Sheltie Cubbie Roo

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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Olesia711
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Sheltie Cubbie Roo

Post by Olesia711 » 16 Apr 2020, 22:16

Hi everyone,

I am posting this for a new member who was having difficulty posting to the forum. If you can please help out with your suggestions... this is what she wrote:


I just registered for the forum after three weeks of reading and learning so much about epi. i'd like to make a post, and get some feedback. Please see below.

My Sheltie Cubbie Roo just turned 13. He had been diagnosed with pancreatitis and more recently with EPI. I believe from what I've read on your site that he progressed from acute bouts of pancreatitis (over the past few years which we were able to correct) to chronic (last three
months) and now to end stage pancreatitis with epi. The pancreatic tablets had worked in the past. My vet has now recommended Epizyme powder which initially I was unable to get Cubbie to eat. But after reading "camouflaging" the enzyme on your site, I had success last night and again this morning! My vet wants me to take him off all antibiotics for a few days, feed only chicken and small amounts of rice, and use the powder to see if we can get his runny puddles of poop moving in the right direction again. I have so many questions but I have learned a lot in the last few weeks. I fully understand the need for the powder every single time. But what else can I do to firm up the stool? Cubbie was on Royal Canin low fat and also Purino Proplan EN low fat. He loved it in the past but over the last few weeks he has refused to eat it. The only thing I can get him to eat is boiled 99 percent fat free ground turkey and poached skinless, boneless chicken breasts. Am I being impatient in want just two dosages of epizyme to work?
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

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Olesia711
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Location: North Carolina
Country: United States
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Pet name: Izzy
My name: olesia

Re: Sheltie Cubbie Roo

Post by Olesia711 » 16 Apr 2020, 22:43

Cubbie Roo's caregiver,

Thanks for asking, we have had lots of dogs who have developed what we called secondary EPI ... which is from chronic pancreatitis that segued into EPI (end stage chronic pancreatitis) .

In regards to your questions... first.... what kind of antibiotics does your vet have Cubbie Roo on? If Metronidazole (Flagyl) ask your vet if you can please stop this and instead have him prescribe Tylan (Tylosin Tartrate soluble powder).... You will need to give this twice a day for 45 days. MAny times the Metro does not work at all on EPI dogs when trying to get the SID /SIBO under good control... and all EPI dogs have SID. It is when it is out of control (loose stools, vomiting, acid reflux, etc) that we try to do something about it . This may be what the problem is..... or not. If not, see below:

At this time, please DO NOT feed your dog rice. Most of the time (but not every single time) EPI dogs do not do well with grains in their diet.... fiber can inhibit the efficacy of the enzymes from anywhere between 0% to 50%.... and there in lies the problem.. from one dog to the next, we don't know how well or not each individual EPI dog will tolerate the grain.

I do agree with your vet regarding trying Epizyme powder to see if these enzymes will stop the loose stools. The pills are convenient, unfortunately they usually don't work or don't work well unless they are crushed, extra given and then you still are better off incubating them just like you would do for powder... so going to the real powder is a very good suggestion from your vet.

1. What could be doing on with Cubbie Roo.... is either what the vet suspects or this is SID and you need to put Cubbie on a different antibiotic, like Tylan.

2. OR,,,,, the food you have him on is simply not agreeing with him at all.... often times runny stools is because of a sensitivity to the food or the food simply is not agreeing with the dog.
so.... what you might want to try is the real food (turkey and chicken) that you are feeding now with baked, skinned and mashed sweet potato (no rice!).... see if this helps firm up the poo... Use 20% sweet potato and 80% meat.

3. If this helps but not 100%... then the next thing i would try would be SLippery Elm powder. Slippery ELm powder is a prebiotic and a mucilage
https://epi4dogs.com/slippery-elm/
... some times this is just enough to get SID back under good control to where you do not need to use an antibiotic...

4. OR....what might be going on is a real food sensitivity and Cubbie Roo might do better with a prescription HYDROLYZED food (when recommending hydrolyzed foods, our 1st recommendation is Royal Canine "Ultamino")... but just based on what you wrote... i would try this last.... as i think some other possibilities may be more relevant.

5. OR.....Sometimes when EPI dogs liked eating but then start to go "off" their food like what you described.... often times means that their B12 is not optimal. Has Cubbie Roo been given B12? If not, and if the any antibiotic tried doesn't fix the problem.... then this might be the underlying problem of the loose stools and the fading appetite. The proper thing to do is have the B12 tested. It needs to be upper mid range (high 500's to 600's at a minimum) low or low normal B12 is not good enough for an EPI dog. Or you can buy some special B12 pills that work really well with most EPI dogs called Wonderlabs Pet Factor B12 https://www.wonderlabs.com/itemleft.php?itemnum=K9688 for a sheltie 's size, you would only have to give 1/2 capsule once a day.. If this is the problem you should see improvement within 3 weeks or sooner.

6. When trying to figure out the right balance of the EPI protocol... after starting everything at once, if things don't improve as expected, like in your case.... where you had a set-back, that means that something needs to be tweaked. In which case you need to try things (such as above) once at a time to see what the problem was. It sounds like your vet was guiding you to do one-thing-at-a-time.... which is good. Might want to keep a journal...write everything down as that will help you.. a Lot.

I hope this give you some ideas of what might be going on and what to try.........
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

cgourley
Member
Posts: 8
Location: Clarks Summit, PA
Country: United States
State: Pennsylvania
Pet name: Cubbie Roo
My name: Cathy

Re: Sheltie Cubbie Roo

Post by cgourley » 17 Apr 2020, 09:50

Thank you so much! About the drugs. He had a two week run of Metronizale (Flagl) that only partly firmed up stool. His would start formed and then water out. But the color was more brown to normal with this drug. He had started Tylan a week ago, but the vet (I saw someone other than the one who prescribed it as she was unavailable that day) suggested going without antibiotics for a few days to see if perhaps the good flora might increase. And we did start a probiotic. Testerday I was able to use the powder Epizyme on his turkey and chicken and yes, I totally eliminated the rice. I also administered a syringe of diagel. Last night's poop deposit was every bit as runny as before but it may take more time.

That said, this morning, he refused to eat the chicken-turkey meal (with the enzymes mixed in and incubated). I did try him on some moistened Anamaet which he took. I had mixed the powder on the dry Anamaet last night, added water, allowed it to incubate. This morning, that was his meal of choice.

My intention is to start the Tylan (I will call the original vet of course) again. We are giving him pain meds for his pancreatitis (started on Wednesday evening) and we hoped that would entice him to eat again his Royal canin. But not yet. Anamaet he won't eat dry, although he loved it in the past.

I have used slippery elm in the past with great, great results for a pancreatic cat and still do. Cubbie also got the elm when he had bouts of pancreatitis in the past and again with great results. But he won't take it now. I can disguise it in a pill pocket and that works.

This website has been such a comfort to me. At the minimum - and I'm tearing up now - it has reinforced that I am doing the right things or at least doing as best as I can for him. And at 13, I know we won't our gentleman sheltie much longer. But I do not want him to starve. Weight down since December from 38 pounds to 31 this week.

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Olesia711
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Location: North Carolina
Country: United States
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Re: Sheltie Cubbie Roo

Post by Olesia711 » 17 Apr 2020, 17:29

Ahh... thanks for our kind and sweet words about tour website..... and yes, it sounds like you are doing the very best that you can to help Cubbie Roo get better and be comfortable... all i can say for any dog that has continuous loose stools.... it has got to be miserable! POor baby.

Thanks for sharing with us... some of what you tried and what is going on.

Oh... before i forget... Please try everything one at a time..... so you can identify what is helping or hindering.

One thing you mentioned that is giving me pause.... probiotic!!!! Often times... a probiotic will actually give an EPI dog the runs! what you can try is stopping the probiotic and see if the stools improve. If so... you can eventually add the probiotics back in, BUT start with only 1/2 the recommended dose, make sure it is not giving the dog diarrhea.. and then after a week or two you can slowly increase the dose to the recommended portion. Some of these dogs simply have to get acclimated to it.

Next just a FYI.... Slippery Elm is a PREbiotic not a PRObiotic.... 2 totally different things. You will want to give a prebitoic :)

Is it possible the pain pills that you are giving him is triggering the loose stools? some medications can do that.

Now back to the inappetence issue.... since Cubbie Roo is 13.... just as another possibility that i have not mentioned..... has your vet checked for any kidney issues? This is something that you can give them relief with diet. We have had a good handful of EPI dogs... who's appetites started fading..... and the owners tried all the thing mentioned above, one by one, and when nothing helped.... we suggested looking beyond a possible EPI problem and suggested that they ahve their vet check for a possible kidney issue.... and in the end, it was finally diagnosed as a kidney issue that had nothing to do with EPI. SO..... just mentioning this, especially since Cubbie Roo is an older dog, that this is another possibility....

This February, i just lost my EPI gal at 15 years old.... broke my heart as she was not only the inspiration for the website, but she was my heartdog and such a HUGE part of my daily life, Our world literally revolved around her... so my heart goes out to you having an elder dog and knowing that they are inching into the twilight of their life.............
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

Barb
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Posts: 918
Country: United States
State: New Jersey

Re: Sheltie Cubbie Roo

Post by Barb » 18 Apr 2020, 16:42

Hello and welcome. I am sorry you and your pup are having difficulties. For some dogs, the beginning of EPI is the hardest stage. Especially since your pup is coming to EPI after bouts of pancreatitis.

Our Kolby, who is now my Bridge German Shepherd, had a terrible time stabilizing after he was first diagnosed. We could not find the right food, he needed B12 forever, and was a lifer on antibiotics. He got diarrhea on the probiotics. We tried so many different foods and finally ended up with the prescription Royal Canin which did the trick. And all this happened even though he had been with us since he was a 9 week old puppy. Eventually, with trial and error, we found the right combination of food, enzymes, B12, and antibiotics.

I highly endorse Olesia's suggestion of keeping a journal. It helped us enormously. Record everything you give him each day, the amounts, and the resulting poos. This will give you information you might not have noticed if you hadn't written it down. And as Olesia said, make only one change at a time.

I know how anxious you are to find the right combination. Try not to be too stressed. I know it's hard, but it will go better if you can relax. You are doing a wonderful job. He is very lucky to have you.

Keep asking questions and let us know how he is doing.

Barb

cgourley
Member
Posts: 8
Location: Clarks Summit, PA
Country: United States
State: Pennsylvania
Pet name: Cubbie Roo
My name: Cathy

Re: Sheltie Cubbie Roo

Post by cgourley » 19 Apr 2020, 18:34

Thank you all so much. Here is Cubbie Roo's update.

I started him on the Tylosin again two days ago. I used the Epizime powder on Anamaet Lean, let it incubate about an hour. And bingo. Yesterday was a really good day. BUT I also had stopped the gabapentin. OK, so far so good.

This morning's "package" in the grass was soft, mostly formed, and a fairly good color, just like yesterday. I fed him boiled chicken breast for lunch (with some enzyme and slippery elm). Then this afternoon, whoosh. Back to runny poop.

Maybe it is the chicken? Maybe it is the proviable-DC (the probiotic) I gave him. Yesterday when things looks and smelled better, I had given the proviable tablet to him about the same time as the Tylosin, which means it might have killed the probiotic critters before they actually got to work. Today I spaced it about two hours apart. Those are the only two things I did differently.

If I could judge the transit time, I'd be better able to figure it out. For all that, he is a happy guy. Played with his football this morning.

In the past when Cubbie had a bout of pancreatitis, which at the time including vomiting (he does not have that, thank goodness), I switched to Canine Caviar with very good results. This was two years ago. When his cholesterol went sky high last November, the vet wanted him on a low fat prescription diet. I used Anamaet Lean. Again, very good results. So I am not new to Anamaet. Love it.

So the only other factor here that I haven't brought up was the really high cholesterol level. Shetlies are prone to hyperlipidemia, I've learned.

I will keep trying and I do keep logging back in to see what others are writing. Thank you again for any feedback. We are going to get through this.

cgourley
Member
Posts: 8
Location: Clarks Summit, PA
Country: United States
State: Pennsylvania
Pet name: Cubbie Roo
My name: Cathy

Re: Sheltie Cubbie Roo

Post by cgourley » 19 Apr 2020, 18:36

Olesia, thanks for mentioning the kidney functions. His were tested two weeks ago and they were good. In fact, everything was good -- heart, liver, kidneys. So that is a relief of course.

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Olesia711
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Posts: 3859
Location: North Carolina
Country: United States
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My name: olesia

Re: Sheltie Cubbie Roo

Post by Olesia711 » 19 Apr 2020, 22:48

glad to hear that his kidney functions was checked and all is okay..... so you can take that possibility off the table.

to figure out what is going one.... as you know, you need to do things one at a time.... SO.....Personally i would only give Tylan for now and temporarily stop the probiotic .... simply because probiotics often gives dogs loose stools in the beginning.... so try things without it and see if the loose stools firm up..... Proviable is probably one of the better probiotics to give our EPI dogs.... so if tolerable, you probably can go back to giving it later... but when you do, give only 1/2 of the recommended dose and then take a week or two to work up to the full recommended dose.... sometimes doing it this way will alleviate loose stools if these loose stools are indeed caused by the probiotic.

If not.....then stop the slippery elm next... see if that was the culprit.... go without it for a few days and see if things improve

If not... then i would focus on maybe the chicken being the culprit....

As you remove things, do not add them back until you (hopefully) figure out what is triggering the loose stools... once you do figure it out... then add things back in one at a time.

Sounds like you are making progress... please keep us posted
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

cgourley
Member
Posts: 8
Location: Clarks Summit, PA
Country: United States
State: Pennsylvania
Pet name: Cubbie Roo
My name: Cathy

Re: Sheltie Cubbie Roo

Post by cgourley » 20 Apr 2020, 09:38

Last night: total plop! I went to bed crying. This morning, a dark brown just about right stool. Crazy! But I think it might have been the slippery elm! I had given it yesterday early afternoon and given the transit time, that one makes sense. So today: No slippery elm. But again, craziness because it had always worked in the past and continues to work for my 20year old cat.

Barb
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Posts: 918
Country: United States
State: New Jersey

Re: Sheltie Cubbie Roo

Post by Barb » 20 Apr 2020, 14:09

I'm sorry you are having such a roller coaster ride. Sometimes it goes like this. You mentioned not knowing the transit time of the food. If you take a small piece of raw carrot and put it in the food, it will come out undigested and you will have the time it takes to pass.

I think I mentioned that my Kolby always got diarrhea when I tried to intorduce probiotics......but as Olesia said, test it out by removing it first and see if that helps. I know this process is tedious, but it is worth it in the end.

Let us know how it goes. Hang in there.

Barb

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