Need Advice!!

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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CD214

Need Advice!!

Post by CD214 » 22 Jan 2020, 15:13

My boyfriend rescued our lab/chow mix about 3 years ago. We think he’s around 9-10 years old and other than these EPI issues, he’s in good health!
About 3 months ago, he was diagnosed with EPI. He lost a substantial amount of weight and his stools were very yellow and soft, like the typical “cow pattie.” We didn’t know what was wrong and after switching vets 2 times, the 3rd vet tested his TLI levels and determined he had EPI.
Since then, we’ve been doing the trial and error period. He’s been on numerous different foods and currently, he’s on Hills Prescription I/D low fat and seems to be doing okay on that. Just last month we switched him to Hills Ideal Balance and noticed his stools were back to the soft cow pattie substance and he wasn’t himself. We put him back on the Hills food and his stools have improved a bit. We have him on 1 1/2 cups, twice per day with 2 tsp of enzymes each time he eats (twice per day). I also switched his B12 to B12 with intrinsic factor to help. He gets two capsules of that per day.
Over the last couple weeks, we have noticed that his behavior has changed, he’s not listening at all and eating everything in sight, including his own stools. He’s very anxious, can’t seem to settle and his belly is making awful sounds. He wants to go outside all the time and we can’t figure out if it’s because he has the urge to go or wants to find little surprises in the yard to eat. I figured he may have had SIBO, so he’s also on a dose of Tylan powder (1/4 tsp every 12 hours).
Last night he had us up at 3 am and was gagging. This has been going on for a couple weeks. After reading and researching, i am wondering if this has to do with acid reflux. Our vet said we could give him an antacid, but i was ready about Slippery Elm Bark powder and just ordered that last night to try.

My question is, should i be doing something else? I hate to have him uncomfortable and he pants a lot and paces at night now. Our vet has been very helpful, but they also have not done a blood test in a few months to check levels so we aren’t sure where his B12 levels are or if there is something else attributing to these new behaviors. Help :(
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Tuckaboo Pam
Member
Posts: 1345
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: Need Advice!!

Post by Tuckaboo Pam » 22 Jan 2020, 18:18

Hey there, it's Pam. A staff member will respond soon, I'm sure, but in the meantime, I'm gonna guess your pup has SID, which is treatable with either slippery elm or Tylosin (an antibiotic to prevent the overgrowth of bad bacteria in the small intestine). I use Tylan brand, prescibed by my vet. Other antibiotics may be given, but Tylan is most often recommended. Recently, research about slippery elm has been posted here, so I'm sure you'll hear about that, too. There are specific brands that are suggested. I tried it, but didn't like the look of Tucker's poo, so he's back on Tylan. Whichever treatment you decide on works pretty fast, so hang in there!!!
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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jilbert57
Staff
Posts: 2091
Country: United States
State: Washington

Re: Need Advice!!

Post by jilbert57 » 22 Jan 2020, 20:10

Hi Cate and welcome. Sounds like you are implementing a few things for EPI, the Tylan at a dose of twice a day, the B12 capsules and the enzymes. How are you preparing the food with the enzymes? The enzymes are dosed at 1 level teaspoon enzyme for every 1 level cup kibble. So you should try lowering the dose of the enzymes to 1.5 teaspoons per 2.5 cups kibble.
The 4 cornerstones for Epi are:
Enzymes
Diet
Antibiotic
B12

As far as the diet, you might want to try a grain free diet with 4%or less fiber. The grains tend to inhibit the action of the enzymes.
Here is a dog food link:


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.

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

Re: Need Advice!!

Post by Tuckaboo Pam » 22 Jan 2020, 20:26

Hi Cate. Sorry, my son was talking to me while I was reading your post, and I missed the part where you are already giving Tylan. Your dog is so cute!---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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Jean
Forum Director
Posts: 1707
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: Need Advice!!

Post by Jean » 23 Jan 2020, 08:33

good afternoon from the UK and welcome to you and Bodey

he is so handsome

few things here

which variety of ideal balance food are you/ were you, feeding, and what variety of Hills now

which enzymes are you using

what weight is Bodey ? Tylan is weight dosed

it sure sounds like he is struggling with SIBO (SMALL INTESTINAL BACTERIAL OVERGROWTH),

several reasons for this, unless there is another illness there is no need for prescription, low fat food, he may not be able to tolerate the ingredients of the food you are giving.e.g . chicken, rice grains etc. my girl couldnt tollerate any of it

he may need something like live yougurt to sooth his gut, as to an an acid, steer clear of Zantac, there are some issues with it and it has been recalled by the manufacturers in UK in October last year, and also in USA, there is a lot about that on the internet

the doseage of Tylan could be wrong

are you giving ANYTHING without enzymes

please keep a diary or journal its essential

how much weight did he lose if any ?

the supplementation of b12 is good, but if this is a big SIBO attack it will be depleting the b12 so we need to get that under control

sorry about all of the questions
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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Riley's Mom
Staff
Posts: 203
Country: United States
State: Virginia

Re: Need Advice!!

Post by Riley's Mom » 23 Jan 2020, 16:34

Hi and welcome to the forum!
Sorry your boy is struggling so. The beginning is the hardest part as you try to dial in to your boy's specific needs. As Jill said, there are 4 cornerstones--but each dog responds a little differently so sometimes we need to "tweak" things and find his perfect balance. Jill brought up some good points about enzyme amount and food type...
Please keep us posted as things progress and we can continue to help you sort things out.
Elisabeth

Riley is a 10 year old Labradoodle. She was diagnosed with EPI in 2014.
She currently eats Taste of the Wild, I cup in the morning, 2 cups in the evening, each meal with 1 Wonderlabs B12 sprinkled over her dinner. Enzymes are EnzymeDiane, 1 tsp per cup of food, mixed in home made bone broth. No other supplements or meds at this time.
Riley currently weighs about 44 pounds, which is pretty heavy for her.

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

Re: Need Advice!!

Post by Madelon » 23 Jan 2020, 22:14

Hi and welcome to you and your absolutely adorable pup to our EPI family. Can you tell us what the TLI, B12 and Folate levels were as that will help us make better suggestions to get your dog stable.

First thing that stands out is 1 1/2 cups of kibble with 2tsp enzymes - too much enzyme is as bad as too little enzyme - loose poop. The second thing that stands out is the food might not be the best. There are four cornerstones to properly managing EPI:

Enzymes: Recommended starting dose is 1 level teaspoon per cup of kibble, mix with a little luke warm water, then mix in kibble and wait 20-30 minutes before serving. Most of us use EnzymeDiane 6x as it's a lot less expensive than the prescription enzymes from the vet

B12: Most EPI dogs have low B12 when diagnosed and if not they will develop it. EPI dogs need their B12 on the high side of normal 600+. You can either do shots or use WonderLabs B12 Pet Factor pill but supplementing B12 is for life.

Antibiotics: In the beginning when dealing with SID (small intestinal dysbiosis formerly called SIBO) we recommend using the right B12, enzymes and food to see if the gut will correct itself - if not you can either try slippery elm bark powder or Tylan antibiotics for 45 days

Food: We recommend grain free with 4% fiber or less, feed 150% of the food for the weight your dog should be but in smaller more frequent meals throughout the day

Keep a detailed journal of everything you give and the resulting poops and know you are not alone - we are here to help guide you along the way
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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