Won't Eat

[Jbergman10]

Hi All,
Sending out an SOS!

My pup Zeppelin (estimated age is 4- we adopted him about 2 years ago!) was diagnosed with EPI at the beginning of June 2020 after weeks of vomiting, explosive diarrhea, and weight loss. His labs on diagnosis: TLI <1.0 and cobalamin of 321 ng/L.. He was started on enzymes right away and weekly B12 injections. Once we went through the enzymes supplied by the vet, we turned to Diane's to save money. We did not see a huge improvement in Zeppelin's poop or weight gain. The vet increased his dose to 3 tsp with every meal. Still, no improvement and Zepp started to refuse to eat at all. A couple of weeks ago he started having complete liquid diarrhea for every BM, multiple times a day. We went to the vet again and started Metronidazole 250 mg (1.5 T PO BID for 10 days), omeprazole 40 mg by mouth once per day for 30 days, sucralfate 1 gram twice per day 1/2 hour before food for 14 days, and Proviable probiotics daily. For food they recommended Purina EN +/- Hills science diet sensitive stomach (which is the food he has been on for probably about a year up until diagnosis). We have been on this regime for about a week now. He had one formed stool a few days in, but the rest have still been loose or liquid. The big challenge has been getting Zeppelin to eat anything. He refuses to eat any type of dog food with enzymes but will pounce on any people food that drops on the floor and continues to scavenge for any potential people food dropped on sidewalks while we are out walking. We tried pretty much everything recommended on this site for masking the enzymes and nothing has worked. He would eat a bite or two of something one day, but refuse it the next. We finally bought a capsule filler and have given him enzymes that way for 2 days now. However, now he has realized what we are doing and will spit out the pill no matter what we put it in.

I am at a loss and feel so heartbroken that it has been 7 weeks now and we have not seen any improvement. It seems for every possible step forward, we take 5 steps back. He continues to not eat despite not having any enzymes mixed in and his poop remains liquid or very loose/mushy at best. He has gotten so skinny, we can basically feel every bone and his face looks skeletal. He is also slowing way down, cannot jump in the car anymore, and has troubles walking up and down stairs.

I am grateful for any input or advice- So thankful to have this community to turn to!

[jilbert57]

If the food is a kibble the correct amount is 1 level teaspoon enzyme to 1 cup kibble.
It is given by amount of food.

The diet that would be recommended for Epi would be grain free 4% fiber or less.

Have you looked around the site? There are many good articles.

Here is a quick start guide:
https://epi4dogs.com/epi-quick-guide-usa/

Jill

[Jean]

Good afternoon Jess from the UK

The rule of thumb with Dianes enzymes is 1 level teaspoon of enzymes to 1 cup of kibble, which is 8 ounces, too much enzyme is as bad as too little, and three teaspoons is WAY over

I really sympthise on no eating, Kara would have eaten a scraggy cat when she first got hit by EPI, after, no

metro is a great drug but we prefer Tylosin as its much less severe, and its weight of dog dosed, see below

the food you are giving may well have too much grain in it, and it has chicken in it and chicken fat, a lot of our dogs dont to well on chicken or chicken or poultry fat mine included

https://www.hillspet.com/dog-food/sd-ca ... d-skin-dry

what you are seeing is mainly undigested food being excreted, and is likely not a stomach disorder, I feel a course of Tylosin would help no end, twice daily, 12 ish hours apart, we reccommend 45 days, I had Kara on it for life, but a very little maintenance dose

https://epi4dogs.com/antibiotics/

you may well end up having to try Creon which is a capsule of enzymes in microsheres, no taste, no smell, you might also have to push the capsuled enzyme down his throat followed by food in the bowl

you COULD try pan fried liver with carlic, but a very little, feed on a flat pie plate, preferably glass, the muzzle goes in less

its likely you need to continue with b12

https://www.wonderlabs.com/itemleft.php?itemnum=K9688

maybe more injections

one thought, have you tried hand feeding

until Kara stomach stopped rumbling with bugs she refused food ,and I can understand why, I have a friend with EPI, and she said the pain when she was bad was worst that any period pain you can imagine, so there you go, the non eating could have this in mind, maybe the smell of the type of food is not to his liking, we put Kara on lamb based food for life, Tylosin got rid of the bugs

to give you some hope, my Kara was 39 pounds at her worst, and we persevered, she got to 90 pounds and stabalised till we lost her may 2019

keep a diary and let us know

keep the faith


Jean

[Barb]

Hi Jess,

I am so sorry you and Zepp are going through this. We had similar difficulties with Kolby when he was first diagnosed. We could not find a food that agreed with him and he hated the enzymes. . We eventually had to go to a prescription diet, which I didn't want to do, but we were desperate. He finally stabilized on Royal Canin Gastrointestinal Veterinary food. Now I understand that Royal Canin has a hydrolized food that can work well for dogs having trouble.

A couple of things:

As others have mentioned, the ratio of enzymes to food is 1 teaspoon per cup of kibble.

Not all dogs respond well to probiotics. Kolby never did well on them, so I would take Zepp off them until he stabilizes.


Kolby often went off his food. One thing we ultimately tried that really worked until he got sick (unrelated to EPI, we lost him to cancer in January) was giving him the canned version of his prescription food. I think he thought it was people food and he gobbled it down even with the enzymes on it. Actually, you have to adjust the enzymes down a bit for canned food because of the water content. I will look up the exact amount for you if you want to try this route. Have you tried other foods? Just make sure you make only one change at a time and record everything in your log/journal.

I know this is a trying time for you. Hang in there. The beginning is the hardest time when you are trying to get everything in balance.

Barb

[Barb]

Jess,

When I gave Kolby the canned food version of Royal Canin , I started at 1 teaspoon enzymes per CAN ......which is about a 1/2 teaspoon per cup. I thought I would have to move it up from there, but it turned out that I didn't. That dose was fine for him when he went to the canned version of Royal Canin Gastrointestinal....there is more water content in canned form, but the same ingredients if you stick with the food you are giving as kibble.

I hope this makes sense.

On the other hand, as others have said, maybe there is too much grain in the food he is eathing. Have you tried other foods?

Barb

[Jbergman10]

Thank you all so much for the input! I will definitely re-evaluate the dose of enzymes we are giving him... and look into getting a grain-free food! I also asked my vet about switching to Tylosin after this round of metro. I think Zepp does have an imbalance of bacteria in his gut (something we have dealt with prior to his diagnosis) and it sounds like that one works best for EPI dogs.

Any advice on giving pills? We have also been struggling with that!

Thanks again for the advice! I am so grateful.

[Jean]

giving pills is hard

I had no issue with Kara , she just opened her mouth, very biddable

are we talking any pills or the enzymes ?

the pill pockets sometimes work, try the liver garlic all of mine would kill for it , including my cat , obviously you need to get the enzymes down somehow, and the garlic might take the taste away of the enzymes

toppers such as parmesan cheese , tripe sometimes works, just anything smelly

but try some canned food, as Bard suggested, we gave a bit of cat food on top of Karas food, she gobbled it down, kibble sometimes is not the way forward

I really feel for you


Jeanx

[Tuckaboo Pam]

Hi Jess. It's Pam from Florida. When I give a pill, I hold Tucker's mouth open, put the pill way in the back of his throat, and clamp his mouth shut. You can also rub the bottom of their muzzle to make them swallow. This is how we gave pills to our dogs when I was a kid, and it may seem a little harsh but it works most of the time. I mask the taste of the tylan & enzymes with room temp turkey bone broth, which may soften his poo just a little bit, but he tolerates it & it's so good for him. My maltipoo gets a tiny touch of tylan, and she is finicky, so I put a spoonful of tuna right on top of the powder & she devours it. You will get through this, we promise. You just have to tweak for awhile, and there are lots of us to help you. Take care---Pam

[Madelon]

Hi. I am so so sorry your Zepp is struggling. I know how heartbreaking it is to watch them struggle. Please do change the dose of enzymes to what has been recommended. One other change you might consider is using the WonderLabs Pet Factor B12 pills - they have intrinsic factor which helps with B12 absorption but it also is a different form of B12 than the shots and some EPI dogs do better with the pills - you can open it and sprinkle it on the food - than with the shots.

Another thing to look for, check the muzzle for mouth sores. The enzymes are caustic and cause mouth sores which in some will make them not want to eat.

Glad you are asking for Tylan, however, while you are waiting for it, please consider using Slippery Elm Bark powder. It's a pre-biotic mucilage that coats the gastrointestinal tract. In recent research studies it has been proven to be as effective if not more so in some EPI dogs than antibiotics at correcting the gut imbalance. Here's a link to the dosing https://epi4dogs.com/slippery-elm/. You can get it from WonderLabs as well and if you use the code EPI4DOGS15 you'll get a 15% discount on your B12 and Slippery Elm.

If you're having a hard time pilling, try putting the pills in a dollop of cream cheese - seems to work for even the pickiest of eaters.

The mouth sores, possibly not responding to B12 and antibiotics could all be affecting the lack of appetite.

It's tricky getting the right balance of things in the beginning of EPI, but you'll get there. Please keep us posted on how things are going.

[Montgomery]

If your veterinarian hasn't given you one, get a pill gun. It makes it very easy to get the capsule to the back of the throat, and very difficult for the creature to spit back out. Follow with plenty of water.