Bella - Involuntarily leaking liquid/nausea/gurgling

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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sjbernardo
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Posts: 4
Location: O Fallon
Country: United States
State: Illinois
Pet name: Bella
My name: Suzanne

Bella - Involuntarily leaking liquid/nausea/gurgling

Post by sjbernardo » 05 Sep 2019, 10:25

Thanks in advance for any advice that anyone is willing to share with me. My dog, Bella (5 1/2 years-old Westie), was diagnosed with EPI about 2 1/2 years ago. Once diagnosed, the enzymes (Pancreatin 6x from EnzymeDiane) worked their magic. Every once and a while, she'd get nauseous and get stomach gurgles, which we would manage to control by feeding her small amounts of over-cooked rice and chicken (per vet instructions) every 2 to 3 hours. Over timeI was able to wean her back to regular amounts and regular feeding times. The past year she's had many flares and lately she's had problems with diarrhea in addition to nausea and stomach gurgles. About a month ago she was treated using a round of Metronidazole and Cerenia. She did better while on the medication, but her symptoms came right back after she finished. Now she has been put on another round of Metronidazole/Cerenia with plans to have an ultrasound performed to see if Bella has IBD in addition to EPI. I read the EPI4dogs site voraciously in the middle of the night and gleaned that perhaps we should ask our vet to switch her over to Tylosin. It also seems as though rice/chicken is maybe not the best thing for her to be eating right now. I love and respect our vet, but they have not handled many EPI cases. The ones that they have handled are doing well on just enzymes. I guess my questions are: (1) Am I correct to ask our vet about switching over to Tylosin instead of Metronidazole? (2) While in this flare-up, any suggestions as to what might be a good thing to feed her? (3) Am I correct that there are many EPI dogs that deal with recurring diarrhea and that this may be EPI-related as opposed to IBD-related? I'm so thankful for this site and would very much appreciate input on these topics. I'll continue to use EPI4Dogs to read-up and learn everything I can. Just as is the case for all of you, Bella is precious to me, and I'll do all that I can to make her healthy and happy. Thank you!

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jilbert57
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Country: United States
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Re: Bella - Involuntarily leaking liquid/nausea/gurgling

Post by jilbert57 » 05 Sep 2019, 11:27

You might try cooked chicken and plain mashed potatoes.
Most Epi dogs do well on a grain free, 4% or less fiber food.

Did your pup have B12 checked? It needs to be 600 or higher. Low B12 needs weekly shots and follow up with B12 pills with Intrinsic Factor.

https://epi4dogs.com/b12-in-brief-2/

Tylan would be a better choice long term, it is easier on the system with little to no side effects.

Jill
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.

sjbernardo
Member
Posts: 4
Location: O Fallon
Country: United States
State: Illinois
Pet name: Bella
My name: Suzanne

Re: Bella - Involuntarily leaking liquid/nausea/gurgling

Post by sjbernardo » 05 Sep 2019, 12:14

Jill, thanks for the input. Plain mashed potatoes makes sense. Bella does get monthly B12 injections (forgot to add that). I did contact my vet, and she said that they've had mixed results with Tylan, but she's getting it ready for me to pickup. She suggested that Bella finishes the Metronidazole first, although if Bella's stool does not firm by the end of the week she's instructed me to give both concurrently.

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

Re: Bella - Involuntarily leaking liquid/nausea/gurgling

Post by Madelon » 05 Sep 2019, 13:10

Hi and welcome to the forum.

I have a few questions first, which I suspect may be the problem - are you supplementing B12? what food are you feeding? Right now, I think you are dealing with SID and not IBD and I would try addressing that to see if that is what is going on before looking into IBD. As for EPI dogs, they need much more than just enzymes on their food - they need B12 supplementing for life and they need a low fiber food.

It sounds like Bella has SID (small intestinal dysbiosis) that has not been properly addressed. If you are not supplementing B12, I would have her B12 tested and start supplementing right away. EPI dogs need their B12 on the high side of normal 600+ and supplementing is for life. Low B12 can result in weight loss, affect mood, affect energy and SID. You can either follow the shot protocol and then switch to pills or go ahead and just try the pills - we recommend WonderLabs Pet Factor B12 - it has intrinsic factor which helps with B12 absorption.

I would definitely ask the vet for a prescription for Tylan - please feel free to print off the information from our website about Tylan and share it with your vet. You'll want to give it for 45 days and then slowly wean off. If the vet is not willing to give a prescription for Tylan, you could try Slippery Elm Bark Powder or the Metronidazole but Metro needs to be given for 30-45 days in order to get rid of SID and you'll need to watch for neurological side effects.
https://epi4dogs.com/antibiotics/

As for food - I would stay away from the rice and chicken - most EPI dogs cannot handle grains or chicken. We recommend using a grain free food with 4% fiber or less and try to avoid or limit peas and other legumes.
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.

sjbernardo
Member
Posts: 4
Location: O Fallon
Country: United States
State: Illinois
Pet name: Bella
My name: Suzanne

Re: Bella - Involuntarily leaking liquid/nausea/gurgling

Post by sjbernardo » 05 Sep 2019, 14:11

Thanks for the welcome Madelon!

My vet (not experienced with many EPI cases) prescribed Royal Canin GI Low Fat Dry, but it's first ingredients are "brewers rice, chicken by-product meal, wheat, barley . . ." As soon as I read (which was just last night) forum postings and some EPI management articles on this site, I realized that this was not a good idea. Her food was about 40% the Royal Canin dry (ground up), 50% boiled chicken, 5% broiled beef liver and 5% pureed baby food vegetables. Today I'm feeding her more of everything else but the Royal Canin dry.

She does get monthly B12 injections from our vet. Do you suggest that I find out how much B12 is in the injections or should I actually have her retested before trying the WonderLabs pills? She is DEFINITELY having problems with weight loss, mood and energy.

Since posting my initial post, I did sent my vet a link to the antibiotics section of EPI4Dogs, and she's currently having some Tylan readied for my pickup. Yay!

If I'm allowed to ask, do you have a specific suggestion for dry food that meet the criteria that you've outlined? We met with an internist at a teaching hospital at the beginning of August that told me to stay away from grain-free food because of the resulting heart problems.

Thanks very much for your response!

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jilbert57
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Posts: 2092
Country: United States
State: Washington

Re: Bella - Involuntarily leaking liquid/nausea/gurgling

Post by jilbert57 » 05 Sep 2019, 14:55

Here is a link from our website:

https://epi4dogs.com/dog-food-options/

Jill
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.

sjbernardo
Member
Posts: 4
Location: O Fallon
Country: United States
State: Illinois
Pet name: Bella
My name: Suzanne

Re: Bella - Involuntarily leaking liquid/nausea/gurgling

Post by sjbernardo » 05 Sep 2019, 22:03

Thanks again Jill! I'll take a look.

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jilbert57
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Posts: 2092
Country: United States
State: Washington

Re: Bella - Involuntarily leaking liquid/nausea/gurgling

Post by jilbert57 » 06 Sep 2019, 09:17

Very polite of you to ask if you are able to ask a question. Please know any question is great to ask, so make a list and ask away!

Jill
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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