Introducing 12-year-old Lab Shep Mix, Nilla

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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CarolinaT
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Country: United States
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Pet name: Nilla
My name: Carolina

Introducing 12-year-old Lab Shep Mix, Nilla

Post by CarolinaT » 07 Oct 2020, 16:33

My 12-year old lab shepherd mix, Nilla, began loosing weight 1.5 years ago. Last fall, I took her to our regular vet for stomach gurgling and the first gas she had in her life. We always remarked about how she was a dog that never seemed to have gas. The vet gave her antibiotic for a possible stomach parasite and we went on our way. Two months into COVID lockdown, she drastically started loosing weight. I took her to two emergency vets including an Internal medicine pet specialist since my regular vet couldn't fit us in due to a COVID backlog. The emergency vets were looking for cancer and surgery-type issues. No one suggested EPI, but we did get her on an IBD diet of Royal Canin. By trial and error, she responed to the Royal Canin Low Fat diet the best. This helped her gain three pounds (she was down to 48 from a high of 71 pounds). I did research and thought she may be low in some nutrients. I started giving her human B12. One emergency vet who specialized in Internal Medicine told me he could switch her to Colbalmin B12. This dramatically changed her stool consistency. I also started her on a probiotic once per day. My research then led me to EPI. She had gained another 5 pounts on the LF RC diet with B12. My regular vet then tested her for EPI. I was already giving her the enzymes for about three weeks. She had TLI: 2.3; B-12: 1548; Folate: >24.

The vet prescribed Tylan for SID due to her high Folate levels. This seems to make her not want to eat as much. Also, her stools became worse and her coat is a bit more coarse. The vet was concerned about her not getting enough fat. I just started her on a teaspoon of coconut oil once per day. We will likely need to get her tested for Pancreatitis, but I can tell from trying the full fat version of RC GI food that she likely also has this condition since she hasn't responded well to fats.

She is so happy and is a healthy 62 pounds. We feel like we have our dog back.

Should we continue her on the Tylan despite the negative changes in her stool and coat luster? Could reducing her B12 to every other day help with folate?

Thanks for any ideas you may have. I know each dog is different.

Carolyn

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Madelon
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Re: Introducing 12-year-old Lab Shep Mix, Nilla

Post by Madelon » 07 Oct 2020, 19:32

Hi Carolyn! Welcome to our EPI family. I'm so sorry you have to be here but so glad you have a definitive diagnosis. I can't even imagine going through all of that with your dog during COVID lockdown.

It sounds like you've done thorough research but I'd like to go over the four cornerstones of managing EPI:

ENZYMES: The recommended starting dose is 1 level teaspoon per cup of kibble, mix in a little luke warm water then mix kibble and sit 20-30 minutes before serving. Most of us get our enzymes from EnzymeDiane as her enzymes are about 1/3 of the cost of the prescription enzymes from the vet.

B12: EPI dogs need their B12 on the high side of normal 600+ and supplementing is for life. It sounds like you've got the B12 well handled so I wouldn't change anything - just keep an eye for any signs of the B12 dropping like loss of appetite, lethargy, weight loss, bad poops, mood, etc.

MANAGING SID: In the beginning when dealing with SID we recommend trying the right dose of enzymes, B12 and food for a week or so to see if the gut will correct itself. If not, then we recommend trying Slippery Elm Bark Powder https://epi4dogs.com/slippery-elm/. If SE doesn't help then we recommend trying a probiotic with a prebiotic like Proviable and finally if all else fails we recommend a 45 day course of Tylan (slowly wean off after 45 days).

FOOD: We recommend grain free with 4% fiber or less and avoid peas and legumes. Feed 150% of the food for the weight your dog should be but in smaller more frequent meals throughout the day until they reach their goal weight.

It's hard to know if it's the Tylan making her not want to eat or if it's that the SID is still not under control. Tylan can be bitter and some dogs don't like it so you might try putting it in a dollop of cream cheese or a capsule - be sure you're giving the proper dose as your dog as gained weight so the dose might need to be adjusted https://epi4dogs.com/antibiotics/. I believe the food you are feeding contains grains which most EPI dogs don't do well on so you might need to change foods in order to help get the SID under control. There's no reason for prescription low fat food unless your dog has another underlying condition requiring it.

If you suspect pancreatitis based on symptoms of discomfort I would suggest talking to your vet about running the specific test for pancreatitis. If however, she's not displaying the typical signs of belly discomfort etc then you might try changing the food first.

Keep a log of everything you give and the resulting poop to help you figure out what works and what doesn't. We'll be here to help guide you along the way.
MADELON and Doc. DX EPI and SIBO: 5/22/2015
Test Results: (1st) 7/2014 = TLI 16.5, B12 894, Folate > 24; (2nd) 5/2015 = TLI < .4, B12 406; Folate >24; (3rd) 10/2015 TLI < .4; B12 >1000; Folate 14.4. Prior to DX: May 2014 (2mos) - DX coccidia/bladder infection; July 2014 (3mos) 1st EPI test = TLI 16.5, B12 894, Folate >24 - Dx SIBO not EPI; Feb 2015 thru May 2015 - weight loss only; May 2015 vomitted several times, diarrhea and eating poop. Regimen: 4 cups Sport Dog Food Elite Herding - Diane 6x 1tsp per cup; 1 WonderLab PetFactor B12 2x day; 1/2tsp Slippery Elm 2xday; Multivitamin; 1 Zyrtec 10mg 2x day; Salmon Oil

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CarolinaT
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Country: United States
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Pet name: Nilla
My name: Carolina

Re: Introducing 12-year-old Lab Shep Mix, Nilla

Post by CarolinaT » 09 Oct 2020, 16:57

Thank you, Medelon! I really appreciate your insights and recommendations.

Tuckaboo Pam
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Re: Introducing 12-year-old Lab Shep Mix, Nilla

Post by Tuckaboo Pam » 09 Oct 2020, 18:22

Hi Carolina, and welcome! What is the dose of tylan Nilla is taking? Are you splitting it over two meals? I try and mask the bitterness by pouring turkey wing broth over the kibble & tylan, with enzymes, of course. Tucker eats it fine, but my maltipoo who takes tylan for SID only, has to have it put into a capsule, which I slather with soft butter & push down her throat. I've heard about a pill shooter that some people use, but my method works for me. I empty Tucker's B12 capsules into his food & save them to put the tylan into. So, this is a warm, friendly group, and you need to be sure and ask all the questions you think of, and to keep us posted about your progress, OK?---Pam & Tucker
Tucker is a shepherd/lab mix; he has tested positive on the ScheBo test for EPI, as well as the fasting TLI. Results--- TLI 1.3, Folate 9.7, Cobalamin 666, Lipase 38. Currently taking Diane's Enzymes 4 teaspoons/day, Wonderlab B12 capsules 2-3 per week, slippery elm 1/2 teaspoon/day, Proviable 1 capsule/day, and Tylan 1/16 teaspoon/day. Sport Dog Elite, herding dogs 4 cups/day. No more poop eating, his weight is steady, and he is a happy member of the family, though a bit of a stinker, if you ask the other dogs. Tucker is my boyfriend, and my husband is OK with that.

Barb
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Re: Introducing 12-year-old Lab Shep Mix, Nilla

Post by Barb » 09 Oct 2020, 20:26

Welcome, Carolyn, to you and Nilla. You have done a great job of doing investigative research. Nilla is lucky to have you. Knowing that you went through all this during the Covid lockdown is so commendable. You've done an amazing job. You now have a positive diagnosis and can proceed.

You have already received excellent advice and we are so glad that Nilla is improving. You will need to keep an eye on her stools to see if she is exhibiting signs of pancreatitis, as you mentioned, but it sounds like you are doing that already. As Madelon said, the tylan is bitter. We had to put it in capsules for Kolby. He would not touch his food with tylan sprinkled on it.

Let us know what you find out about the pancreatitis and keep us posted on Nilla's progress.

Barb

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CarolinaT
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My name: Carolina

Re: Introducing 12-year-old Lab Shep Mix, Nilla

Post by CarolinaT » 10 Oct 2020, 01:11

Nilla is on 1/8 of Tylan every 12 hours based on her Folate test. Her stools were excellent before the Tylan. My vet recommended the Tylan based on her folate levels and some reported gurgling in her stomach.

Her energy and mood is great.

About a week after being on Tylan, her hair felt coarser. Two days ago, I started giving her a teaspoon of coconut oil. I know it may take two weeks for her coat to come back. I'm considering Vitamin E and Salmon Oil.

I've spaced out the vet bills over several months. The emergency vet bills over the summer amounted to 2k with one faulty congestive heart failure diagnosis for which I was given free care after inquiring (telehealth isn't going so well especially without video). I do want to know if she has pancreatitis. That is another 300 USD test. I have Royal Canin High Energy foot that I could slowly add to her food to see if her stools change. That would likely tell me she has chronic pancreatitis. I asked the vet what to do about her low fat intake if that is the case? My vet said she would be on the prescription low-fat diet for the rest of her life. I also read on a kennel club society site that I should take her off the probiotic if she has pancreatitis. I still have more exploring to do.

I'm just so glad that she gained back her weight and is happy and full of energy. At one of the lowest points, she would occasionally have this strange quivering in her head and neck even on a hot day. I did a lot of gazing at her while working from home! I now think she was experiencing some kind of nervous system issue due to nutrient deficiencies. I shudder to think about what was happening to her.

I am grateful to this platform for all the helpful information. I think EPI4dogs came up when I was researching why the B12 helped her so much. I was actually giving it to her based on an IBD-related illness I thought she might have.

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CarolinaT
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Country: United States
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Pet name: Nilla
My name: Carolina

Re: Introducing 12-year-old Lab Shep Mix, Nilla

Post by CarolinaT » 10 Oct 2020, 01:11

Nilla is on 1/8 of Tylan every 12 hours based on her Folate test. Her stools were excellent before the Tylan. My vet recommended the Tylan based on her folate levels and some reported gurgling in her stomach.

Her energy and mood is great.

About a week after being on Tylan, her hair felt coarser. Two days ago, I started giving her a teaspoon of coconut oil. I know it may take two weeks for her coat to come back. I'm considering Vitamin E and Salmon Oil.

I've spaced out the vet bills over several months. The emergency vet bills over the summer amounted to 2k with one faulty congestive heart failure diagnosis for which I was given free care after inquiring (telehealth isn't going so well especially without video). I do want to know if she has pancreatitis. That is another 300 USD test. I have Royal Canin High Energy foot that I could slowly add to her food to see if her stools change. That would likely tell me she has chronic pancreatitis. I asked the vet what to do about her low fat intake if that is the case? My vet said she would be on the prescription low-fat diet for the rest of her life. I also read on a kennel club society site that I should take her off the probiotic if she has pancreatitis. I still have more exploring to do.

I'm just so glad that she gained back her weight and is happy and full of energy. At one of the lowest points, she would occasionally have this strange quivering in her head and neck even on a hot day. I did a lot of gazing at her while working from home! I now think she was experiencing some kind of nervous system issue due to nutrient deficiencies. I shudder to think about what was happening to her.

I am grateful to this platform for all the helpful information. I think EPI4dogs came up when I was researching why the B12 helped her so much. I was actually giving it to her based on an IBD-related illness I thought she might have.

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Madelon
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Re: Introducing 12-year-old Lab Shep Mix, Nilla

Post by Madelon » 11 Oct 2020, 11:44

Hi there. Yes if she has pancreatitis then it's not recommended to give a probiotic. If you think the Tylan caused the bad stools you could try discontinuing it but I don't recall ever hearing it made stools bad but then again every EPI dog is different. When adding coconut oil, salmon oil etc we recommend starting with 1/2 the recommended dose and wait a few days to see how it affects the poops. My boy cannot tolerate coconut oil at all - immediately turns his poops bad.
MADELON and Doc. DX EPI and SIBO: 5/22/2015
Test Results: (1st) 7/2014 = TLI 16.5, B12 894, Folate > 24; (2nd) 5/2015 = TLI < .4, B12 406; Folate >24; (3rd) 10/2015 TLI < .4; B12 >1000; Folate 14.4. Prior to DX: May 2014 (2mos) - DX coccidia/bladder infection; July 2014 (3mos) 1st EPI test = TLI 16.5, B12 894, Folate >24 - Dx SIBO not EPI; Feb 2015 thru May 2015 - weight loss only; May 2015 vomitted several times, diarrhea and eating poop. Regimen: 4 cups Sport Dog Food Elite Herding - Diane 6x 1tsp per cup; 1 WonderLab PetFactor B12 2x day; 1/2tsp Slippery Elm 2xday; Multivitamin; 1 Zyrtec 10mg 2x day; Salmon Oil

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CarolinaT
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Pet name: Nilla
My name: Carolina

Re: Introducing 12-year-old Lab Shep Mix, Nilla

Post by CarolinaT » 03 Apr 2021, 18:25

Thank you Madelon! I just realized I never responded to your post on the thread. This community has been so helpful.

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