Leaking Mucus? Need help

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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dbartusi
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Country: United States
State: Colorado

Leaking Mucus? Need help

Post by dbartusi » 05 Oct 2018, 13:47

Hello all,

I am new to this forum and am here to ask for some help and suggestions on how to approach my poor little girls problem.

Some background information. My dog, Jasmine, is 3 and a half years old and has been diagnosed with both EPI and IBD for a little over a year now. Before they hit her full force she weighed about 35 pounds and over a couple of months she dropped down to about 15 to 20 pounds and looked like a skeleton. Thankfully we diagnosed her with a few days to live and were able to turn things around. She is now pretty stable between 40 and 42 pounds which is a relief.

Her new issue is having a seriously detrimental impact on both our lives. Within the last 2 months she has started excreting what I believe to be mucus throughout the day while she is just lying around. She is now only allowed to lay on two blankets as to not damage out couches and carpets and has to wear diapers all day to prevent it from being spread around if she decides to sit anywhere. She also hates the smell of it which makes any crate stays unpleasant for her and results in a ton of laundry loads to clean these things. Her stools are pretty soft and definitely have the greasy mucus yellow liquid she leaks on it and almost sounds like a sprinkler system starting when she defecates as the geese and poo squirts out (according to the poop chart she is at about a 5 or 6, occasionally a 4). I am at a loss for what to do to get this under control and it has totally taken over both of our lives.

Our treatment regimen:
-Royal Canin Veterinary Diet Hydrolyzed Protein Adult HP Dry Dog Food: 1 cup twice a day ground up and softened with water
-PanaKare Plus Powder Rx: 1.5 tsp per meal incubated for 5-15 minutes each time
-Famotidine: Half a 10 mg pill of this acid reducer each meal
-Prednisone: 2.5 mg per meal
-Proviable-DC: One probiotic capsule in the morning only
-Atopica: Once at night before bed (I think we use this Cyclosporine to help with the IBD)
-At one point we used Tylan but not anymore (I still have a prescription for it and have a bunch left over)

I am fully open to any criticism or thoughts on our regimen and would love to discuss any recommendations with my veterinarian. He is a great vet but is not entirely familiar with EPI and from what we were told EPI and IBD together is a nasty combo and very rare, we had to call in specialists to help with diagnosis.

My thoughts and questions:
-I have read on here that a lot of people are weary of probiotics due to SID and to me this seems like this could be a serious case of SID, but I am new to the idea of SID and don't really know.
-I do vaguely remember getting a few B12 shots when she was first recovering but we haven't don't anything with B12 since then, could that be a problem. I think I should test B12 and potentially get on B12 pills with intrinsic factor
-What is intrinsic factor?
-I'm thinking that maybe I should back off the probiotics and then potentially get back on Tylan
-Is that too much pancreas powder? We were doing one tsp per meal but when this acted up we increased it and it seems to be a bit better but we are still having leaking issues.


Thanks to everyone who made it through that amount of reading. I am at my witts end with this situation and any help is greatly appreciated. I am hoping we can get this figured out so my leaky girl can go back to being a normal little girl.

Kind regards,
Dylan and Jasmine
Jasmine, Rescue Mix, 3 Years Old, Dylan
Onset: 2016 Lowest: 15lbs Current: 40lbs
EPI and IBD diagnosed
PanaKare Plus Royal Canin Hydrolyzed Protein (1 cup with 1.5 tsp enzyme 2/day)
5mg Prednisone per day / Proviable-DC / Atopica 50mg / 5mg Famotidine per meal

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Olesia711
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My name: olesia

Re: Leaking Mucus? Need help

Post by Olesia711 » 05 Oct 2018, 17:18

Hi Dylan and welcome to you and Jasmine but so sorry you are having an issue.

One remote possibility is that the leaky/stinky part is not really due to EPI but rather/possibly an anal gland issue..... i would first check with the vet to make sure this is not part of the leaking problem.....

Because you mentioned the yellowish poo... to me that smack of SID.... either something no longer agreeing with or triggered by something setting off either the IBD or the EPI..... and my heart goes out to you, cuz dealing with both of these together can be real tricky.

SO..... the best, least invasive way to figure this mess out is strip it all down and work back up..... BUT you will need to work with your vet on this (please share with your vet EVERYTHING i am going to suggest) do not do anything without running this by your vet first... especially cause of the drug your vet has your pup on because of the IBD (I am assuming... is this correct???) Does your dog have anything else going on besides EPI + IBD?????

Your regimen is fine ... but something is now amiss. The 1+1/2 tsp of enzymes is fine.... that would not cause yellow stools if too much but would rather/most likely cause just looser stools....so leave this as is for now...........

"Our treatment regimen:
-Royal Canin Veterinary Diet Hydrolyzed Protein Adult HP Dry Dog Food: 1 cup twice a day ground up and softened with water
-PanaKare Plus Powder Rx: 1.5 tsp per meal incubated for 5-15 minutes each time
-Famotidine: Half a 10 mg pill of this acid reducer each meal
-Prednisone: 2.5 mg per meal
-Proviable-DC: One probiotic capsule in the morning only
-Atopica: Once at night before bed (I think we use this Cyclosporine to help with the IBD)
-At one point we used Tylan but not anymore (I still have a prescription for it and have a bunch left over)"


DO ONE THING AT A TIME, ASSESS the situation.... THEN move on to the next.

1. Ask your vet if you can try stopping the Cyclosporine and (for now) treat the loose yellow stools with Tylan. My 1st resasoning is because sometimes Atopica can cause loose stools.... my 2nd reason is because this could all just be SID rearing it's ugly head and Tylan could very well be more adept at treating it and you might not need to keep giving the Atopica.

2. Once you decide if the above can (or cannot) be done.... but for a different reason (the acid reflux control), and as another 1-thing-at-a-time... try swapping out the Famotidine (for now) and use SLippery Elm powder or a different acid reducer. Sometimes Famotadine can stop being effective, so you should stop it for a bit and can go back later if needed.... this is why i am suggesting Slippery Elm (as long as your pup does not have an Elm Tree Allergy!)

3, as another thing to try... AFTER the above is tried.... i would see if stopping the Proviable helps or hinders.... not all probitoics do what we need them to do cause each dog is different and to-date, all probiotics are lsold as a "one-size-fits-all" and that just doesn't always work............

4, And last but not least i suspect your vet has your pup on steroids (pred) cause of the IBD.... and sometimes that is the ONLY thing that really helps..... but if possible.... you want to try and see if you can find the magic formula of all things working well together so that maybe, just maybe you don't need the prednisone. BUT... never, ever stop the pred- -ALWAYS talk to your vet about when and how much should you or could you try to withdraw your pup from it... if and ONLY if your vet agrees........ If you vet agrees that this might be another thing to try..... THEN what you might want to do is first..... change the food to Royal Canin "Ultamino"..................this is also a true hydrolyzed prescription food..... but we have found that many of our EPI dogs struggling with IBD too just don't do well on the other Hydrolyzed foods, but then do very well on this version of hydrolyzed food.... sometimes this makes all the difference in the world with these EPI +IBD dogs.....

If your vet agrees..... try changing the food to this version of Hydrolyzed food and then if it does appear to work well... maybe then (with your vet's guidance....) you can withdraw the prednisone too...........

Like i said earlier, and especially because of the special drugs your vet has your pup on, PLEASE share with your vet everything i am suggesting to you first before trying..... cause to me it sounds like your vet has your pup on these potent drugs cause of really hard to control IBD.............
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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dbartusi
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Country: United States
State: Colorado

Re: Leaking Mucus? Need help

Post by dbartusi » 06 Oct 2018, 01:28

Wow, thanks a ton for the very thorough reply. Definitely a challenging situation, one heck of a first dog I got on my hands but we love her all the same. I plan on consulting my vet before I make any changes, I'm hoping we can get this figured out.

I did explore an anal gland issue with my vet and we had an expression performed and one hundred percent different smell and consistency than the leaking fluid. Vet said glands felt normal and everything. He has never seen the leaking issue or heard of it and I can't find anything on the internet of pets with similar problems which worries me about the potential severity of her digestive issues...

I can ask and see about taking a break from the cyclosporine. I know we used to be on tylan and cyclosporine as the cyclosporine I believe was supposed to be a more targeted medicine on here inflammation of her intestines (been a while since I talked to my vet about this so I may be wrong).

Any concerns about not having any B12 shots or check ups for over a year? I'm thinking it may be worth looking into as some of her symptoms seem to line up with less than ideal B12 numbers but I know there is a lot of overlap for symptoms of a lot of her issues.

I have been reading up on the slippery elm and it seems interesting and I will bring it up with him as well for potential future options. I also like the idea of trying another dog food to see how that goes but for now I will try things in the order you think is best as long as my veterinarian agrees to it. Hoping the end solution cuts out some of the more expensive meds and things, fingers crossed.


Thanks again,
Dylan
Jasmine, Rescue Mix, 3 Years Old, Dylan
Onset: 2016 Lowest: 15lbs Current: 40lbs
EPI and IBD diagnosed
PanaKare Plus Royal Canin Hydrolyzed Protein (1 cup with 1.5 tsp enzyme 2/day)
5mg Prednisone per day / Proviable-DC / Atopica 50mg / 5mg Famotidine per meal

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Jean
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Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: Leaking Mucus? Need help

Post by Jean » 07 Oct 2018, 05:16

I wonder, has your vet taken a sample for analysis of the leakage ?

they are all sent to try us, mine certainly has

might be worth asking about PLE (protein leaking enteropothy)

just as a possibility, also leaking gut syndrome

please keep a journal, and only change one thing at a time

please keep us updated with everything you find out

jean
My name is Jean we live in Liverpool in Uk

I am the Forum Director which I am very proud of

My Kara born 21 July 2009 diagnosed with EPI by cTLI test August 2010 TLI = <1...folate 14 Cobalamin 408, shot down to 94, b12 injections every other day

Lowest weight 39 pounds

We used Panzym enzymes, Tylan and Chemeyes b12 capsules

Sadly, on 10th May 2019, we lost her to DM


Jeanx

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Madelon
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Pet name: Doc

Re: Leaking Mucus? Need help

Post by Madelon » 07 Oct 2018, 16:40

Hi there and welcome to our EPI family. I'm so sorry you are going through this. Olesia has given you great advice but to answer your question about B12 - yes it can be an issue that it has not been continuously supplemented. B12 supplementing is for life with these dogs. Not sure if it can be related to the leakage or not but still something that needs to be addressed. Most of us use the WonderLabs Pet Factor B12 pills - no prescription needed. I would recommend testing the B12 again since it's been a while so that you will have a reference starting point. Please keep us posted on how things are going.
Madelon, owned by DOC. DOC dx EPI 5/2015 = TLI < .4, B12 406; Folate >24. DOC taught me so much and together we battled and overcame EPI, food sensitivies, environmental allergies but we lost the cancer battle. DOC was dx with hemangiosarcoma 5/2022 and crossed the rainbow bridge July 24, 2022. He is and always will be the love of my life, my soulmate, my heart dog.

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Olesia711
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Posts: 3858
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Leaking Mucus? Need help

Post by Olesia711 » 07 Oct 2018, 17:24

Hi again Dylan.. and OMG... this is a first dog???!!!! YIKES ! you sure are getting a crash course in doggie health, eh?!
But that's okay, many folks have been exactly where you are and with a little help from friends their vet - -every one working together- - many crazy conditions have been well navigated with good outcomes :)

Okay.. the B12... heavens YES!!! Dogs with chronic gastrointestinal conditions should always be tested for low B12... IF the B12 is low and IF the dog has a chronic condition, the B12 should be brought up to upper mid-range B12 levels and then DO NOT stop the B12 but rather you and your vet decide on a plan of how much and how often B12 should then be given going forward to "maintain" upper mid-range B12 levels.
Reason being is that with a lot of chronicc gastrointestinal conditions (not jsut regular low B12 because of a situation that happened..... SID (messed up gut flora) happens and that in turn can eat away at B12 levels..... it can be kind of a vicious cycle.

(Sorry i tend to go on and on- -but i like to cover as many details as possible so that members can make well thought out decisions....)

Also...i 110% agree with Madelon regarding giving Wonderlabs "Pet Factor B12" can be purchased either directly from Wonderlabs https://www.wonderlabs.com/itemleft.php?itemnum=K9688 or Amazon https://www.amazon.com/dp/B07GPR8WBP. Please share with your vet.... check out our B12 page that REALLY explains things about the oral B12 https://epi4dogs.com/b12-protocol/ and https://epi4dogs.com/lexis-b12-story/ and why we strongly support this oral B12 made with 1000mcg Methylcobalamin B12, 800mcg Folate + 40 mg Intrinsic Factor....this has worked so well, sometimes better than the Cyanocobalamin shots that one vet clinic actually switched from giving the B12 shots to giving these B12 pills to their clientele!

Hope this helps.
Please keep us posted and let us know what you and your vet decide to do!

Oh... while i am thinking of it..... we have a ton of research that you vet might be interested in reading about.... regarding mostly recent microbiota research by Dr. Suchodolski at Texas A&M Gastrointestinal Lab- -bad gut flora (responsible for SID in EPI, IBD, Pancreatitis, PLE, etc, etc) which bugs, and how they are discovering better ways of treating it..... if your vet is interested... have him/her check out the SID/SIBO & Microbiome Research page
https://epi4dogs.com/sid-sibo-microbiome-research/
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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dbartusi
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Posts: 4
Country: United States
State: Colorado

Re: Leaking Mucus? Need help

Post by dbartusi » 09 Oct 2018, 13:44

Thanks again everyone for the help and support. Definitely been a huge crash course in doggie health, patience, and personal finance, ha. I am really glad I found this community and hopefully we can find a way to get through this so that hopefully in the future it is easier for anyone else with the same symptoms that Jasmine is experiencing.

To keep you all updated I reached out to my Vet who reached out to an internal medicine specialist to try and figure this out we are going to go back on Tylan and also start to give her B12 injections. I would like to switch to oral B12 at some point but for now I think the injections should be a sure fire way to get us back on the right track before we start maintaining more healthy B12 levels with the oral pills.

The specialist also suggested a potential medicine to use called Colestipol (cholestyramine). I am little weary of using any new medications that have come out, let alone something I have never seen on the internet mentioned for treating EPI or IBD, or treating dogs period for that matter. So for now I told him I would like to stick to the Tylan and B12 for now and see how those go first.

If any of you have experience with using Tylan and Probiotics at the same time do you find it works better to give Tylan separately from the probiotics (separated by 30 min, 45 min, and hour?) or is it fine to give them both at the same time? Jasmine is great at eating pills with her breakfast so if I could toss Tylan on the pile with her other meds for breakfast that'd be awesome but if I should separate it from the probiotics I can do that as well.
Jasmine, Rescue Mix, 3 Years Old, Dylan
Onset: 2016 Lowest: 15lbs Current: 40lbs
EPI and IBD diagnosed
PanaKare Plus Royal Canin Hydrolyzed Protein (1 cup with 1.5 tsp enzyme 2/day)
5mg Prednisone per day / Proviable-DC / Atopica 50mg / 5mg Famotidine per meal

User avatar
Jean
Forum Director
Posts: 1707
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: Leaking Mucus? Need help

Post by Jean » 09 Oct 2018, 15:10

pre/pro, biotics, and Tylan, preferably maybe several hours apart, we used 8

jean
My name is Jean we live in Liverpool in Uk

I am the Forum Director which I am very proud of

My Kara born 21 July 2009 diagnosed with EPI by cTLI test August 2010 TLI = <1...folate 14 Cobalamin 408, shot down to 94, b12 injections every other day

Lowest weight 39 pounds

We used Panzym enzymes, Tylan and Chemeyes b12 capsules

Sadly, on 10th May 2019, we lost her to DM


Jeanx

User avatar
Madelon
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Posts: 1317
Location: Nashville, TN
Country: United States
State: Tennessee
Pet name: Doc

Re: Leaking Mucus? Need help

Post by Madelon » 09 Oct 2018, 16:23

As Jean said you want to give probiotics at least 2 hours apart from antibiotics or they cancel each other out. I have never heard of that medication being used in EPI - I have owned dogs my entire life, but I always just did what the vet said and never questioned anything - until now. After having an EPI dog, I now do my own research and question the vet on everything so that I am completely involved in my baby's treatment and know what the drugs are and what the possible side effects are.
Madelon, owned by DOC. DOC dx EPI 5/2015 = TLI < .4, B12 406; Folate >24. DOC taught me so much and together we battled and overcame EPI, food sensitivies, environmental allergies but we lost the cancer battle. DOC was dx with hemangiosarcoma 5/2022 and crossed the rainbow bridge July 24, 2022. He is and always will be the love of my life, my soulmate, my heart dog.

User avatar
Olesia711
Founder & Research Director
Posts: 3858
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Leaking Mucus? Need help

Post by Olesia711 » 09 Oct 2018, 23:54

Okay, i have got to tell you, whoever you have as an internal vet really knows what they are doing!!!! :) Reason why i am saying this is because "cholestyramine" is an old treatment that they used (it's a bile acid binder/bile sequestrant) and our pups have bile acid issues whether we physically notice any symptoms or not .

Anyway... cholestyramine technically works on cholesterol and that in-turn affects the bile acid....(i can't remember if it affects the primary or secondary bile)... but short, it works and can have a positive effect on EPI dogs and help with loose stools. Getting EPI under control is like playing with dominos- -everything affects everything!

I am going to have to look up the drug "Colestipol " see if it is new on the market... the repackaging of a quality old drug... and/or if it is real expensive..... that might have been part of the problem

Anyway... in short.... i am very impressed that this was recommended :)
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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