Newbie question...

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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Danielle Crownover
Member
Posts: 9
Location: Concho
Country: United States
State: Arizona
Pet name: Monday

Newbie question...

Post by Danielle Crownover » 27 Jul 2019, 10:54

Monday's enzymes were at the vet yesterday, so we were able to pick those up - I will be buying from Diane's enzymes in future - my goodness these were expensive!

Anyway, Monday had her very first dose of enzymes with her dinner last night. Overnight she had watery, horrible diarrhea.
This morning, she is back to her normal, yellow cow patty.

How long before we see a difference in the poops before we need to adjust things?

Against the vet advice, she is now on low fiber food (4%) and higher 15% fat (vet wants her on low fat - but we are not going that route just now)

I am attributing the water bout of diarrhea to:
- She got a bath yesterday - she was not a fan
- She went to the vet yesterday - again, not a fan
- She had the enzymes for the first time on her food - it was food, so she approved, but it was a switch up by adding the enzymes and she doesn't do well with changes.
Dog Name: Monday
Date of Birth: May 18, 2018
Diagnosed EPI: July 22, 2019
Treatment began July 26, 2019 PM meal
Weight at time of diagnosis 32 lbs
Weight at time of treatment 31 lbs
Ideal Weight 40 - 45 lbs
Current Weight 31.8 lbs

Current Treatment:
Food - 4Health Chicken & Rice - dry food, 1.5 cups three times daily 6am, Noon, 6pm
PanaKare Plus Enzymes 1.5 tsp per meal, Incubated with warm water on food 30 minutes
Vit B12 injections 2x weekly (Monday and Thursday)

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

Re: Newbie question...

Post by Jean » 27 Jul 2019, 12:01

HI THERE

Your post duplicated so I deleted one

they were identical

so which enzymes are you using , and how much to say a cup of kibble ?

which food are you using ?

are you supplementing b12

any tummy rumbles ?

if you have said any of this before, many apologies

keep a journal on anything you do

could you add a signature saying what your regime is so we can keep up

any problems, please ask


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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jilbert57
Staff
Posts: 2088
Country: United States
State: Washington

Re: Newbie question...

Post by jilbert57 » 27 Jul 2019, 12:04

Lol I posted a long reply. Must've been on the deleted one!
Jean covered it. Good luck.
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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Jean
Forum Director
Posts: 1707
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: Newbie question...

Post by Jean » 27 Jul 2019, 12:06

Jill I am so sorry I checked there was nothing there before I deleted it

J
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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jilbert57
Staff
Posts: 2088
Country: United States
State: Washington

Re: Newbie question...

Post by jilbert57 » 27 Jul 2019, 13:55

I was going to ask how you prepare the food with the enzymes. Thanks
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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Danielle Crownover
Member
Posts: 9
Location: Concho
Country: United States
State: Arizona
Pet name: Monday

Re: Newbie question...

Post by Danielle Crownover » 27 Jul 2019, 14:40

The vet has her on Panakare enzymes 1tsp per meal.

We feed her 4Health Chicken and Rice, 1.5 cups per meal, 3 times per day. Her ideal body weight is 40 to 45 lbs (she currently weighs 31lbs)

Obviously, this all very new for her - new food, enzymes, etc.
First enzymes were given last night. about 45 minute incubation. She ate last night at around 6. (may have been a few minutes later, we were on a walk before dinner, observing the pretty bees in the sunflower and then Monday decided to go chasing rabbits, so that got us back to the house late)

Vit b12 shot given around 4:30 pm yesterday. 1/ml per vet instruction.
Midnight - watery diarrhea.

6AM breakfast time... after a 20 minute incubation.
6:15 AM - her poo was her normal yellow cowpie - now this was ONLY her second dose of enzymes

She is super gassy today. And I am having to keep a close eye on her as she has decided to eat poo again... I am so glad she isn't a licker... other than that she is her normal self...

You know, on her cTLIs test, doc said her Folate and Cobalamine were good, but she didn't even register for the TLI. :( It wasn't low.. it wasn't there at all!
Dog Name: Monday
Date of Birth: May 18, 2018
Diagnosed EPI: July 22, 2019
Treatment began July 26, 2019 PM meal
Weight at time of diagnosis 32 lbs
Weight at time of treatment 31 lbs
Ideal Weight 40 - 45 lbs
Current Weight 31.8 lbs

Current Treatment:
Food - 4Health Chicken & Rice - dry food, 1.5 cups three times daily 6am, Noon, 6pm
PanaKare Plus Enzymes 1.5 tsp per meal, Incubated with warm water on food 30 minutes
Vit B12 injections 2x weekly (Monday and Thursday)

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jilbert57
Staff
Posts: 2088
Country: United States
State: Washington

Re: Newbie question...

Post by jilbert57 » 27 Jul 2019, 14:54

Hi
If she is eating 4.5 cups of kibble a day she should be getting 4.5 teaspoons of enzyme If they are 6x strength.
The amount of enzymes is in accordance with how much kibble is fed, not on weight of dog or how many meals a day.

At some point if you can't get the poop right it might be the rice .Some dogs can have rice, some not. Sometimes chicken might be iffy.

If gassy it might be SID and would need to be addressed with antibiotics.
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.

Tuckaboo Pam
Member
Posts: 1345
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: Newbie question...

Post by Tuckaboo Pam » 27 Jul 2019, 21:47

Yes, my Tucker was only on the enzymes & B12 (just over the counter people pills), but it wasn't until the vet added Tylan, an antibiotic, that we really started seeing a difference. I know a lot of people use probiotics, but those gave Tucker the runs, so we stopped. As I recall, the changes came gradually, so hang in there. ---Pam
Tucker was a shepherd/lab mix--- TLI 1.3, Folate 9.7, Cobalamin 666, Lipase 38. Took Diane's Enzymes 4 teaspoons/day, Wonderlabs B12 one capsule per day, and Tylan 1/16 teaspoon/ morning (to hold SID at bay). Taste of the Wild High Prairie, 1 1/2 cups/day, with a total of 4 cups of Fresh Pet. Stopped eating everything in sight, and went from 60 to 85 pounds! Tucker was my boyfriend, and my husband was OK with that. Tucker succumbed to hemangiosarcoma, but we cherished every day we had with that wonderful, beautiful boy. I will always, always miss my sweet big boy.

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

Re: Newbie question...

Post by Madelon » 27 Jul 2019, 22:00

Hi and welcome to our EPI family. A few questions to help us get a better idea of what to suggest. What was the TLI, B12 and Folate score when tested and was your pup fasted for at least 12 hours before the test was done? What B12 shot are you giving - is it simple B12 or a multi-vitamin B12?

It sounds like you are dealing with SID (small intestinal dysbiosis), which all EPI dogs have, it's just a matter of getting it under control and then keeping it under control - easier said than done sometimes. So, first, if it were me I would switch to a grain free food with 4% fiber or less with little or no peas - several of us have recently switched to Sport Dog Food Elite with really good results but there is a list of dog food option on our website https://epi4dogs.com/dog-food-options/. Next, I would ask your vet for a prescription for Tylan antibiotics - a lot of vets are unfamiliar with using Tylan to treat SID and usually recommend Metronidazole (Flagyl), however, research has shown Tylan works better, is gentler and doesn't wipe out the entire gut flora . https://epi4dogs.com/antibiotics/

Next, the recommended starting dose of enzymes is 1tsp per cup of kibble, so unfortunately your vet has given you wrong instructions, which is common. Mix the enzymes in a little luke warm water, then mix with kibble and incubate 20-30 minutes.

The hardest part of EPI is the beginning, finding the right balance of everything to get the optimal results, but it can happen and we are here to make sure it does.
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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Danielle Crownover
Member
Posts: 9
Location: Concho
Country: United States
State: Arizona
Pet name: Monday

Re: Newbie question...

Post by Danielle Crownover » 28 Jul 2019, 10:57

...was your pup fasted for at least 12 hours before the test was done?
Yes.
What B12 shot are you giving - is it simple B12 or a multi-vitamin B12?
Vitamin B12 Injection (Cyanocobalamin) 1000 mcg/mL
It sounds like you are dealing with SID (small intestinal dysbiosis), which all EPI dogs have, it's just a matter of getting it under control and then keeping it under control - easier said than done sometimes. So, first, if it were me I would switch to a grain free food with 4% fiber or less with little or no peas
- the food she is on: 4Health Chicken and Rice - I got the brand from EPI4Dogs dog food options page. We selected this variety, even though it isn't on the list, because it has 4% Crude Fiber, 15% Fat, specifically - this one has no peas, the other ones (the ones with potato, do have pea as one of the top ingredients and higher fiber. This is one of those areas we will be watching and ready to switch out as needed. Tractor Supply is the seller, and because I live rural, I am limited in my immediate need choices.... Good news, today is much better.... one of the key things I put in my post is that she had JUST started treatment with her PM feeding on Friday. Monday is VERY sensitive to any change... on Friday these things happened: She had a bath - she hates that. She went to the vet - hates that too. She had an accident at the vet in front of a whole room full of people - she is very shy and was embarrassed so she hid behind my knees after, poor thing. She had enzymes for the first time! She was JUST coming off the vet prescribed Bland Diet and onto a new food - very sensitive. I was not super surprised she had diarrhea that night. It was a really stressful day for her. THAT SAID, only the one bout of diarrhea, since then her poos are getting progressively better in quality, and way less quantity! YAY :D!!!! This morning's poo was well-formed, still yellow, but not as soft. Fun finds, apparently Monday is eating a toy (which I have since thrown away). Coprophagia behavior does seem to be increased at the moment... keeping an eye on that. Since Friday, she has gained almost a pound in weight. INCREDIBLE!
- several of us have recently switched to Sport Dog Food Elite with really good results but there is a list of dog food option on our website https://epi4dogs.com/dog-food-options/
. - Thank you! I will look at that Sport Dog Food Elite option if we see we need a change and will order
Next, I would ask your vet for a prescription for Tylan antibiotics - a lot of vets are unfamiliar with using Tylan to treat SID and usually recommend Metronidazole (Flagyl), however, research has shown Tylan works better, is gentler and doesn't wipe out the entire gut flora . https://epi4dogs.com/antibiotics/ -
Thank you! Do you think we should wait until confirmed that we need it or just get her on it forever and ever? Do the bacteria become immune over time like with other antibiotics? After her first vet visit, she was treated with two antibiotics Metronidazole and something else. I am noticing possibly undigested food still in her stool from Thursday. Seems to be some whole rice grains (vet had her on homemade chicken and rice for nearly two weeks while we worked on figuring out what was wrong) so would not be surprised to see a bacteria issue due to the length of food stayed in her gut. What about probiotics? The food Monday is on, DOES have a healthy dose of several good gut flora - Lactobacillus
Next, the recommended starting dose of enzymes is 1tsp per cup of kibble, so unfortunately your vet has given you wrong instructions, which is common. Mix the enzymes in a little luke warm water, then mix with kibble and incubate 20-30 minutes.
Yes! Made that change yesterday midday meal
The hardest part of EPI is the beginning, finding the right balance of everything to get the optimal results, but it can happen and we are here to make sure it does.
And this is the heart of my question - Monday is super sensitive to change... When do I know I need to tweak something? How long do we try something before deciding it doesn't work? a week? 5 days? I know I am not going to see immediate changes.
Dog Name: Monday
Date of Birth: May 18, 2018
Diagnosed EPI: July 22, 2019
Treatment began July 26, 2019 PM meal
Weight at time of diagnosis 32 lbs
Weight at time of treatment 31 lbs
Ideal Weight 40 - 45 lbs
Current Weight 31.8 lbs

Current Treatment:
Food - 4Health Chicken & Rice - dry food, 1.5 cups three times daily 6am, Noon, 6pm
PanaKare Plus Enzymes 1.5 tsp per meal, Incubated with warm water on food 30 minutes
Vit B12 injections 2x weekly (Monday and Thursday)

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