Epi4Dogs

I am so thankful to have found this website and forum. Sorry this is so long!
Peanut my 7 year old 10lb Havanese (was originally 14 lbs) has had diarrhea for almost 6 weeks now. Background history-- She has struggled with a poor appetite at times, and 6 months ago had a bout of pancreatitis. which she seemed to recover from except the weight loss.
Currently she has a very good appetite. Our original vet put her on a prescription of Metronidazole for 10 days and gave her science diet id canned chicken stew. After not much improvement, I called the vet, and couldn't get in for 4 days but was told to give her her regular diet Origen regional red, as maybe it was a chicken allergy. They prescribed Entero truBenefits. Things didn't improve and after being told I'd have to wait another 3 days to get a GI panel done, I went to a new vet. He did the GI panel immediately. Told me her pancreas was not working right, she wasn't digesting her food. He made further calls to the lab and told me her pancreatic enzymes were very low. Her B12 level is not sufficient.
He didn't tell me she had EPI, but I am assuming she does. He told me her enzyme levels . It was a phone call, and I don't remember them. I will get this info after the holiday weekend.
He prescribed Viokase for her, told me this could be a long term thing. I started her a few days ago. Her stool got worse almost to all liquid. I was giving her 1/2 tsp 3 times a day with Royal Canine canned low fat GI food. She probably eats 3/4- 1 13 ounce can a day. I kept giving her the Entero as well at this time.
I spoke with the vet and he told me she needed a weekly B-12 shot, which she received yesterday for the Viokase to be effective. He also said to lower the dose of Viokase to 1/4 stsp. twice a day.
She still has very watery stools today. I am wondering how long the B-12 shot takes to work. She has a very loud rumbling tummy.
I am very confused on the dosage. I am also wondering if the combination with the Entero is causing the diarrhea. My vet told me too much Viokase can lead to diarrhea as well.
Entero contains a phylaxobiotic™, a source of live (viable) naturally occurring microorganisms, their required nutrient source and natural gut stabilizers.
I just want to know if I am doing the right thing with Peanut. If I should discontinue to Entero, change the dosage of the Viokase, stop the Viokase all together until the Vitamin b-12 deficiency is addressed. My vet is gone until Tuesay!

Hi and welcome to you and Peanut.
The recommended amount of enzyme depends on how much food your dog eats. The dose is 1 level teaspoon per 1 cup dry food or 3/4 teaspoon per 1 cup of cannes food. Ever meal needs enzymes.

Is your dog showing discomfort after eating? Just wondering if Peanut never got over Pancreatitis. If it is Pancreatitis it is not recommended to give a probiotic. It is thought to restrict blood flow to the stomach.

Also the canned i/d stew was among the food on the recall over the past months. That might be in the picture?

What test was performed to know her pancreas wasn't working right?

I know you have changed to the RC canned food. We really can only tell you what we would do if it was us in your situation, but since your vet has given you a protocol to follow I might follow it until you can take her in on Tuesday.

It might also be good to know which B12 shot the vet gave.

If it was me I would go basic back to only food with recommended amount of enzymes and water. I suspect with the tummy rumblings SID might be going on in the gut and a 45 day course of antibiotic might be needed.

https://epi4dogs.com/sidsibo-in-brief/

I checked the recall list before giving her the Science Diet ID. She seems to like the Royal Canine GI Low fat canned more right now. I will stop the Entero - probiotic for tomorrow.
She doesn't appear to show any discomfort after eating. Just ends up having diarrhea usually within 3-4 hours of eating.
So the dosage 3/4 tsp per cup of wet food doesn't matter for the weight of the dog?
Is it possible to mix the enzymes with the canned food and keep it refrigerated, then take out smaller feedings when needed, allowing them to reach room temperature and waiting 15-20 min before serving?
Thanks for your help!
I will pot the lab results when the vet returns Tuesday.

Hello and welcome!!! The amount of enzyme is directly proportionate to the amount of food. The Viokase is a 1 tsp per 1 cup dry food and 3/4 tsp per cup of canned or wet. If Peanut was eating a good solid kibble with 4% or less fiber, go back to it and add the appropriate amount of enzyme. Add enough water to dissolve the enzymes and cover the food, then let it sit for 20-30 minutes stirring once or twice during that time and again before serving. Did your vet say anything about b12 supplementation? The little ones all seem to drop their b12 quickly. We ended up doing a combination of b12 injections (at home) and Wonderlabs b12 capsules with the intrinsic factor added.
Susan

Yes, Peanut just started B-12 shots once a week. Thanks for the info on the food. Right now she is gobbling down the Royal Canine low fat GI canned and it's easy to mix with the Viocase so I guess I will stick with that for a bit. She was a very picky eater before the diarrhea started.
Peanut does not have yellow- tan stools. Her poop - diahrrea is brown like the color of the canned food. I think it is just going right through her.
Thanks for the feedback. I would love to get her back on her grain free orijen kibble eventually.

The dogs do love the Royal Canin but it contains grain, which can interfere with the efficacy of the enzymes. Have you tried the grainfree Origen with the enzymes?

If he's eating, that's half the battle, as a lot of dogs don't like to eat with the enzymes in their food. Stay with it for now, but understand it might not be the best food for the long run. For now, adjust the enzymes and see if you don't see an improvement. One thing that worked for us when we fed raw (same ratio as canned), was we took the daily amount we were feeding (ended up being a half a cup a day) and prepared the entire day's food at one time. Rather than trying to figure out the ratio for three or four tiny meals a day, it was much easier doing it at one time. After we added the enzymes and allowed the food/enzyme combo to "incubate", we refrigerated the food we weren't feeding for that first meal. When we fed the subsequent meals we just allowed it to warm to room temperature and fed the meal. Just letting you know one way we made things easier on ourselves with the little dogs.....
Susan

Hi and welcome to our EPI family. First you've been given great advice on the dosage of enzymes - be sure to incubate for 20-30 minutes with food before feeding. Second, the food might be an issue. There is no need for prescription food unless there's another underlying medical condition requiring it. As Jill said, it contains grains which can interfere with efficacy of the enzymes. We recommend grain free food with 4% fiber or less. Be sure to keep a detailed log of everything you give and everything that comes out When you get the results be sure to post them.

So Peanut went from midnight until 9:30 AM without having diarrhea, which is pretty good for her. Her poop was still pasty but not all watery which was an improvement. After squatting several places in the backyard, she came in only to have a little very liquid diarrhea on a pee pad with some tiny specks of red blood. She then had a yellow mucousy type. At first I thought maybe she threw up but I don't think so. This is the first time I have seen a yellow mucous from her and specs of blood.
Looking for feedback here. At first I thought I should take her to the emergency vet, but she just ate a little bit and seems normal other than a little less appetite than normal. The specs of blood could be from straining. They yellow mucous is strange.

I found this by googling yellow mucous in dog stools:

https://www.caninejournal.com/dog-poop-color/