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

Post by Olesia711 » 22 Dec 2018, 22:42

it is very possible that she has IBD also..... we see this a lot.

Try to have a wonderful holiday, don't worry too much.... and we'll pick up after the holidays!!!

Merry Christmas and Happy New Year!
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 » 01 Jan 2019, 16:13

So, an update on Loo. Her smell seems to have gone away. She is continuing to receive the 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 and has a variety of meds for separation anxiety. (We were working on that prior to the stomach issues taking over). She also has Gabapentin 200-300mg as needed for discomfort and Cerenia 24 mg as needed for discomfort. Here is what I’ve noticed:
1. Her smell seems to have gone away!
2. Her poops continue to be fine (they always have been), 2, sometimes 3 on the scale.
3. She doesn't have a huge appetite. (They accidentally sold me the reduced fat Purina EN wet food, so that might not help either with the appetite, but even before that, she was skipping meals). She often doesn't show interest in her breakfast (skips 1 out of every 2-3 meals). She usually eats her evening food.
4. After eating, she shows some signs of upper indigestion. She usually will let out a burp and usually will do the licking her lips mixed in with mouth opening (yawn-like) behaviors. I'd say 1 or 2x/week, she's been uncomfortable enough that she will climb on me in bed. She hasn't had pain bad enough that she'll whine, but still, she doesn't seem fully comfortable. I haven’t noticed loud gurgling as much either.

A couple questions:
1. Any next step suggestions? I’ve thought about whether I should switch her to the Hydrolyzed protein diet for now given the possibility that she could have IBD or something else as well.
2. Another vet mentioned that she might just hold food in her stomach too long and that could be causing the discomfort. She noted that this would be “treating the symptom” vs “underlying cause”, but suggested that a med called Reglan might help. I will ask the internal med specialist about that.
3. I looked at the website for Creon. When I tried to create an account, it told me I couldn’t add Creon to a pet’s cart. Is there some trick to this?
4. Is it okay for her to have been on the Tylan for this long?
5. I honestly wonder if EPI is her real issue. Her TLI level was 2.6. Does that mean that even if she is slightly above the dx level, it is still a sign that her pancreas isn’t at top notch condition? I mean, is it low enough to assume that she needs enzymes to really process her food.
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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Jean
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Re: Enzymes-My pup smells awful!

Post by Jean » 02 Jan 2019, 08:02

hi

well good on the smell going away

yawning sometimes is a symptom of stomach upset, does she ever bring up froth

we had the yawning thing with Kara, we gave her Ranitidine 75mg 1/2 hour before food, it worked for us

can I ask, does the Fluoxetine help with Anxiety Separation ?

2..6 cTLI is very close to EPI positive

the drug you mention is Metoclopramide, and I would look up the side effects

have a look at this

http://www.marvistavet.com/metoclopramide.pml

this in particular

The chance of neurologic side effects is increased when metoclopramide is used in conjunction with mirtazapine, an appetite stimulant. The same is true when metoclopramide is combined with antianxiety medications such as amitriptyline, clomipramine, and fluoxetine.




please ask your vet about this

being on Tylan is fine Kara has been on it for 7 years

I will leave the Creon thing to maybe Olesia, I will ask her

Jean
My name is Jean we live in Liverpool in Uk

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 use Panzym enzymes, Tylan and Chemeyes b12 capsules

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


Jeanx

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Caroline831
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Re: Enzymes-My pup smells awful!

Post by Caroline831 » 02 Jan 2019, 11:50

Jean,

Thanks so much for catching that about the potential interactions! I will mention this to the vet. I will also ask about Rantidine or something else to give prior to the meal.


I don't notice a ton of difference with the fluoxetine at this point, however, I believe she is on a low dose. I was working on the separation anxiety piece but then the stomach stuff took over and we've kind of put the separation anxiety part on the back burner for now...
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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Jean
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Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara
My name: Jean

Re: Enzymes-My pup smells awful!

Post by Jean » 02 Jan 2019, 12:44

someone I know has the same isue, and was thinking of Fluoexetine (Prozac)

i have taken it for years !

Jean
My name is Jean we live in Liverpool in Uk

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 use Panzym enzymes, Tylan and Chemeyes b12 capsules

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


Jeanx

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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 » 02 Jan 2019, 15:59

Hi and Happy New Year (my apologies, i've been off for the holidays)

Anyway... Jean gave you some great info and i would like to also give you some more input regarding your questions.

Oh.... but before i do... Jean's suggestion about the Rantidine.... is a very good suggestion... i was going to suggest it also... BUT talk to your vet and ask first about using this ( this would be for acid reflux)... OR.... if the vet feels you should try the Reglan first.....just check with the vet.

okay your questions:

A couple questions:
1. Any next step suggestions? I’ve thought about whether I should switch her to the Hydrolyzed protein diet for now given the possibility that she could have IBD or something else as well. Maybe not yet... although keep this as a possibility. i would first try an antacid or Reglan.... see what this adjustment yields
2. Another vet mentioned that she might just hold food in her stomach too long and that could be causing the discomfort. She noted that this would be “treating the symptom” vs “underlying cause”, but suggested that a med called Reglan might help. I will ask the internal med specialist about that. Definitely ask about this and/or an acid reflux med- -which would be more appropriate.....
3. I looked at the website for Creon. When I tried to create an account, it told me I couldn’t add Creon to a pet’s cart. Is there some trick to this? They won't allow you cause CREON is legally a human drug.... USA doesn't produce enteric coated enzymes for dogs, whereas the UK has these products, but this is why we use CREON for some of our dogs- -also because CREON is available world wide.... Your vet can write you a script and you can have your local pharmacy fill it OR..... what i did was order some from Canada :) https://ycdscc.com/
4. Is it okay for her to have been on the Tylan for this long? Absolutely. Some EPI dogs stay on Tylan for Life.
5. I honestly wonder if EPI is her real issue. Her TLI level was 2.6. Does that mean that even if she is slightly above the dx level, it is still a sign that her pancreas isn’t at top notch condition? I mean, is it low enough to assume that she needs enzymes to really process her food. That is so close to EPI that i would treat it as EPI.... after, the testing is not an exact science, but rather a range. HOWEVER.... what might be needed (and this is something you might want to try as a one-thing-at-a-time trial... is that she may not need a full dose of enzymes but rather3/4 or even just 1/2 dose of enzymes................
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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Madelon
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Re: Enzymes-My pup smells awful!

Post by Madelon » 07 Jan 2019, 20:42

Hi - I just wanted to see how things were going.
MADELON and Doc. DX EPI and SIBO: 5/22/2015
Test Results: (1st) 7/2014 = TLI 16.5, B12 894, Folate > 24; (2nd) 5/2015 = TLI < .4, B12 406; Folate >24; (3rd) 10/2015 TLI < .4; B12 >1000; Folate 14.4. Prior to DX: May 2014 (2mos) - DX coccidia/bladder infection; July 2014 (3mos) 1st EPI test = TLI 16.5, B12 894, Folate >24 - Dx SIBO not EPI; Feb 2015 thru May 2015 - weight loss only; May 2015 vomitted several times, diarrhea and eating poop. Regimen: 4 cups Sport Dog Food Elite Herding - Diane 6x 1tsp per cup; 1 WonderLab PetFactor B12 2x day; 1/2tsp Slippery Elm 2xday; Multivitamin; 1 Zyrtec 10mg 2x day; Salmon Oil

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Caroline831
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Country: United States

Re: Enzymes-My pup smells awful!

Post by Caroline831 » 15 Jan 2019, 17:15

I am looking at the Canada website (https://ycdscc.com/). How long does it take to get the enzymes usually? I realize I only have 1 weeks supply left (I have been a bit overwhelmed by all of the meds she's taking and just lost track). I can always try the ones where you mix it with food and wait 20 minutes if i run out of these, but I imagine she won't like it!

Apologies for being dense, but i just want to clarify a few things regarding the Creon and theCanada website.
I create an account and request Creon 10000. I'll need to get a prescription from my vet that is for the same amount.
When i'm creating an account, it's asking about height, weight etc... what am i putting, 1 foot tall, 30 lbs? I just laughed out loud imagining someone reading that.
After all that, it says "submit order", but it hasn't asked me to upload a prescription... I assume it will ask me to do that after submitting.

Things are about the same with Loo. Smell appears gone. She still does a decent amount of lip smacking, yawning after eating. I've heard stomach gurgling and given her nausea pills occasionally. It seems manageable at this point, but also like I'm missing something.
Also about 10-15 minutes after eating, she will go and lick the bowl clean again, and go around doing what seems like she is looking for more food. She will go around the kitchen or other rooms, smelling everything, licking places on the ground etc. I suppose the licking could be nausea, but there it also seems as if she is food focused.
Vet suggested either trying Cerenia consistently for a bit, or Omeprazole 10mg in the evening (a few hours after eating). He mentioned that dogs tend to build a tolerance to the -dines (famotidine, rantidine etc...).
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 » 16 Jan 2019, 11:04

Your vet is 100% correct (and i am so glad to see a vet actually say this).... that YES!!!! those wonderful problem solving acid reducers that we give our dogs often do stop working after taking it consistently for a period of time.

If this happens.... the solution is to stop using that particular acid reflux med... either see if the dog can get along without it for a while... OR.... switch to a different type of acid reflux med... temporarily. The interesting thing is that you actually will be able to go back to the original acid reflux med that stopped working once your dog takes a break from it.... but in the future, you will once again have to 'take a break" from it.
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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