At Wit’s End

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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Ineedhelp27
Member
Posts: 3
Country: United States
State: Florida
Pet name: Skippy
My name: Gabriel

At Wit’s End

Post by Ineedhelp27 » 28 May 2020, 09:49

Hi,
This is going to be long—sorry in advance.

My dog, Skippy is an 18 year old chihuahua. About 6-8 months ago, I noticed he started to get skinnier. Despite my feeding him the same amount and becoming more generous with food, he wouldn’t put on any weight, so I chalked this up to his old age. His vet told me it was atrophy because he is old. Ok fine, seemed logical.

Around that same time, he started needing assistance from me to poop. I hold him in one arm and gently massage and squeeze down there almost as if expressing the glands, to get him to get it out. He has suffered from some kind of spine/nerve disorder for years and years now, so it seemed reasonable that those muscles have lost their functionality, hence. His back legs are pretty much paralyzed now too, but that has been progressing since he was idk 11 or 12. I was doing the squeezing thing at times, but as time has passed it has become more frequent until now, that I haven’t seen him take a dump on his own In months.

Beginning of March, I could tell something was off. He seemed uncomfortable. I waited to see if it would pass but it got worse. I took him to the vet After he pooped something that looked like purplish jam and he was diagnosed with pancreatitis. Did the whole 9 yards iv fluids no food etc etc for a couple days and he didn’t really get better. I took him to another vet. I left him there overnight for 2 nights hoping that he would get better with round the clock care. He did. I brought him home and started his new diet of hills z/d.

He was fine for a while, but it came back some weeks later. Back to the iv fluids at vet. Brought him home, he was good another couple of weeks. And then the same thing. His vet suggested hyperbaric treatment sessions. I took him to about 15 sessions and he really did not seem any better. It was now beginning of May.

I did more bloodwork. He had become anemic. He was now so skinny that it became painful to even look at him and hold him. The vet suggested I just put him to sleep. I went home with him and was trying to spend a last few days with him but I just could not believe that this stupid thing was going to kill him and there was nothing that could be done.

I feel like my vet was kind of over treating him so often as I was taking him to the vet several times a week. You should know that in my area, he was the inky vet nearby at one point, but in the last 3 or 4 years, so many high rises have been built in my neighborhood and so many people live here now, and I could tell that he is completely slammed with patients, whether it’s right or wrong, the consequence was the same, I felt brushed off and that skippy was dismissed as just an old dog and it’s time to let him go.

I have had him for 18 years. I don’t care what the vet says. I know exactly when he is thirsty, I know when he needs to pee, I know when he needs to poop, I know when he’s in pain and I know when he is happy. It goes without saying that I KNOW there is something there that is making him sick and it’s not solely attributed to old age. He was completely fine before the pancreatitis business began in March and it’s simply not possible that from one few weeks to the next, his age just became too much for him.

So I’m spending the last few days with him before taking him to be put down but he is just inconsolable at this point. Constant crying, whining, yelping, screaming. I tried everything. I didn’t sleep for days. This was the worst week of my entire life. And for Skippy too.

I noticed that he became more agitated usually immediately or shortly after I would feed him. I also noticed that his stomach would audibly gurgle around this time too. Mealtime seemed to be triggering whatever was happening with him.
His crying would prompt me to pull out my phone and start googling things. “Dog gas pancreatitis” “dog pain after eating pancreas”..... etc. I Must have seen 1000 times the same stupid webmd pages of geneeal pancreatitis info that I already could basically like recite them from memory.

One late night like 3 am during one of these attacks, about a week after I decided I would put him down, I came across something that attributed gurgling stomach to a lack of pancreatic function. It was just a brief mention, but it was all I needed to put me searching in the right direction. From there I quickly figured it out and it made so much sense as he probably had had it since at least 8 months ago whEn he first started losing weight. And the pancreatitis May have just been a symptom of the epi, as well as the last nail in the coffin for Skippy’s pancreas that was probably already hanging on by just a thread.

I don’t know how people will react to the things I did next, but as a disclaimer, I did not have time to waste by taking him to the vets to get to is figured out. I could tell he was on his deathbed and now I was almost sure he probably was starving slowly to death for months. Anyway, why take him to the same dismissive people who failed to even bring this up to me? Like if I figured this out on google, Me, a regular joe blow.... how could it not have been like a flashing neon sign to you, as a vet, of what was going on? Were you sleepwalking all those times you checked my dog? I had spent over 5k in the matter of a month trying anything possible, anything they suggested might help, so that skippy could be ok. To think the issue had a solution so simple, the one solution that was never brought to my attention.. it was borderline insulting. So no, I did not take him to the vet.

The next morning I had pancreatin from vitamin shoppe and I was crushing it up and mixing it with his food which, I won’t even go into detail about how tough that part has been cause he will not eat food if I was even handling it and I touch the separate plate that his actual food was on without washing my hands. Long story short, I mixed it with the food, got him to eat it, and lo and behold, for the first time in a week he didn’t flip out right after he ate. I felt like freaking isaac Newton. I also began to give him metronidazole for what I assumed was SIBO.

Ever since then, the past 4 weeks have been up and down. Some days he is totally fine, actually, great, for days at a time. Then he will have a cluster of days where, although nothing like before the enzymes, they are still a trying time for the both of us. I can’t figure it out. He has gained weight thankfully. I am giving him pantenex now, which I ordered online the same night I first found out about epi as it had the same exact composition as the prescription one called viokase. And I have since stopped this z/d bs which just seemed to make everything worse for him and started him back up on chicken with pumpkin. However, because I mix his enzymes with a small amount of chicken and pumpkin in a syringe which I squirt in his mouth Right after mealtime, he started to become less of a fan of those. Lately I have been experimenting with tuna, as well as boiled, mashed squash and sweet potato. So I alternate between ground cooked chicken with squash/sweet potato as meals, followed by pantenex Dosage immediately after, and tuna with squash/sweet potato, followed by pantenex right after.

The last 3 days have been his worst in a long time. His stool has become increasingly bloody. To the point that I can see actual droplets of blood following the turds that leave his butt. He screams when he is pooping. He looks generally uncomfortable all day. His stomach is gurgling a lot and it becomes swollen immediately after eating with what I assume is gas. I give him gas x and that seems to work and calm him down and he falls asleep. But I am worried. It’s day 3 of this and it is at the worst of the 3 days now so far. I’ve tried everything but I’m at wits end. Can this be caused by too much enzymes? He has been on metro for 3 weeks now, so how could it be SIBO? The bacteria should all be dead. I am giving him probiotic chewables as well. I have tried the different combinations of food, but no improvement. I also tried putting the enzymes in capsules, still nothing.
I just tried to administer only half the usual dosage of the enzymes but 5 minutes later the gas came, the crying, the pooping with blood... I gave him gas x and he’s asleep now. But that’s not sustainable. I need to figure this out.

Could going an hour or two extra without eating cause this? Is it getting worse because I should withhold food for 24 hours? Is it the squash? Is it the tuna? Is it when he eats food that was not prepared on the same day and stored in a freezer bag in the refrigerator? He is also drinking water like crazy the last 2 weeks. I did a diabetes test on him, 2 actually, and they both came back negative.
I can’t figure it out. There are so many factors...

I tried to be this detailed in hopes that someone might see a small detail that allows you to connect some dots which I obviously am not connecting. Someone please help me/him?

EDIT: I wrote this last night but it wouldn’t let me post because it thought I was being spamful. So just a little update he pooped just now and there was no I blood it was Much more firm now. I did give him something i bought on Amazon yesterday it’s called Clay for dogs and it’s to regulate their vowels. Maybe this helped? My questions all still stand, however.

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jilbert57
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Posts: 941
Country: United States
State: Washington

Re: At Wit’s End

Post by jilbert57 » 28 May 2020, 22:14

The pancreatin powder is meant to be mixed with food and warm water and incubated for 15 minutes before eating. It would be in the pups best interest to have a fasting Tli test done to confirm EPI.

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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Jean
Staff
Posts: 953
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara
My name: Jean

Re: At Wit’s End

Post by Jean » 29 May 2020, 11:24

hello and welcome from the UK

after 18 years you are totally in sinc with your dog, and you know the score

I am so sorry you are both going through this, I lost my Kara last May, and am still struggling, so my love is with you

I trully have no answers, but I have asked Olesia our founder to have a look

take care

love


Jean
My name is Jean we live in Liverpool in Uk

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 use Panzym enzymes, Tylan and Chemeyes b12 capsules

Sadly, on 10th May 2019, we lost her to DM


Jeanx

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Olesia711
Founder
Posts: 1210
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy

Re: At Wit’s End

Post by Olesia711 » 29 May 2020, 12:07

Hi,

I read thru your post and am so so sorry that Skippy (and you!) are going thru all of this. As Jill mentioned, it would be best to have a TLI test done.....to confirm EPI.

However, based on your lackluster experience with your vet at the moment, i will share my observations, but please know that to best serve Skippy, you really need to work with your vet (or another vet). Sometimes what we have found is that you just have to be firm with your vet...... after all SKippy is your dog, and you are spending your dollars on his treatment so this is what you want further examined or done or whatever...................

The fact that it sounds like he might have chronic pancreatitis and maybe has even had it for a while and that now the enzymes "appear" to be helping could be one of two things:
1. With many chronic pancreatitis cases, it is actually suggested that pancreatic enzymes are given (usually at a lesser dose) to help the pancreas function since it is so inflamed and not working right at the moment. In some of these cases the enzymes are given temporarily ... in other chronic pancreatic cases, the enzymes are given at a low does as maintenance.
2. With some chronic pancreatitis cases, they segue into EPI which secondary EPI can happen from chronic pancreatitis.

Based on your post, it is possible that that blood you are seeing is from colitis, in which the metronidazole "should" help.... is the blood bright red or dark red. If dark red, please bring Skippy to a vet, any vet, ASAP as that can indicate an internal bleed and he needs immediate attention. If bright red blood, i would continue with the metronidazole (which is usually the antibiotic they give for colitis) maybe for 1 more week, but that would be it.because on the flip side.... metronidazole is not always the safest drug (can trigger metro toxicity, especially if you see anything that looks like back leg neurological issues... that's a good indication that a toxicity is happening)...... in which case, i would try Tylan antibiotic powder instead.

Typically we recommend Tylan over metronidazole (in most cases) if this was SID. Too often Metronidazole doesn't even touch SID... but Tylan does.... SOmetimes the opposite happens but usually Tylan works much better on SID.
The fact that his poo looked like a meat grinder got at his bowels early on .... this could also have been HGE or shedding of the lining or so many other things... again..... some of which usually is given an antibiotic for...... but it really depends on what the heck is going on to correctly decide what antibiotic to give.

The fact that you gave a clay product, which was a good move, the clay absorbs toxins.... so that indicates to me that this is something bacterial and whatever it is is askew. If the clay works, continue it... BUT... if Skippy is constipated you might be giving too much clay.... so i would try and reduce it.... and see if that helps. OR.... see if you can purchase some slippery elm powder and give this instead of the clay... Slippery elm helps with loose stools AND constipation AND with SID. The dosing instruction are here https://epi4dogs.com/slippery-elm/... and jsut a FYI... with Slippery ELm..... sometimes less is better.

If you can get your hands on Tylan, i would maybe try that also if the clay helps but not enough.

Regarding the food... if you suspect the food....first try reducing the veggies... try one kind at a time... and see if that is causing the discomfort.... and then try reducing different proteins or just trying them one at a time... to see if they might be the culprit.

Now the BIG thing that really worries me from you post is the fact that Skippy is drinking tons of water.... and it is not Diabetes..... my concern is that SKippy might be dealing with some sort of kidney issue. ..... and that the kidneys are no longer removing toxic waste........... in which case, he REALLY needs to be seen by a vet. If you are really turned off.....maybe check around and see if you can find another vet that friends/neighbors/etc. mention that really LISTENS to the pet owner and works WITH the pet owner.....vs. just brushing you off............

The other possibility (although i think this is probably remote in SKippy's case.. but i have learned to keep an open mind) is Cushings or A-Typical Cushings.... which does happen with older dogs... might want to look it up and see if any of it sounds relatable..........

I am not sure if any of this is helpful.... unfortunately much of our suggestions are based on just guess work since there is no absolute diagnosis and then we hope/suggest that the owner investigates the possibilities that we suggest with their vet..... so i do hope our suggestions give you some sort of guidance to look further into............

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.........

Ineedhelp27
Member
Posts: 3
Country: United States
State: Florida
Pet name: Skippy
My name: Gabriel

Re: At Wit’s End

Post by Ineedhelp27 » 06 Jun 2020, 10:46

Hi guys,

First off thanks to those who responded and tried to help. I wrote this entire thing last week in a moment of frustration, because although it was my first time writing in here, I have been reading peoples posts for some time now

So, thankfully, the blood in the stool has not come back anymore. But yes, Olessia, I believe that when this first happened, unfortunately his pancreatitis went hehmorragic. Luckily, it has never come to that again.

You are right, i need to take him to the vet. Just to give you an update on what the past week has looked like:
No more bloody stools, but constant gas and visible discomfort from Skippy. I have to help him poop maybe 5-10 times a day, it always comes out the same. There is an orange tinge, but i do feed him a little pumpkin and squash every meal—i am actually going to try to not give him either today to see if it will make a difference. It always comes out the same. Pardon the reference, but its the only way I can possibly think of to describe it. It has a slightly translucent character, and the consistency is in line with that. If you have ever seen or held hashish, that is the best way i can describe it. Like very dense, maleable stools. He has let up on drinking so much water though, and that coincides with me having started to give him less enzymes. Which btw, For the first person to answer this thread, sorry for not calling you by name but i can’t go back Now to remind myself because i don’t want to lose what I’ve already wrote lol—but yeah i have been incubating his enzymes with food before putting into the syringe, and for way more than 15 min, at that. I may have not explicitly mentioned that part because it’s kind of like a given to me, then again i have been researching exhaustively for so long now so im thinking things like automatically without explaining myself—but just in case anybody thought otherwise, I am administering the enzymes correctly. Even after incubating for 2 hours he wont eat them willingly. He is definitely better this week than last, and for that i am grateful, but I need to see more improvement because he still seems like he is suffering. Im going to look for a vet in Miami that perhaps specializes in gastro or pancreatitis and take him there. I was so upset with how my other vet handled everything, but it’s not realistic or fair to just withhold skippy from any medical attention.

I will update you shortly once he is seen and tested


Thank you all for the help, the care, the suggestions... Its comforting to feel i am not facing this alone. I live alone. I work for myself from home. I am always home especially these last few months with all the craziness of this world. And its been a long 3 or 4 months of usually just being silent here, by myself.... which i do not mind, but it really makes Skippy’s illness that much more deafening and really Places starkly at the forefront of my day-to-day that my little angel will soon one day not be with me. Because pancreatitis or not, he is 18. I cant imagine my life without him. I have no idea what its like. The last time i had a life without him, I was 10 years old—I honestly dont know what im going to do. But for now I wont think about it and will take him to the vet.

Thanks guys 🖤

Ineedhelp27
Member
Posts: 3
Country: United States
State: Florida
Pet name: Skippy
My name: Gabriel

Re: At Wit’s End

Post by Ineedhelp27 » 06 Jun 2020, 10:47

Oh and btw his probuotic that i give him has slippery elm. I haven’t given it to him in a couple days though to se if that settles his stomach issues. So far, it has not.

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Jean
Staff
Posts: 953
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara
My name: Jean

Re: At Wit’s End

Post by Jean » 06 Jun 2020, 11:14

You will never be alone on this forum

we are from the UK, and its so odd at the moment with Covid, and being alone makes things very stark , and multiplies everything

Please let us know how you get on

Take care


Jean
My name is Jean we live in Liverpool in Uk

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 use Panzym enzymes, Tylan and Chemeyes b12 capsules

Sadly, on 10th May 2019, we lost her to DM


Jeanx

User avatar
Olesia711
Founder
Posts: 1210
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy

Re: At Wit’s End

Post by Olesia711 » 06 Jun 2020, 15:22

Hi Gabrielle,

Glad to hear that SKippy sounds like he is feeling a little better, but as you wrote, yes he still should be seen by vet.... and i wholly understand your frustration with your current vet and that you would feel better finding a new vet. SO..... what i would like to mention to you, which is what we tell everyone who has experienced the same lack of service / care.... that it is not necessary to find a specialized vet that deal with the pancreas..... the very best vets turn out to be those that are not necessarily specialized but rather they are the type of vet that LISTENS to the dog owners, and work WITH the dog owner, not just tells the dog owners what to do, a vet who is excited about his patients , especially the "complicated" ones and do research on their own to figure out what the heck is going on. The one that go above and beyond. How do you find these vets? Ask around, ask you neighbors, friends that live locally, go to pet stores and ask who they heard is good, check out references on the internet..... you'd be amazed what you can dig up :) etc.,etc.....

Next, i 2nd what Jean said, you are not alone in this even though you physically work alone /at home.... we are all just a click away and many of us have had complicated cases with our dogs and did not know where to turn either. Sometimes we just need to vent our frustrations. SO please feel free to post anytime. We may not have the answers, but we sure can listen and share our personal experiences in hope that something we did to address a similar situation might be helpful to others.
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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