Enzymes-My pup smells awful!

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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Caroline831
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Enzymes-My pup smells awful!

Post by Caroline831 » 04 Nov 2018, 16:09

Hi! My dog started taking pancreatic enzymes (pancreaplus i believe) a few months ago and I wanted to ask others whether they have dealt with a TERRIBLE odor... I'm honestly not sure what to do at this point. It doesn't seem to be coming from anywhere in particular, more just a general aura of stench. Any advice or tips would be appreciated!

Also, a few other points, in case they might be relevant somehow:
When she had her pli levels done, they were sub clinically low as opposed to full EPI. The vet is not 100% positive if this is the issue or if it could be more connected with something else like inflammatory bowel disease.
She was honestly never excessively food motivated prior to the enzymes. She'd usually eat it, but sometimes wouldn't in the AM if she was worried i was leaving her :roll:
Since she started taking the enzymes, I feel like she's become MORE interested in food. Licking the bowl, sniffing around, more begging with human food which she never did before.
Lastly, she's a somewhat small wheaten terrier (~30 lbs) and is currently taking 1 big tsp of enzymes with her meal 2x/day. I mix it with wet food and water and let it set. Then I may add some of her dry food before giving it to her 20-30 minutes later.

Any advice would be really appreciated!
New to EPI... Loo is a 5-year-old wheaten terrier muppet pup. Rescue to me, likely puppy mill hx :cry: History of "sensitive stomach", numerous late night crying pup/panicked mom ER visits.
Loo’s testing (8.2018): ~30 lbs. TLI=2.6, B12 levels=414, Folate=10.
Meds: Creon 10k, Tylan 375mg 2x/day, Vitamin B12 with intrinsic factor (Folic acid ~400mcg and vitamin b12-~500mcg) 2x/day. As an FYI, she also takes Fluoxetine 30mg 1x/day for anxiety.

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Olesia711
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Re: Enzymes-My pup smells awful!

Post by Olesia711 » 04 Nov 2018, 16:56

ahhh... the "stink". Many of us have experienced that smell to one degree or another. The EPI researchers say that it is "putrifaction"
Definition: Decomposition or rotting, the breakdown of organic matter usually by bacterial action, resulting in the formation of other substances of less complex constitution with the evolution of ammonia or its derivatives and hydrogen sulfide; characterized usually by the presence of toxic or malodorous products.
Synonym(s): decay (2) , decomposition
[L. putre-facio, pp. -factus, to make rotten]


Whether your dog has IBD, EPI, PLE Chronic Pancreatitis, or any other gastrointestinal situation.... this putrefaction can happen. I suspect although i do not know for sure) is that when there is a problem and THEN we give enzymes that help maybe somehow this gets the rotting stuff moving and that is why we then start smelling it. Typically with our EPI dogs, once you get the SID (small intestinal dysbiosis) under good control this stench goes away... or else we "think" it goes away cause we no longer smell it. If it is any consolation, you are not alone. we actually did a survey on it... in time "most" said the smell went away. Some got it to improve when they changed the food, added B12, did antibiotics..... but if you step back and look at the big picture, al these fixes are also part of the treatment to getting SID under good control in an EPI dog :)

I am sure you were hoping for a quick and easy solution,, but unfortunately.... this stench takes it sweet ol time going away...........

THe fact that your pup is now more interested in food could be simply because they enzymes have made her feel better overall.... of because she is segueing into EPI and it is really helping.

FYI... your preparation is good, but you mentioned heaping tsp.... rule of thumb to start with is a level tsp per 1 cup of food... not per meal....is her meal size approx 1 cup? If more than a cup but if her poos are good... then i would continue to use the ratio you are using "IF" you feel that she is now doing well, especially since your pup is not yet clinical EPI. Sometimes when you don't have a confirmed diagnosis, you jsut have to play around with things until you find a protocol that appears to help while you continue to look for what might be wrong.

What was the TLI score? (not PLI which is for pancreatitis)
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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Patsy
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Re: Enzymes-My pup smells awful!

Post by Patsy » 05 Nov 2018, 15:04

Hi there. This is probably irrelevant, but wheaten terriers are genetically prone to PLE (protein losing enteropathy), which my epi dog suffered from and pulled through. Has you vet excluded this?
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.

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Caroline831
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Re: Enzymes-My pup smells awful!

Post by Caroline831 » 05 Nov 2018, 15:11

OOPs... Loo typically eats 1 cup in AM and Evening. When I started enzymes, I believe I was doing 1.5 tsp per meal, but she had a really hard time starting out and was vomiting, so it was lowered to 1 tsp/meal and i gave her anti nausea meds with it fora few days and she did well with them.
Last time I spoke with the vet (an internal med specialist), he said i could lower it to 1/2 heaping tsp/meal. She's been doing well on all of it in terms of normal looking poops, but the SMELL is BAD...

I am about to call the doctor and discuss it more, he seemed surprised by the smell, but im going to let him know what you said too!

Will get back about her test levels.
New to EPI... Loo is a 5-year-old wheaten terrier muppet pup. Rescue to me, likely puppy mill hx :cry: History of "sensitive stomach", numerous late night crying pup/panicked mom ER visits.
Loo’s testing (8.2018): ~30 lbs. TLI=2.6, B12 levels=414, Folate=10.
Meds: Creon 10k, Tylan 375mg 2x/day, Vitamin B12 with intrinsic factor (Folic acid ~400mcg and vitamin b12-~500mcg) 2x/day. As an FYI, she also takes Fluoxetine 30mg 1x/day for anxiety.

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Olesia711
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Location: North Carolina
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Re: Enzymes-My pup smells awful!

Post by Olesia711 » 05 Nov 2018, 16:01

Yea... the stench most likely will go away..... eventually.

If you want to have a good chuckle... here is the survey we did on stinky EPI dogs :
https://epi4dogs.com/epi-odor-study/

Glad you reduced the enzymes..... too much doesn't always agree with them either. We found starting at 1 level tsp per cup is a good overall average place to start.

When reducing the enzymes further..... just reduce by 1/8 tsp.... watch the poos for 3 to 5 days.... and if poos are still good... then reduce again by another 1/8 tsp.... and again... watch the poo output and assess.

You can slowly keep reducing in the above manner until you notice the poos going soft..... that is when you know you went too far in reducing.... and you should go back up to the dose that still produced good poos.
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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Caroline831
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Re: Enzymes-My pup smells awful!

Post by Caroline831 » 05 Nov 2018, 16:20

Thanks for the advice!
It's appreciated.

I did ask my vet about kidney concerns and he looked back at the testing and said that she didn’t seem to be losing proteins in urine, so not concerned about kidneys at that time.

Loo may be an interesting case. She didn't go in because she was losing weight, she went in because of stomach issues, inconsistent, but chronic, sometimes gas, sometimes nausea, sometimes whining with pain, sometimes diarrhea, sometimes totally fine for months. After numerous late night ER visits because she was squealing in pain, I wanted them to start looking into it.
She had ultrasound, blood work etc. Didn't find much initially. When she had an ultrasound, found her stomach had significant inflammation extended into the first part of the intestines, throughout layers of the stomach. 1 is too thick, but not disruptive (didn’t think it was cancer=like pattern). When they did the test for her TLI levels, they found them to be "sub clinically low" on 2 different occasions (i'll post numbers when i speak with the vet later today). I find it interesting that he was so surprised by the stench because he specializes in these issues, but who knows...

I think his idea was try the enzymes first since we know her levels are lower. If that doesn't help, possibly move on to inflammatory bowel disease testing... I am thanking my lucky stars i chose to do pet insurance with her. At this point, it's been cost effective and hugely helpful.
New to EPI... Loo is a 5-year-old wheaten terrier muppet pup. Rescue to me, likely puppy mill hx :cry: History of "sensitive stomach", numerous late night crying pup/panicked mom ER visits.
Loo’s testing (8.2018): ~30 lbs. TLI=2.6, B12 levels=414, Folate=10.
Meds: Creon 10k, Tylan 375mg 2x/day, Vitamin B12 with intrinsic factor (Folic acid ~400mcg and vitamin b12-~500mcg) 2x/day. As an FYI, she also takes Fluoxetine 30mg 1x/day for anxiety.

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Caroline831
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Re: Enzymes-My pup smells awful!

Post by Caroline831 » 05 Nov 2018, 18:01

hello again!
Spoke with the vet who suggested trying metronidazole for a bit.

Her TLI levels were 2.6 on two different occasions. That seems awfully close to full EPI, no?

It's a good thing we love our pups, because they are awfully stressful and expensive :roll:
New to EPI... Loo is a 5-year-old wheaten terrier muppet pup. Rescue to me, likely puppy mill hx :cry: History of "sensitive stomach", numerous late night crying pup/panicked mom ER visits.
Loo’s testing (8.2018): ~30 lbs. TLI=2.6, B12 levels=414, Folate=10.
Meds: Creon 10k, Tylan 375mg 2x/day, Vitamin B12 with intrinsic factor (Folic acid ~400mcg and vitamin b12-~500mcg) 2x/day. As an FYI, she also takes Fluoxetine 30mg 1x/day for anxiety.

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Olesia711
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Posts: 1117
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy

Re: Enzymes-My pup smells awful!

Post by Olesia711 » 05 Nov 2018, 22:59

Yea... at 2.6 you are as close as you can be to clinical EPI..

Try the Metro.... if it doesn't seem to work after 7 to 10 days... go back to your vet and ask if he can swap out the Metro for Tylan.

It is also quite possible with the heavy inflammation/thickening in intestines (i think that is what you meant in your post) that your pup might have/be developing EPI and IBD.... we see a lot of dogs that have both together.... and they are treated with enzymes (like your vet recommended), usually B12 is needed too, and if the SID is not under good control, an antibiotic is also included (usually Tylan over Metro- -but sometimes Metro works too) if the typical pre+probiotics don't get the SID well managed........BUT with IBD thrown into the mix.... what often works better than trying all kind of low-fiber food for the EPI part is to go with a true prescription hydrolyzed food... there are only 5 true hydrolyzed foods out there, and the one that seems to work better with "most" of our EPI dogs tends to be Royal Canine "Ultamino".... just sharing this with you in case this is what is going on with you pup.
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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Caroline831
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Country: United States

Re: Enzymes-My pup smells awful!

Post by Caroline831 » 06 Nov 2018, 10:28

regarding the IBD/EPI combo, I wouldn't be surprised... they haven't pursued dxing IBD at this point (because i believe it's pretty intensive), but theyve told me on numerous occasions that she isnt a typical profile for anything...

Thanks so much for all of the feedback. It's always tough to see your pup struggling, but it's great to get so much more information and really hopeful to see others have worked through it and their pups seem better.

Keeping my fingers crossed that the smell will go down at least enough so that i can convince someone to watch her over the holidays! :lol:
New to EPI... Loo is a 5-year-old wheaten terrier muppet pup. Rescue to me, likely puppy mill hx :cry: History of "sensitive stomach", numerous late night crying pup/panicked mom ER visits.
Loo’s testing (8.2018): ~30 lbs. TLI=2.6, B12 levels=414, Folate=10.
Meds: Creon 10k, Tylan 375mg 2x/day, Vitamin B12 with intrinsic factor (Folic acid ~400mcg and vitamin b12-~500mcg) 2x/day. As an FYI, she also takes Fluoxetine 30mg 1x/day for anxiety.

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Olesia711
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Posts: 1117
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy

Re: Enzymes-My pup smells awful!

Post by Olesia711 » 06 Nov 2018, 22:41

Hopefully she starts feeling better soon.... and that the stench starts to subside... in time for the holidays :)
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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