New Diagnosis - Please help!

Post by **Shirl D.** » 20 Jun 2020, 10:03

Aw, shucks! Glad I could help. I wanted to check in this morning and see how Blu is doing today. I hope you all got some rest last night!

Post by **Jean** » 20 Jun 2020, 13:41

oh blimee. a huge welcome from the UK

I have speed read through all of this

firstly,,this is NOT diahorea, its undigested food that is expressed,and at speed

My Kara at her worst was 39 pounds, she was 14 months old and pitiful, and they CAN LOSE 20 POUNDS in a short time, they are eating, and not digesting anything

Kara was 44 pounds when she was 5 months old !

the thing to do is to keep a diary, and keep it simple, and I mean simple, b12 injections are essential

https://www.petmd.com/dog/wellness/evr_ ... py_for_epi

there are many links with this

Kara had a b12 injection every other day at the start, and then one a day for a week, and one every week, for 12 weeks. and then one a month for life, we something similar to wonderlabs , from Chemeyes in UK

my life changed when I met this group, and am proud to be the forum director,

the point is, you now have a map to navigate a rocky road, and a star to steer you in

you know where we are

Jeanxx

Post by **Rapids77** » 20 Jun 2020, 23:37

Hi Olesia – thanks again for all of the detailed information and for taking the time to go through all of his blood work results, I’m learning so much! I’ll respond to your post in numerical order and answer some of your questions…and likely ask you a few more. One thing to note on the blood work that Shirl posted – one set of results is from this past Sunday and the other set is from 1AM Friday so they are only ~ 5 days apart.

1. The anaplasmosis was diagnosed about 4 weeks ago now as the reason for the sudden onset of the diarrhea. We don’t know how long he’s had it and it was a “faint positive” on the test. I asked if that was like a faint pink link on a pregnancy test- basically, you’re either pregnant or your not. Vet confirmed that he couldn’t tell how long he’d had it but yes, a faint or dark result both indicated the same thing. Blu was treated with Doxy and the diarrhea never stopped and he became very sore….could barely stand up without rocking to get up and whimpered and cried all the time. So he was put on pain meds – that helped. Diarrhea never stopped (now we know why) and they took him off Doxy and did an injection of Convenia instead as they thought it would treat the tick disease but be easier on his intestine. I kept taking him back in and then they drew blood – said he had very low platelets and put him on prednisone. After I took him to the ER vet a week ago they said his platelets actually were NOT low (and that it’s a hard test to get an accurate reading on so that’s why it probably showed low previously) but that he did have low HCT. He’s still taking prednisone but will definitely make sure we continue to monitor this closely. I didn’t realize that the anaplas could ever test negative – I’ll ask vet to re-test for that to see if we’ve knocked it out.
2. Done! Should have it on Monday
3. See above
4. I’ve been giving these since Friday but just realized that I’m supposed to break them open and sprinkle on his food. Should that be done just before feeding the food so the enzymes don’t break them down?
5. That’s really interesting that the folate score can tell us that! He’s always been a picky eater and this makes sense that he probably knows what doesn’t feel good. So far he’s doing pretty well with the Sport Dog but we’ll keep monitoring it.
6. Discontinued
7. Will do – only have about 5 days left but I can request refill
8. That all makes sense re: probiotics, will hold off for now.
9. I stopped this one, hate the idea of giving more drugs than needed and knew it wasn’t going to help with the diarrhea

And great advice to not add anything else to the mix right now, poor guy is on so much already!

Post by **Rapids77** » 20 Jun 2020, 23:40

Hi Jean and Barb! Thanks for you both kind words and guidance. You are so right about finding an amazing group to help navigate these waters!

Post by **Rapids77** » 21 Jun 2020, 00:03

General Blu Update:

6/20: Blu's been on enzymes for 2.5 days now. This morning I saw glimmers of my old Blu. He dropped a ball on my face in bed t(my first thought was YAY, you're coming back to me!! second thought was....wait, you've have been eating poop and now you're spitting your ball on me, third thought...who cares, I sure love you).

FOOD: I'm feeding him 4 times throughout the day, approximately every 4 hours as he doesn't eat a ton at each meal and I didn't want to waste food and enzymes. So he's getting a total of 4.5ish cups of Dog Sport Elite throughout the day (which is 1.5x the recommended amount for his goal weight of 70lbs). I've topped that with some crumbled RC Canned Hydrolyzed Protein food that I brought home from the ER vet as he really seems to like that food. I add 1 tsp of the enzymes for each cup of food...or 1.5 tsp if he gets 1.5 cups of food. This doesn't seem like much food though? I'm following the weight / feeding guidelines on the bag but 4.5 cups just doesn't seem like much. Does anyone have any thoughts on that? I've also been giving him 2 B12s each day but was giving those in little RC Hyrodlyzed Protein meatballs until I realized I'm supposed to sprinkle those on the food. Will start doing that tomorrow. I'm assuming I sprinkle on just before serving and not mix in with the incubating enzymes / food?

POOP: Well, I'm apparently suffering from dyslexia and was using the wrong numbers for tracking his poop. His poop for the last 4 weeks has been a number 6, sometimes mixed with a 7. But today...oh today!! We had our first non-liquified poop! The first poop of the day was a solid 5. Then there was one that almost a 4 and then two more that were in that 4. to 4.5 range. I was little sad that there were 4 medium to largeish poops today (so far, it's 11 and he had his last meal at 9:45pm). Is it still normal to have a larger number of poops when they're first getting started with the enzymes? All four piles were dark dark brown too and not the super scary bright yellow cow piles of the past. I should note that the Dog Sport food is also super dark brown...almost black.

SPIRITS: He was a little maniac this morning and it was great! He was perky and wanted to play ball (which we didn't as I don't think he's strong enough yet to be running and pouncing) and he even had a little strut back in his step. By this afternoon he was pretty tired and seemed a bit down again but hoping he was just tired. He's resting happily now and will get to sleep in my bedroom again tonight instead of his crate as we were accident-free last night! He loves his crate so it's not horrible for if he does have to sleep there. Unfortunately, we were finding poop and pee all over the house when we weren't crating him at night which was so weird because he's been house trained forever and always stayed out and was free to roam all night.

I think that's about all I have for now, hope you all are having a great weekend!

Post by **Olesia711** » 21 Jun 2020, 17:48

Hi Andrea... AWESOME update !!!!! and thanks for responding to each one of my bullet points.

Regarding the B12.... no..... you do not have to open the capsule and sprinkle on the food.... that's what we do with CREON (an enteric coated enzyme for those that can't use the powder or do not have access to the powder to treat EPI).
HOWEVER... that being said, some folks actually do open the B12 capsule and sprinkle on the food/or mix in the food, while others (like me) just give the capsule whole with the food. SO you have not been doing anything wrong

FOOD: As long as you are giving 150% of what is recommended for his size (listed on the bag of food) that should be enough food AND... the fact that you are feeding him 4 times a day is wonderful!!! He sure is lucky to have you as his "companion"

. It is always good with these dogs (in the beginning) to feed smaller portions but more often... once they are stable and as you reduce the amount of food given.... then you can go back to feeding twice a day.

POOPS: AHHHhhh.... so you read the numbers wrong i was wondering about that, SOOOooooo you are already seeing improvement. FANTASTIC!!!! But also know that with these dogs, as they heal, sometimes it is "2 steps forward and 1 step backward " as long as over all Blue is moving in the right direction you are doing good.! Also know that transit time (in the vet medical books) used to say that the transit time is 12 hours. We at Epi4Dogs used to laugh at this, and we'd laugh cause we did the carrot trick to test the transit time (ahem... very scientific in our part ... hahahahaha)... anyway, low and behold FINALLY UC Davis Univ https://epi4dogs.com/poop-transit-times/ came out with a study that finally proved we had it right all along, dog's transit time can range anywhere from 12 hours to 72 hours.... exactly what our carrot trick showed over and over again. SO..... it is possible that when you see good poo and then a little sloppy poo from Blue, don't get discourage..t may be his transit time for some of the food stuff he ingested. If you keep a log (and take pictures of the poo) you will be able to tell what his transit time is... and over time what ingredients agree with him and which food ingredients he has issues with (keep in mind he has some sort of small proximal intestinal disease via that Folate score of 6.2) which in lay terms is that he most likely has some sort of food sensitivities/IBD or IBS... no need to figure out which, just figure out which foods are that bother him ...

Finding poo and pee all over the house (prior to EPI diagnosis) is common... they can't help it when they have EPI and are not on enzymes yet..... this too shall pass in short order

SO glad to hear that his spirits are up and you are starting to see glimmers of his ol self. This is wonderful!!!! Bu remember... it took him a lonnggggg time to get sick to where you recognized that there was a problem, as these EPI dogs don't really show any symptoms that we can visually see until anywhere between 85 to 95% of their pancreas has atrophied... so healing won't happen overnight, but it will happen.... and he is doing greatl!!!!!

Post by **Madelon** » 21 Jun 2020, 21:52

Sorry I am late welcoming you. Everyone has given great suggestions so I don't want to muddy the waters but - My first suggestion is to take poop pictures - gross I know but when you're making changes and looking at so much poop it can really help when trying to make comparisons. My other suggestion is to keep a detailed journal of everything you give and the resulting poops. Please keep us posted.

Post by **Shirl D.** » 22 Jun 2020, 09:32

Andrea,

WooHoo!!! I am so glad to hear there is improvement! Did you ever think you'd be this happy about poop?

And seeing him start to feel better is priceless. It really sounds like you are on the right track at the moment. The tylan should start to help in a few days, too, but you probably can't expect perfect poops until then with the SID he's got.

Sorry for the late response to your posts from late Saturday...I swear I checked in numerous times yesterday for an update but didn't see one. I must be imagining things!

Keep up the good work!

Post by **Barb** » 22 Jun 2020, 13:06

Such a great update. It's so good to hear he is feeling better. You are doing a great job of managing. And yes, you are officially a poopologist. Our neighbors used to watch me going out to the yard with a flashlight to examine poop and the husband said if there is reincarnation, he wants to come back as Kolby. I guess I've heard everything now.....someone wants to come back as a German Shepherd with EPI! LOL!

Keep the good news coming.

Barb

Post by **Rapids77** » 22 Jun 2020, 16:47

Hello all!
So nice to hear from so many of you! It is giving me peace of mind and confidence that I CAN do this and help my guy get healthy again. I do have a bunch more questions so thank you in advance for your patience and guidance!

FOOD: Blu doesn’t like the enzymes. I have to make a big production of amping him up to eat and making him wait the 20+ minutes for enzymes to activate by playing this “oohhh aren’t you hungry…it’s coming buddy….it’s going to be yummy….your doggy brother would love this but he doesn’t get it” game. I really should start my own youtube channel of ridiculous dog antics as I'm mixing up the "show" 4 times a day for him to keep him entertained. He gets pretty excited...then smells it and looks at me like I’m crazy once I put the bowl down. If I mix in the RC Hydrolyzed Protein canned food as a topper (that vet #2 gave me so I could make meatballs with his pills) he seems much more prone to eat it. So my question are:
1) Do I need to soak the canned “topper” in enzymes as well or are a few tablespoons of that stuff mushed up to gravy consistency NOT in the enzymes drizzled over the dry dog food ok?
2) I’m about to order some green tripe and raw pancreas from greencuisine.com for pets (recommended in one of the resource links on this site). But there is a 20lb minimum order. I’m thinking based on the responses here that Blu will enjoy this green tripe and or raw pancreas and this might be feeding a bit easier. BUT – how much green tripe do I add? And does that too have to be mixed in the enzymes first?
3) If I get some pancreas as well as the green tripe, can I do a combo of enzymes and raw? Just trying to gauge if a combo of 20lbs of tripe and pancreas is going to go bad before I use it all?

TYLOSIN: I picked up our script for this today. It is however NOT Tylan. It is “Tylosin Soluble Powder” Pics attached.
4) I get that Tylan is a brand name, but before I start administering this I just want to double-check that it’s the right stuff! I would appreciate any feedback that this is indeed the right med. My vet has said ½ teaspoon of this twice a day with meals for 45 days.
5) If this is the right stuff, can I put the ½ teaspoon powder in an RC hydrolyzed protein “meatball” to mask the taste and get him to eat it?
6) Does that Hydrolyzed protein meatball have to be soaked in enzymes first?

PREDNISONE:
7) What exactly should I request to be continually tested to determine if he needs to stay on prednisone? Is that the HCT blood test? We’ve got about a week left on the original script which had him weaning off slowly but vet #2 put him on 1.5 pills daily with no wean off plan. I know it’s really bad to just stop it cold turkey so just want to get ahead of the curve on getting more if needed but also don’t want to keep him on that long term if not needed. Olesia I think this was exactly what you were talking about on Friday with constantly checking HCT levels, but I just want to make sure I’m requesting and monitoring the right thing for this specific drug. Clearly I get confused easily.

POOP: Ahh, now to the fun stuff! I’ve become quite the food mixologist and poop scientologist (such a fun club isn’t it!?). I’ll attach pics for your viewing pleasure. The yellow one is pre-enzymes and the standard that we have seen for about 3-4 weeks. Sometimes it was substantially more watery and not very photogenic as it really just soaked right into the ground but this pleasant pic was on the floor and thus easier to document than the rest. I deemed that to be a 6 ish on the scale. The very dark, more formed pile (which I determined was about a 4.5) was actually a few mushy logs on top of each other although not a great pic. The dark pile in the grass was from today and we seem to have gone backward a bit looking more like a 5.5-6. But as you guys say...two steps forward and one back so I'm not too freaked out yet. Plus we had a house full this weekend and I imagine he likely found some food somewhere he shouldn't have had - he's a total scavenger and little kids aren't the best at keeping their food up high. Sigh.

In general – Blu’s spirits are good. He’s spunky, playful and not having accidents in the house so these are all wins in my book!

Thanks again for being my lifeline folks – don’t know what I’d do without you all!