GSD Thor lives where its difficult to diagnose EPI and relies on your help

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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Niusvil
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Country: Georgia
Pet name: Thor

GSD Thor lives where its difficult to diagnose EPI and relies on your help

Post by Niusvil » 03 Feb 2020, 09:14

Hello everyone, my name is Anna and it's my first post :) I have been researching EPI resources for a month now, and this forum seems the best of all of them. I saw that people here are very helpful and hope you will help me too, please...

My dog GSD Thor just turned two, he more or less always had problems with diarrhea, was mostly on dry food. Last fall it became worse and the vet gave him IV injections and Metronidazole course for 2 weeks, also Creon and probiotics. His stool improved for some time, but relapsed again. He also lost 6.6 lbs weight (he is 57 lbs now).

Now, the problem is that in my country apparently they don't do TLI test on dogs :( at least three vets told me that they diagnose Pancreas problems with blood biochemical test on Amylase etc, and fecal analysis. I still decided to research more, and one laboratory agreed to send his blood to Germany for TLI and I will have results in 2 weeks :( Meanwhile I am managing his diet with Creon 25,000 three times day with meals, probiotics two times day, and also started B-12 injections, again without having a lab test done on B12. He is more or less stable now, I feed him boiled chicken, beef, sweet potato, sometimes rice, and some hypoalrgenic kibbles from Royal Canine. But seems that he needs more to stabilize, as he had diarrhea again yesterday and today. I am also tryong to slowly switch him to raw diet, and boiling his meats less and less.

Another thing the vets have not heard here is Tylan. I found Tylosin Tartrate 1000mg that seems they only use for poultry and swine here, but it seems to me the same as Tylan. My question is how much of it should I give? it says 1 gram of this soluble powder is 1000mg of Tylosin Tartrate, so should I calculate according the the main chart on the site? https://www.epi4dogs.com/forum/viewtopic.php?t=166
So I just gave him 1/8 spoon of this Tylosin Tartrate 1000mg now with food and keep my fingers crossed.
I have so many more questions but will keep some of them for now :))) At this point would really appreciate your help on Tylosin Tartrate 1000mg. No point of asking our vet as they will prescribe Metronidazole or other antibiotic.
Anna
I am Anna, my German Shepherd Thor is 2 y.o. we live in Eastern Europe. The TLI result came back from the Netherland laboratory as 14.0 but their normal range is 15-50. I still give Creon 25000 with every meal, started Pet Factor B-12. He has diarrhea often and started Tylosin 1/4 tsp.

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jilbert57
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Re: GSD Thor lives where its difficult to diagnose EPI and relies on your help

Post by jilbert57 » 03 Feb 2020, 09:32

Hi Anna and welcome to you and Thor. The Tylan needs to be given 2 times a day. It is bitter so you can try and hide it in his food. I put the doses in gel capsules. For a 57 lb dog you would use 1/8 teaspoon 2 times a day as you are doing.

If I was you I would hold off on the rice in the diet. The carbohydrates can interfere with the action of the enzymes.

The 4 cornerstones to managing EPI are Enzymes (Creon you are using), Diet, usually grain free and 4% or less fiber. Antibiotic(Tylan) and the B12.

Jill
My name is Jill and I live on the Hood Canal in Washington State. I have two dogs: Kiya is an aussie/blue heeler and is 13, TJ is a 4 year old Jack Russell. They keep me on my toes.
Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.
6/1999 - 8/2014

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Niusvil
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Country: Georgia
Pet name: Thor

Re: GSD Thor lives where its difficult to diagnose EPI and relies on your help

Post by Niusvil » 03 Feb 2020, 09:39

Thank you Jill. So you think Tylosin Tartrate 1000 mg dosage would be the same as Tylan's? what is the concentration of active ingredient in Tylan? In this Tylosin powder that I have 1 gram=1000mg Tylosin Tartrate. I am just cautious not to give too much.
Thanks for advice, yes I am trying to give less rice, I think sweet potato or pumpkin is good right?

Once I have TLI result, I will try to get enzymes Diane and hopefully manage it. Also, I noticed that here you do not recommend probiotics, I've been giving it for two months now (a local brand, but have ordered the VetriScience Mega Probiotic, Digestive Relief with Probiotics and Prebiotics, will get this week)> ANy thoughts on this?
I am Anna, my German Shepherd Thor is 2 y.o. we live in Eastern Europe. The TLI result came back from the Netherland laboratory as 14.0 but their normal range is 15-50. I still give Creon 25000 with every meal, started Pet Factor B-12. He has diarrhea often and started Tylosin 1/4 tsp.

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jilbert57
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Re: GSD Thor lives where its difficult to diagnose EPI and relies on your help

Post by jilbert57 » 03 Feb 2020, 15:33

Tylan is Tylosin tartarate. It is a plastic bottle says 100g on the bottle. The link I included in my post tells about it with a picture.
"Tylan Antibiotic

Currently the antibiotic of choice to treat SID in EPI patients is Tylan (Tylosin Tartrate 100 grams- -given according to weight / 30-45 day course given every 12 hours (breakfast & dinner). In some cases the dose may be split into 3 daily doses vs. 2 daily doses if optimal results are not being achieved. If Tylan does nothing within a week, THEN try a different antibiotic. Some of the other options are Metronidazole, Amoxycillan, Oxytetracycline (Oxytet), etc. Scroll to the bottom of this page for the revised 2016 UK Oxytetracycline dosing recommendation.

Tylan Dosing chart





Tylan Dosage Guide

13kg/30 lb – 1/8 tsp
27kg/60 lb – 1/4 tsp
41kg/90 lb – 3/8 tsp
54kg/120 lb – 1/2 tsp
twice per day. "

Yes sweet potato and pumpkin is good,

If your pup is on an antibiotic like Metro, it kills both good and bad gut bacteria so some yogurt might help. The Tylan is a lot milder on the gut. It kills bad bacteria bit not good.

Jill
My name is Jill and I live on the Hood Canal in Washington State. I have two dogs: Kiya is an aussie/blue heeler and is 13, TJ is a 4 year old Jack Russell. They keep me on my toes.
Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.
6/1999 - 8/2014

Ben j v
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Posts: 20
Country: Australia
State: Washington
Pet name: Rorschak
My name: Ben

Re: GSD Thor lives where its difficult to diagnose EPI and relies on your help

Post by Ben j v » 03 Feb 2020, 20:43

Hello
Im new here too and dont know anything you probably havent already read, so if any i say is obviously wrong feel free to correct me.

Why is he on hypoallergenic? If he has ibd, or some food sensitivity, mabey best to have him only on the kibble, and cut out the chicken for sure, but also the beef.

Analergic may be the 1st kibble to try though. Thats the one i was recommended on here, by a different name. I think its protein is sourced from chicken feathers, where hypoallergenic is sourced from some soy bean.
I dont know for sure why analergic is the 1st choice, mabey because hypo is the next place to go if a dog became sensitive to analergic.

Our boy had really bad ibd, but still on occasion has a solid bowel movement(on antibiotics) and even gained weight on non hydrolised food before his ibd diagnosis.
He is strictly on hillz zd cans, and we were warned not to mix 2 hydrolised foods together, as if he were to develop a sensitivity it would probably write both foods off for him. I imagine the same is true of mixing hypo with regular meat.

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Madelon
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Re: GSD Thor lives where its difficult to diagnose EPI and relies on your help

Post by Madelon » 03 Feb 2020, 21:05

Hi and welcome to our EPI family. Thank you for including the picture in your profile - I just love seeing all of these beautiful EPI dogs!!

First, Jill gave you spot on advice regarding the Tylan. Be sure to give it 12hours apart so am and pm feeding. It is bitter tasting so mix in the food if you can.

Most EPI dogs cannot tolerate rice so I would hold off on it for now.

As for the enzymes, can you get Creon 10,000? That is what is recommended. I've reached out to EnzymeDiane and Chemeyes to see if they can ship to your country. This is from our Enzyme page:

CREON (available world-wide!!!!)



These are enteric coated microspheres of enzymes encased in capsules. These capsules may be given whole or sprinkled on food if served immediately. Alternately, some people find that after giving Creon waiting for a period (5, 10 or 15 minutes) before feeding is more effective. Every dog is different and experimentation is required to find the most effective method. Please note: if you are going to sprinkle the contents ensure that the dog eats the entire meal so that all of the Creon is ingested. If in doubt, give the capsule whole before trying the sprinkling method.

CREON is commonly used in many places outside the U.S. Existing CREON enzyme capsule products vary from region to region with not all strengths available in all regions. They can come in 5 , 6, 10, 12, 25, 40 strengths and new strengths approved as of 2009 of 6, 12, strengths are becoming more readily available mainly in the US. When initially treating an EPI dog, it is recommended to start with CREON 12 or CREON 10 which has 10,000 USP of Lipase, 37,500 USP of Protease, 33,200 USP of Amylase. There is some latitude using Creon as its effectiveness is dependent on the dog’s pH level (you do not need to test for this) so getting the exact strength is not strictly necessary.

The CREON the potency measurement comparison is as follows:
CREON 10 Composition : 150 mg Pancreatin
Amylase 8,000 PhEur units (BP Units) also equals 33,400 USP units
Lipase 10,000 PhEur units (BP Units) also equals 10,000 USP units
Protease 600 Ph Eur units (BP units) also equal 37,500 USP units

CREON 25 Composition : 300 mg Pancreatin
Amylase 18,000 PhEur units (BP Units) also equals 74,700 USP units
Lipase 25,000 PhEur units (BP Units) also equals 25,000 USP units
Protease 1,000 Ph Eur units (BP units) also equal 62,500 USP units

However… please know, once you start with a particular brand of CREON and it works… TRY NOT TO SWITCH brands!!!! “There are so many variables with prescriptions for CREON from different countries. Different countries fill the CREON differently. It is not regulated like medicine for hypertension etc. Changing from one CREON made by Abbott opposed to CREON made by Mylan as an example will vary very much. It is strongly suggested that when you use a particular CREON made by a particular company …. stick with the one and do not try to use or vary them from one company or the another unless the amounts are exactly the same as you have been using and working for your pet.

Giving CREON is not straight-forward…. the pet owner will have to trial and error to find the right dose and the right administration technique. The following is a little guidance on how to do this:

The trick to giving CREON is make sure that its activation starts at the right time while going thru the digestive system- -and that will depend on each dog’s very own pH level in their digestive tract / small intestine.. So…. it is all based on what your dog’s pH level is, not his size nor the amount of food given…. and this is why it takes a little trial and error with these dogs when placed on CREON.

First…. the dose. We suggest starting with a CREON 10,000 (or 12,000) per meal (you can add more if this amount doesn’t work)

Next… the technique…. the best way is to just try the following techniques to see which works best … and that is determined by the poo quality:

1. Give the CREON 10,000 (or 12,000) capsule whole or sprinkle the contents and feed immediately or wait for 10 minutes before feeding (some dogs respond better with either method). Watch the poo for a few days and try to assess. Please note: if you are going to sprinkle the contents ensure that the dog eats the entire meal so that all of the Creon is ingested. If in doubt, give the capsule whole before trying the sprinkling method.

2. if the above does not produce optimal poo results, then you can try 2 x CREON 10,000 (or 12,000) capsules. Watch the poo for a few days and try to assess if this helped, or if it is just right or not working at all….

3. if the above is not working at all…. then try giving a CREON 10,000 (or 12,000) capsule about 5 minutes prior to a meal… again, watch the poo and try to assess if this appears to work better than the above or not. If it does appear to work better…. but still isn’t perfect, then try giving the CREON 10,000 (or 12,000) about 10 minutes prior to a meal and again assess the poo over the next few days.

These are some techniques… the trick in giving CREON will be up to you to try and figure out TWO THINGS!

1. what is the best “timing” method of giving CREON.. whole in capsules or in some cases whether opened and served immediately or 5, 10 or 15 minutes prior to a meal.

2. and then the right “dose”… whether one CREON 10,000 (or 12,000) is enough or if you need two CREON 10,000 (or 12,000)… or if your dog is going to need approximately CREON 25,000 .

There is no need for prescription hydrolyzed food unless your dog has an underlying condition requiring, such as IBD. If you suspect IBD, we have noticed most EPI dogs do best with Royal Canin Ultamino.
MADELON and Doc. DX EPI and SIBO: 5/22/2015
Test Results: (1st) 7/2014 = TLI 16.5, B12 894, Folate > 24; (2nd) 5/2015 = TLI < .4, B12 406; Folate >24; (3rd) 10/2015 TLI < .4; B12 >1000; Folate 14.4. Prior to DX: May 2014 (2mos) - DX coccidia/bladder infection; July 2014 (3mos) 1st EPI test = TLI 16.5, B12 894, Folate >24 - Dx SIBO not EPI; Feb 2015 thru May 2015 - weight loss only; May 2015 vomitted several times, diarrhea and eating poop. Regimen: 4 cups Sport Dog Food Elite Herding - Diane 6x 1tsp per cup; 1 WonderLab PetFactor B12 2x day; 1/2tsp Slippery Elm 2xday; Multivitamin; 1 Zyrtec 10mg 2x day; Salmon Oil

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Niusvil
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Posts: 11
Country: Georgia
Pet name: Thor

Re: GSD Thor lives where its difficult to diagnose EPI and relies on your help

Post by Niusvil » 06 Feb 2020, 09:33

Thank you everyone this is a great community!
I have had Thor on Tylosin for 4th day now, ad his stool is still either very soft or runny. My problem is that I do not know if I measure the Tylosin I have: it's powder and says 1 gr =1000mg Tylosin Tartrate. I weighed 1 gram of powder and it is a half of tsp. So if I give 1/8 tsp it makes 250mg right?
On this page Tylan dosing chart suggests 1/8 tsp equals 375mgm. So if my Tylosin is the same strength maybe I am giving too little? the problem is that I dont know if its the same strength, and the bottle that I have does not have dosage for dogs. As I explained, I live in Eastern Europe and I do not have access to Tylan. And the vet here does not recommend using Tylosin orally for some reason, although he used injections.
Can anyone advice what is the strength of Tylosin in commercial Tylan that you all are using?
I am Anna, my German Shepherd Thor is 2 y.o. we live in Eastern Europe. The TLI result came back from the Netherland laboratory as 14.0 but their normal range is 15-50. I still give Creon 25000 with every meal, started Pet Factor B-12. He has diarrhea often and started Tylosin 1/4 tsp.

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

Re: GSD Thor lives where its difficult to diagnose EPI and relies on your help

Post by Madelon » 06 Feb 2020, 13:43

Yes I think you are giving too little and with your dog weighing 57lbs I would go ahead and bump it up to the next dose level which starts at 60lbs - you should be giving 1/4tsp which is 750mg. I think what you are using is the same as what we use here This is likely why it's not working quite right yet. I reached out to EnzymeDiane and Suj with Chemeyes - they both think they can ship to your country. You might want to try ordering the enzyme powder from them as it's easier to work with than the Creon.
MADELON and Doc. DX EPI and SIBO: 5/22/2015
Test Results: (1st) 7/2014 = TLI 16.5, B12 894, Folate > 24; (2nd) 5/2015 = TLI < .4, B12 406; Folate >24; (3rd) 10/2015 TLI < .4; B12 >1000; Folate 14.4. Prior to DX: May 2014 (2mos) - DX coccidia/bladder infection; July 2014 (3mos) 1st EPI test = TLI 16.5, B12 894, Folate >24 - Dx SIBO not EPI; Feb 2015 thru May 2015 - weight loss only; May 2015 vomitted several times, diarrhea and eating poop. Regimen: 4 cups Sport Dog Food Elite Herding - Diane 6x 1tsp per cup; 1 WonderLab PetFactor B12 2x day; 1/2tsp Slippery Elm 2xday; Multivitamin; 1 Zyrtec 10mg 2x day; Salmon Oil

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Niusvil
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Posts: 11
Country: Georgia
Pet name: Thor

Re: GSD Thor lives where its difficult to diagnose EPI and relies on your help

Post by Niusvil » 07 Feb 2020, 14:02

Ben j v wrote:
03 Feb 2020, 20:43
Hello
Im new here too and dont know anything you probably havent already read, so if any i say is obviously wrong feel free to correct me.

Why is he on hypoallergenic? If he has ibd, or some food sensitivity, mabey best to have him only on the kibble, and cut out the chicken for sure, but also the beef.

Analergic may be the 1st kibble to try though. Thats the one i was recommended on here, by a different name. I think its protein is sourced from chicken feathers, where hypoallergenic is sourced from some soy bean.
I dont know for sure why analergic is the 1st choice, mabey because hypo is the next place to go if a dog became sensitive to analergic.

Our boy had really bad ibd, but still on occasion has a solid bowel movement(on antibiotics) and even gained weight on non hydrolised food before his ibd diagnosis.
He is strictly on hillz zd cans, and we were warned not to mix 2 hydrolised foods together, as if he were to develop a sensitivity it would probably write both foods off for him. I imagine the same is true of mixing hypo with regular meat.
I gave Royal Canine hypoallergenic because as I know hydrolised proteins are easier to digest. But you are right should not mix with cooked meats probably. Anyways he seems not to tolerate Royal Canine hypoallergenic as I gave yesterday two cups in the evening and today he had very watery stools :( the problem is I was trying to have him on half cooked and half dry, and transition slowly to raw, but the dry food options are limited here and cant find one that works.

At the moment his regimen is:
cooked chicken or beef, sweet potato. pumpkin, a bit cooked chicken liver, kefir, plain yogurt
Dry food (trying different ones)
Creon 25000 with each meal (tried 10000 but seems to little)
Probiotic
Tylosin twice a day (which I am still trying to find out how much to give).

Started Tylosin just 4 days ago, do not notice improvement yet
I am Anna, my German Shepherd Thor is 2 y.o. we live in Eastern Europe. The TLI result came back from the Netherland laboratory as 14.0 but their normal range is 15-50. I still give Creon 25000 with every meal, started Pet Factor B-12. He has diarrhea often and started Tylosin 1/4 tsp.

User avatar
Madelon
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Posts: 923
Location: Nashville, TN
Country: United States
State: Tennessee
Pet name: Doc

Re: GSD Thor lives where its difficult to diagnose EPI and relies on your help

Post by Madelon » 07 Feb 2020, 14:15

Hi Ana. See my post above - I think you are giving too little Tylan and gave you the amount you should be using. I"m sorry you're having such a difficult time with the food - I'm sure you will get it straightened out - your pup is lucky to have you.
MADELON and Doc. DX EPI and SIBO: 5/22/2015
Test Results: (1st) 7/2014 = TLI 16.5, B12 894, Folate > 24; (2nd) 5/2015 = TLI < .4, B12 406; Folate >24; (3rd) 10/2015 TLI < .4; B12 >1000; Folate 14.4. Prior to DX: May 2014 (2mos) - DX coccidia/bladder infection; July 2014 (3mos) 1st EPI test = TLI 16.5, B12 894, Folate >24 - Dx SIBO not EPI; Feb 2015 thru May 2015 - weight loss only; May 2015 vomitted several times, diarrhea and eating poop. Regimen: 4 cups Sport Dog Food Elite Herding - Diane 6x 1tsp per cup; 1 WonderLab PetFactor B12 2x day; 1/2tsp Slippery Elm 2xday; Multivitamin; 1 Zyrtec 10mg 2x day; Salmon Oil

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