B-12 shots plus WonderLabs B-12 with IF?

Post by Olesia711 » 02 Nov 2021, 22:39

here's the research article that basically says dogs benefit way more from (fish) Krill oil vs. (plant) Flaxseed oil
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8025612/
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.........

maya193
Member
Posts: 77
Country: United States
State: Rhode Island
Pet name: Maya
My name: Debbie

Re: B-12 shots plus WonderLabs B-12 with IF?

Post by maya193 » 03 Nov 2021, 09:42

Thank you so much for the information and the support. It is appreciated beyond words. I'll reach back with the results soon! Debbie
Maya is a belgian mal/german shep diagnosed with EPI on 10/12/21. TLI 1.2, B-12 196, Folate 4.8. Currently on Maximum K-9 raw diet, beef and vegetable, Enzyme Diane, Wonderlabs B-12 with IF, Proviable and Slippery Elm.

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

Re: B-12 shots plus WonderLabs B-12 with IF?

Post by Olesia711 » 03 Nov 2021, 11:59

good luck and do keep us posted!
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.........

maya193
Member
Posts: 77
Country: United States
State: Rhode Island
Pet name: Maya
My name: Debbie

Re: B-12 shots plus WonderLabs B-12 with IF?

Post by maya193 » 24 Nov 2021, 09:11

So it's been a bizarre month so far. I really feel that although we're much better from baseline, we're not there yet. Maya will have days when her stool is great then it goes back to light brown/yellow and soft...not diarrhea but not firm either. It appears to be heavily correlated to her B-12 injections (she got the last of the 6 week protocol yesterday). It takes about 24 hours after her B-12 shot to normalize...then she's fine for a few days then it's half normal/half not. Should I use more enzymes? Have her B-12 tested or is it too early? Could it be her gut flora are not stable? I'm exhausted. She now transitions to the monthly B-12 shot, however, I doubt she will do well over the next month. Any advice would be appreciated! I feel like I'm at my wits end :(
Maya is a belgian mal/german shep diagnosed with EPI on 10/12/21. TLI 1.2, B-12 196, Folate 4.8. Currently on Maximum K-9 raw diet, beef and vegetable, Enzyme Diane, Wonderlabs B-12 with IF, Proviable and Slippery Elm.

Post Reply

Who is online

Users browsing this forum: No registered users and 234 guests