EPI dog (Ivy) not eating well

[KNewman]

Hello,
Our dog Ivy was diagnosed with EPI in January. She was doing very well up until about 2.5 weeks ago. Previously she was on Hill's Science Diet - Digestive Care and Enzyme Diane (6x) and Vitamin B12 from Wonderlabs. She suddenly became uninterested in her food a few weeks ago and now we can hardly get her to eat anything. We aren't sure if this has something to do with her kibble, a new bag of Enzyme Diane (higher concentrations of enzymes from the last bag we had received) or possible SBD. We tried switching her to PurinaPro Sensitive Stomach (per our vet's suggestion), we have tried several different toppers (grain-free canned food, raw food, boiled chicken, chicken stock, etc.). We have tried reducing the incubation time from 30 minutes to 20-25 minutes, because we thought she may not like the sogginess of her food once it is incubated. We have tried warming her food on the stove. We can coax her into eating about 1/2- 3/4 a cup of food in the morning and evening, but that is much less than what is recommended for her weight (46 lbs.). We are very concerned as we don't want to go back down the road we were on before she was diagnosed, her weight got down to 30 lbs. and our (previous) vet wanted to put her down. I did order a new bag of Enzyme Diane to see if that makes any difference. Please help!! We are desperate. We appreciate all the expertise on this forum, thank you all ahead of time.

[Olesia711]

Hi So sorry to hear that Ivy is not doing well right now... and is going off her food...

First .... suspect would be that SID (small intestinal dysbiosis) is getting out of control in her ..... as they now know that all EPI dogs have SID to some degree or another and our objective is to keep it in good control as best we can. So, i would like to know if you are seeing ANY other possible SID symptoms ....... repeated signs such as yellowish-coloring to the stools, loose stools, gelatinous stool coating, flatulence, lack of appetite, stomach noises, low or low normal B12 ....... we know you are already checking 1 box... the lack of appetite..... any other signs/symptoms?

Second.... whether or not this is SID, it might be wise to just go ahead and order some slippery elm powder (it's cheap).... normally i recommend getting it from Wonderlabs cuz i know for a fact that they source high quality slippery elm... but they appear to be out of it at the moment, so you can also go on Amazon and order the NOW SLippery Elm powder...
(here are the dosing instructions on slippery elm https://epi4dogs.com/slippery-elm/ )

WHat you can do is as soon as the Slippery Elm comes in.... give it to Ivy with her breakfast and dinner meals (add a few tablespoons of water to the meal when you add the slippery elm.... and if you see an improvement iner appetite within 1 to 2 days.... then you can assume that this is SID that is causing her to go off her food.... and the Slippery Elm just may be enough to get her back on track or it may help, but you still may need to give an antibiotic (like Tylan) to get the SID under control. But it is best to try SLippery ELm first as it is natural, a mucilage that creates a protective coating, and a fiber (given i a controlled amount) that has the SCFA Butyrate in it that is known to combat SID before automatically jumping to an antibiotic... just in case you can get the SID in good control without resorting to an antibiotic.

Third.... if you do not see any improvement within a day or two on the SLippery Elm... please take Ivy to the vet and have your vet check for a possible kidney issue. We have seen this happen quite a few times, when the dog goes off their food and then they literally stop wanting to eat, and once we eliminate possible SID that is out of control.... many times, it has turned out to be a kidney issue ... so...... not saying that this is what is going on.... but just erring on the side of caution.... just in case this is not SID.

[Barb]

Hello, welcome. I am so sorry to hear that Ivy is not feeling well and has gone off her food. I know how stressful it is when your dog won't eat. Olesia has given you excellent advice on how to proceed. I just want to endorse her recommendation that you see your vet if the other suggestions do not effect a change. Sometimes we are so focused on the EPI that we miss the fact that there might be something else going on .....and we want to make sure we cover all the bases.

Let us know how she does with Olesia's suggestions. And hang in there. This is a stressful time.

Barb

[Madelon]

Olesia's given you great advice so I won't muddy the waters, just wanted to welcome you to our EPI family.

[jilbert57]

So your pup's basic food as I read it contains rice or other grains? This might be exacerbating the issue. Most EPI dogs do better on grain free 4% fiber or less. Just to keep in mind.

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

Jill

[Olesia711]

Thanks for posting that Jill.... i actually MISSED that little detail that they are feeding Ivy "PurinaPro Sensitive Stomach (per our vet's suggestion"

This can very likely be triggering SID to get a little more out of control due to the high fiber content., (if this is what is going on and why Ivy doesn't feel so great, as with some dogs, uncontrolled SID can start with a tummy that just doesn;t feel right... and then in short order, other SID signs usually pop up...

The Purina Pros food, although a good food, and although some EPI dogs can handle it, many of our EPI dogs do not do well with foods with grains in them cuz fiber inhibits the enzyme activity anywhere from 0% to 50%.... we just don't know by how much from one dog to the next.... this is why we have general guidelines BUT oftentimes we just have to try things and keep a journal ....

SO.... As Jill mentioned.... you might want to try a food that is low in fiber... taste of the wild/pacific stream version might be a good commercial food to try... just buy a small bag to see if it helps.... without having to spend a lot of money.

But in the meantime... my thought is to still try some slippery elm powder to help the SID (if this is what is going on) improve.... and if it does help then by changing the food to a lower fiber content diet you should see improvement

However, as i mentioned earlier though, if you do not see improvement ( Ivy's appetite getting better) then i would have the vet check her over as this might be something else, like a kidney issue.

[KNewman]

Hello,
Thank you all for the advise! I picked up slippery elm from our natural food store yesterday and gave her a dose last night with her meal and a dose this morning. Haven't noticed much of a change in her appetite yet. Ivy had a vet exam last week when we were about 1 week into this "decreased appetite" phase. The vet did a full physical and did blood work. Everything came back completely normal, which is why she suggested changing the food (sorry should have mentioned the vet visit in my first post). We were still in the process of transitioning her to PurinaPro, so we are mixing 1/2 her recommended amount of that and 1/2 of the Hill's Science Diet Sensitive Stomach (which she was on previously). I will get a bag of Taste of the Wild Pacific Stream today and discontinue the PurinaPro.
Our vet recommended repeating her GI panel soon to see how she is responding overall to the enzymes, would you all recommend doing that at this time?
Thank you again,
Kelsea

[Michaela]

We know this all too well unfortunately

Have you checked for mouth sores from the enzymes?

Nikki absolutely hates the enzymes and we had to beg her to eat (she's on steroids now for PF's and is eating great). I ended up switching to Pan-Tenex which doesn't have that chemical smell like most enzymes. Something to keep in mind in case nothing else helps.

"Pan-tenex™ is also Acetone-Free. Some enzyme supplements may contain a fowl or pungent odor. This is because the enzymes in their product may have been manufactured using Acetone during the extraction process. Not only can this odor be offensive, but many pets do not accept the product once it is mixed into their food." https://www.pantenexdogenzymes.com/enzyme-basics

I've also used Goat Milk from The Honest Kitchen to get her to eat and she really liked that. https://www.thehonestkitchen.com/instan ... probiotics

Good luck, I know how frustrating this is.

[Olesia711]

Hi Kelsea,

Thanks for the information regarding the vet visit.
Glad you picked up some Slippery Elm... continue with that (give it a couple of days) and then change the food (try TOTW). Although no guarantees, TOTW, especially the pacific stream version seems to work well with many of our EPI dogs... but not all, so worth trying.

What you do want to do is make one change at a time... the SLippery Elm has a fairly quick response time... that is why i am suggesting after 2 days on Slippery ELm... then the 3rd day you can try implementing a low fiber food. You can also add more meat/fish (protein source... to further decrease the ratio of fiber.

Slippery Elm is also a prebiotic (not probiotic) which is a fiber, but it is controlled by the pet owner as how much is given... where as commercial dog food has fiber baked in and you have no control of how much fiber is REALLY in the dog food.... hence why most (but not all) of our EPI dogs do better with a low fiber food. The catch 22 is that fiber can actually help SID (small intestinal dysbiosis) but too much fiber can wreak havoc in an EPI dog....so you kind of have to find a happy medium.

Please keep us posted on how all this goes AND be sure to let us know if Ivy shows any other signs/symptoms.

If after about a week on a low fiber food (TOTW)... if Ivy still has an aversion to eating.... please let us know!

Oh.... i also want to mention that i like Michaela's suggestion of goat's milk.... i have heard of other dogs doing well on it (although i have not tried it).. but sounds like it is worth trying ...BUT...... do wait a bit as you only want to try things one at a time.