Worried about Sophie, 2 yr.old Sheltie with EPI

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virtualist
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Worried about Sophie, 2 yr.old Sheltie with EPI

Post by virtualist » 05 Feb 2019, 13:06

I'm really worried about what I am doing with Sophie and her treatment. I feel as if I don't know what to do next to help her. A tiny bit of background: She has vomited on Jan. 21,23 ,and 26, Feb. 2,3 ,and 5.

Her eating regimen has been with Royal Canin wet and dry. 1/2-2/3 c. wet and 1/4 dry with 3/4-7/8 t. enzymes with Tylan breakfast and dinner. Lunch had 1 t. of Entero.

Here are the changes that I have done with her meals:

26th- switched to Metronidazole because of the vomiting
27th,28th,29th,30th - same and some great poop
31st - Slow to eat breakfast, very reluctant but ate lunch and dinner
1st - Slow to eat breakfast, added B12 at breakfast and changed Entero to 1/4 t. of slippery elm with 2T water at lunch.
But ate lunch and dinner quickly.
2nd - Wouldn't eat breakfast. Gave her 1/2 pepcid. Two hours later ate all. Then vomited an hour later 11:30 a.m.
1:45 p.m. BIG CHANGE . I switched foods to old favorites, Pedigree wet and Pro Plan dry, same amounts and
meds, Ate lunch and dinner.
3rd - Hesitant to eat breakfast. Fed 1/2 c. Pedigree wet and changed back to Royal Canin 1/4 c. dry. Meds same.
Ate about half. I put a little Parm cheese to entice her. She ate it all. Spit up a little then vomited all later.
Lunch and Dinner changed back to royal canin for wet and dry and kept meds the same. She ate about 1/2 then
finished all within an hour.
4th - Breakfast and lunch back to original regimen with the royal canin with the enzymes, metro, slippery elm, B12.
10 a.m. PERFECT POOP!!! I was so excited....
Dinner added a little chicken broth 2T. and crushed up the heartworm pill in her food. Very reluctant to eat and
she finally finished all after and hour and a half
5th - Breakfast same as above. Gave metro in a little tuna salad. 11:00 am vomited at least 1/2 of her food with a
litle white in it.

I don't know what to do. Sophie is active, plays, very affectionate. I can tell she is hungry and she would love to have bites of our meals which she was used to having. She begs for treats. But no changes really in her behavior. With all the snow and ice last week, I didn't go out to check every day on her poop. Yesterday and today I have seen enough in the yard to say that her poop is brown and well formed for the first 6-10 inches and then there may be a soft "dot" of brown soft poop. So this is a huge improvement since Dec but it isn't normal yet. The one day I was thrilled to see the perfect poop!!!

Should I give the slippery elm at breakfast? I didn't think I was to give it with the antibiotic which is am and pm. Should I change when I give the B12? I read many of the posts and see what a range of food people give to their dogs. How do you decide what to give.? Today I'm going to go just to read the ingredients etc. on bags of dog food and the cans. I can't tell if Sophie isn't eating because of the food or the meds or both. ALso should I change back to Tylan?

I have to give regular food to give her the metro pill. I give it after she eats so she has the enzymes in her but I wonder if that is upsetting her. She gets about 2 t. of our food, one to entice her and then another with the pill.

I'm really floundering here and feel so guilty and badly for Sophie....that I am not succeeding with helping her. Please tell me what you think I should be doing to help her. Our two weeks prescription of the metro is done in about 3 days.
Sophie is not losing weight. She weighed 30.5, then lost weight to 26.6, then has gained back to 29.6 and yesterday weighed 29.8. Thank you in advance for any advice. Today I'm just going to feed her the regular lunch. And hope she can eat it.
Sara Simpson

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Madelon
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Re: Worried about Sophie, 2 yr.old Sheltie with EPI

Post by Madelon » 05 Feb 2019, 21:12

Hi there. Take a deep breath - you've got this and we're here to help. First - try to only make one change at a time and wait 3-5 to see the results. I highly suggest cutting up some carrot and putting it with the food - then watch poop closely for the next 72 hours - when you see the carrot in the poop that will tell you your dog's digestion time so you can correlate it to the correct feeding. I'm thinking the good poop you got was from the prior days meal when you went to the pedigree can and pro plan kibble.

I would try backing off the enzymes - too much enzymes can cause loose stool just like too little enzymes can. If you are feeding 1/2 cup dry then you would need 1/2 tsp enzymes - then if you add 1/2 can wet I would use 1/4 tsp enzymes. As for the B12 - it doesn't matter when you give it - what matters is the amount. If you are using the WonderLabs Pet Factor B12 pills I would start with 1/2 a pill 1x day.

There are four cornerstones to managing EPI:

1 - Enzymes (discussed above - be sure you are mixing with a little luke warm water, then adding food and sit 20-30 minutes before serving)
2 - B12 (discussed above - supplementing is for life)
3 - Antibiotics (discussed above)
4 - Food (grain free with 4% fiber or less - feed 150% of the food for the weight your dog should be but in smaller meals throughout the day until you reach ideal weight)

EPI can be a bit frustrating in the beginning but it will get easier.
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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Shirl D.
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Re: Worried about Sophie, 2 yr.old Sheltie with EPI

Post by Shirl D. » 05 Feb 2019, 22:30

Hi Sarah,
The first thing that really stands out to me is that the food you are feeding (Royal Canin) is almost never tolerated well by an EPI dog. I'm not sure about her old favorites, either, because some of their foods have rice (typically not tolerated by EPI dogs). It sounds like her stomach is most likely not feeling great, based on both the reluctance to eat and the vomiting. It could be a couple different things. Acid reflux is one. You mentioned Pepcid at one point, but I wasn't sure if she is getting it regularly or not. You could give her a dose before her breakfast and dinner and see if that helps. You should give it 20-30 minutes before she eats. I gave Pixie Pepcid for a long time because she was having some problems with reflux. I would put her enzymes in her food, give her the Pepcid, then wait 30 minutes until her food was ready and feed her. The wait was perfect for both the enzymes and the Pepcid. Another possibility is that she may be still struggling with SID because of the food she is eating. If the food doesn't agree with her, it may not be digesting properly causing problems in the digestive tract. My recommendation would be to change foods to a good quality grain-free food with less than 4% fiber. Make sure that most of the protein comes from meat, with as little peas and legumes as possible. Buy a small amount at first until you see how she does on the food. Sometimes it takes a while to find a good fit in terms of food. At this point I would also just feed her the recommended amount of food for her weight. Since she doesn't need to gain any more weight, she shouldn't need the extra food. If she's eating more food than she needs, it might reduce her appetite (she may just not be hungry because she's eating more than she needs). (I don't know if you're feeding her 150% of her recommendation or not, but I'm mentioning this just in case.)
As Madelon said, make one change at a time and wait 3-5 days to see what happens before you make another change. I would just stick with the metro until the prescription is up in a few days. You may or may not have to start the tylan again, but I think changing the food is the more pressing change to make first.

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Re: Worried about Sophie, 2 yr.old Sheltie with EPI

Post by Jean » 06 Feb 2019, 03:40

i will add my stand on Royal Canin

unfortunately, it just didnt work for Kara, and as Shirl says, it doesnt with a lot of our EPI dogs

clearly, you are keeping records, and that is so important when things are not adding up

I too would change the food to a grain free, low fibre food preferably without chicken and chicken fat, again a lot of our dogs are intollerant of chicken in dog food, mine included, and no rice

as to acid reflux, we use Ranitadine (zantac) 30 mins before food, not so much now but it worked for us

is any of the sickness first thing in the morning

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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Re: Worried about Sophie, 2 yr.old Sheltie with EPI

Post by Olesia711 » 06 Feb 2019, 19:34

How is Sophie doing today?
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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Re: Worried about Sophie, 2 yr.old Sheltie with EPI

Post by virtualist » 10 Feb 2019, 18:27

Thank you for your advice. I have been trying to follow your advice before replying. Sophie ate well and was not sick the rest of Tues the 5th. Wed the 6th she ate well and quickly. I had to leave prepared food for dinner for my husband to give her. When I returned, she vomited at 10 p.m. Brown liquid and a little food. Thursday the 7th, I gave her 1/2 pepcid before breakfast. She ate all fine. Then I felt the advice you all gave was to change her food. So I changed the wet RC food to Whole Earth adult wet food. I kept all else the same. All 3 meals on Friday the 8th were fine and no vomiting. And I continued with the Whole Earth wet food. However, at dinner on Friday, I noticed some swallowing and burping so I gave her another 1/2 pepcid and she finished all her food later. Sat the 9th , breakfast was fine. After lunch, she vomited almost immediately, all food, no brown liquid. Dinner was fine. Today, Sun the 10th has been the 4th day with the change of wet food. Breakfast was at 7:40 and she vomited at 11:00, brown liquid and some food. I gave her 1/2 pepcid. She had lunch at 12:40 and she didn't want it at all. We were outside for some time and she raced around with Katie, our other Sheltie, for 15-20 minutes, playing hard. Then came in and ate all her lunch. We left at 2:45 for errands and returned at 5:15 and she had vomited...some food, not very much brown liquid. It is 6 and I haven't fed her dinner yet.

I have a unique situation at home in that my husband has dementia. He sometimes understands what we are doing to help Sophie and other times, he doesn't and thinks we are making her life miserable and he wants to just feed her what she used to eat. It is terribly frustrating. AND when I cleaned up the vomit 3 out of the 4 times, I found table food. Not much but it was from our meals. My husband obviously had given her bites from his plate. I do my best and will have to do better in watching him when we eat. I don't know that it was enough table food to make her vomit. I also don't know if it is the new wet food. It is difficult with Larry, my husband, because he doesn't understand what we have to do to save Sophie and he complains at times that I am killing her. I explain and explain but he doesn't comprehend what we are having to do at times and other times, he is really understanding and helpful.

I did get another prescription for the metro for another 2 weeks. She now weighs 30.6 lbs which is what she weighed before the weight loss started. I am cutting back a little on the wet food going from 1/2 c. to 1/3 c. I still feed her 3 times a day. She gets 3/4 t. enzymes with 1/3 c. wet and 1/2 c. dry (RC still) with one B12 capsule with breakfast, 1/2 t. slippery elm with lunch, metro morning and night.

Why is she vomiting? She is gaining weight. Her poop is not all normal but always brown and probably 2/3 of it is formed and 1/3 softer. Should I try a different wet food? She likes the Whole Earth wet food. Should my next change be a different dry food? I will start giving her 1/2 pepcid 30" before eating breakfast and dinner. Do you count that as a change? Should I just try the pepcid and not change anything else? i am at a loss. She must be digesting some food because she has gained back all her weight loss since Dec. 26 when we started her meds. Should I cut her back to 2 meals because I took it seriously your advice that she may not be hungry some of these times. But normally she wolfs down her food and even after she vomits, she is ready to eat the next meal.

It helps me so much to have your support and advice. I am trying to do what you are suggesting but I don't know which foods to change to. It is overwhelming to check all the foods at the pet store. Thank you for responding so quickly with such good detailed advice. It is immensely helpful to me.

Sara Simpson

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Re: Worried about Sophie, 2 yr.old Sheltie with EPI

Post by Olesia711 » 10 Feb 2019, 20:14

Oh Sara, my heart is just breaking for you....it is SOOOooooo hard to be a caregiver for a loved one with dementia or Alzheimers. My mom lived with us and had dementia in her final years and it can be very very wearing......... and then they really don't understand when you explain and although you understand that they don't understand, it still gets very frustrating..............

Regarding Sophie, based on what you wrote...for now i would continue with the Earthborn food...she may have vomited because she played hard and then came in and ate.... and then when you returned home, you had to clean up the vomit... *sigh*.

if your hubby is sometimes sneaking her your food.... that might be triggering the now once-in-a-while vomit episodes- -the good news is that it won't do any serious damage to her but she will continue to have a bacterial infection in her tummy.
The underlying cause of the initial bout of the brown liquid vomit was a bacterial infection/gut flora imbalance. Is she all done with the Metro? If yes, is there anyway to convince your vet to give her a short course of more Metro (just for another 7 to 10 days?) or better yet....ask for Tylan antibiotic instead for a short 14 day course/twice a day. Her bacterial infection sounds like it is still lingering.. just not as much and possibly when hubby sneak her food, that is when she vomits, but the fact that the vomit is still a little brown liquid.... that to me indicates that the bacteria is still present.

For now (as a next change) you can add the pepcid AC (temporarily) to see if that helps prevent the vomiting.

See how this goes.

If still the once-in-a while vomit happens and you cannot tie it to food you husband gave her..... and if your vet will not let you have more antibiotics..... what you then might want to try is feed her a smaller portion of food just sneak in another meal sometime during the day to make sure she still gets all the food that she requires.

Please keep us posted... it sounds like you ARE making progress, but just not fully "there" yet.................
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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virtualist
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Re: Worried about Sophie, 2 yr.old Sheltie with EPI

Post by virtualist » 11 Feb 2019, 15:29

Thank you for understanding and your kind words. I will give her the pepcid for a few days for breakfast and dinner. And I will continue with the whole earth wet food. I did get two more weeks of the metro but I still have tylan and could go back to it for 2 weeks twice a day 1/8 t. Should I continue with the metro or switch to tylan? I can do either. The tylan is much easier to give but we manage with the metro pills.

I really thank you for your patience with me and Sophie! She is such a love and bless her heart, she never ever complains or behaves badly with all her meds and funny food. I have to figure out how to put her picture on my posts.

Is there any type of chewy that she can have? She was used to chewing on bully sticks and loved them. She started chewing on the toy box (cardboard) two days ago and she chews on her toys. I suppose she can't but I thought I'd ask.

We're having more snow which the dogs love!
Sara Simpson

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jilbert57
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Re: Worried about Sophie, 2 yr.old Sheltie with EPI

Post by jilbert57 » 11 Feb 2019, 17:16

I would say to use the pepcid consistently for at least a week to give it a chance to work. How long have you been using the metro? Does it seem to be helping? I would try giving the bully stick right after an enzymed meal. That being said we usually recommend waiting for the pup to be stable a month before giving treats. Maybe Nylabones or other non edibles.
My name is Jill and we live on the Hood Canal in Washington State. We currently have 2 Jack russells, TJ is 8 and Sadie is 2.

Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.

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Re: Worried about Sophie, 2 yr.old Sheltie with EPI

Post by Madelon » 11 Feb 2019, 20:56

Sarah - you are dealing with so much. I can only imagine how hard it is - my father has dementia and I know my mom has said many times it can be exhausting. Sophie is very lucky to have you.

One thing I'm wondering is you said you're still giving her the RC dry food. Which one is it? If it's the rx dry food, that too could be the problem and something to consider changing to see if it helps. Maybe try and get the kibble version of the Whole Earth wet that you are feeding. I personally would not give her bully sticks until you've figured out/eliminated the vomiting.

Please keep us posted. Sending you hugs.
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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