New here & would appreciate a bit of advice

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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reremedies
Member
Posts: 2
Country: United States
State: California
Pet name: Binky
My name: David

New here & would appreciate a bit of advice

Post by reremedies » 20 Mar 2021, 16:57

My dog was diagnosed with EPI after severe and sudden weight loss. I got some PancreaPlus and my dog went from 13 lbs to about 17 lbs in 10 days, which is great. She is a voracious eater, but yesterday she stopped eating after a few days of vomiting a little clear brown liquid. Not sure what this is. I've been incubating her enzymes for 20-30 minutes, and I've now cut back on them a bit. Today, her stomach is making really loud rumbling sounds. And she doesn't seem happy. Do I need to adjust something? Also, I read about vitamin E and Zinc deficiencies. So, if I am only treating her with the PancreaPlus am I missing something important?

Thanks for any advice!

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Olesia711
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Posts: 3858
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: New here & would appreciate a bit of advice

Post by Olesia711 » 20 Mar 2021, 19:05

Hi David,

Thanks for writing us and asking about this.... that clear brown liquid and those tummy noises.... that is most likely all SID (small intestinal dysbiosis)...... all dogs with EPI have SID, but.....we dont treat unless it gets out of hand... like what you are seeing.

Technically, if it was just the tummy noises and or loose stools all of a sudden after everythiing was going great, THEN we would normally suggest a prebiotic and if that doesn't work well enough then the next thig would be a probiotic with a prebiotic.... BUT.... since your gal (who by the way had a GREAT weight gain!!!!) is also vomiting, she probably would be better off with a course of Tylan (Tylosin Tartrate antibiotic soluble powder).

Please ask your vet for this. DO NOT let your vet give your dog Metronidazole )Flagyl) for any chronic gastrointestinal issues going forward. We are trying to educate vets now not to do this - - but most were taught that you give the Metronidazole as an antibiotic. Please don't as it may permanently kill certain bacterial strains (Metro kills good and bad bacteria where as Tylan only inhibit bacterial reproduction) and these poor EPI dogs have enough problems in the gut with (1) not enough bacteria (2) not enough bacterial strains variety!

You can actually order Tylan from Chewy, but your vet has to approve the order as Tylan is now a prescription: https://www.chewy.com/tylan-soluble-powder/dp/173768
here are the dosing instructions: https://epi4dogs.com/antibiotics/
Please read this page regarding Tylan dosage.

Technically It is to be given twice a day with meals for 45 days...... BUT.... about halfway thru this course, talk to your vet about adding a good probiotic to the regimen. Tylan won't kill the probiotic (Metronidazole would !) and this way you can start adding good bacteria back into the gut. The only thing we caution everyone is when they start introducing a probiotic, start with less than half the recommended probiotic dose and work your way up to a full dose over the course of a week or two. (some dogs take time adjusting to a probiotic) . Currently we are recommending Visboime or Proviable... but you can also ask your vet what he/she would recommend as a good probiotic that has a prebiotic included in it.

Hope this helps.... and jsut a FYI..... having SID rear it's ugly head AFTER you started the enzymes and things seemed to be going great and then this happened.... well.... just so you know, this is very typical. Oh.. and go back to giving the full dose of enzymes with the food.

If you have any other concerns, just ask... anytime. :)
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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Jean
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Posts: 1707
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: New here & would appreciate a bit of advice

Post by Jean » 21 Mar 2021, 06:04

Good Morning David from the UK

The one big thing that worries me about Metronadazole is its side effects

https://www.petmd.com/pet-medication/metronidazole,

it also has neurological side effects which can only be dealt with by giving Valium

it will never be my choice of medication, the only other question is, is the vomitting of brown liquid at the start of the day, if so it could also be bile which is caused by an empty stomach, a late evering meal would help here, but I totally agree with Olesia about SID
My name is Jean we live in Liverpool in Uk

I am the Forum Director which I am very proud of

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 used Panzym enzymes, Tylan and Chemeyes b12 capsules

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


Jeanx

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jilbert57
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Posts: 2092
Country: United States
State: Washington

Re: New here & would appreciate a bit of advice

Post by jilbert57 » 24 Mar 2021, 11:04

Hi David, you have been given sound advice on the rumblings.
It helps if you keep a log of food and meds in and how they affect your pup.

https://epi4dogs.com/epi-log/

Jill
My name is Jill and we live on the Hood Canal in Washington State. We currently have 2 Jack russells, TJ is 8 and Sadie is 2.

Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.

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

Re: New here & would appreciate a bit of advice

Post by Barb » 25 Mar 2021, 13:40

Hi David,

You may already be doing this, but I was wondering if you are giving any B12 supplements. Your pup's issues seem to be SID related, but sometimes lack of appetite can be caused by low B12. Wonderlabs provides an excellent product that is an easy fix and is very reasonable. Many of us have used it over the years. It is B12 with Intrinsic Factor and is called Pet Factor. The Intrinsic factor is necessary for absorption for EPI dogs.

I didn't see any B12 levels in your post, so you may not need this (For EPI dogs B12 should be in the moderately high range 600 plus), but I just wanted to put it out there.

Barb

reremedies
Member
Posts: 2
Country: United States
State: California
Pet name: Binky
My name: David

Re: New here & would appreciate a bit of advice

Post by reremedies » 05 Apr 2021, 20:00

Wow these responses are wonderful, thank you all! We are now roughly at the 6 week mark after treatment began,, and Binky is doing great. She has literally gotten fat. It's getting to the point where she is fatter than she has ever been in 7 years, and I'm glad to be out of the danger zone with the bony dog I had 2 months ago. But, I'm wondering now if I should reduce her food slightly to ovoid health problems in the other direction of weight. The brown liquid has gone for the most part only very occasionally seeing her vomit. That happened as I naturally adjusted her pancreatic enzymes based on her weight gaining which has been aggressive and her stool consistency. I will ask my vet about Tylan still though. As for B12, the vet said her blood levels were normal. Thanks for the tips. I have a great vet who I like, but she has never seen an EPI dog before, so this is really helpful.

Tuckaboo Pam
Member
Posts: 1345
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: New here & would appreciate a bit of advice

Post by Tuckaboo Pam » 06 Apr 2021, 14:25

David, I, too, have a wonderful vet, who had never seen a case of EPI. I have found that some vet consult, a good helping of EPI4Dogs forum, and a touch of I'm with my dog 24/7, has been the healing cocktail that Tucker needed.

My advice would be, ask all the questions you have, here, but also peruse the site, especially the pages on Managing EPI, and you will get many of your questions answered, or your memory will be jogged about something you have forgotten to mention. This is in NO way meant to say don't ask until you've read the instructions, but sometimes just reading through all the categories can be helpful!

It would also be great if your vet was open to looking through the pages, herself. My third vet, the one who finally did Tucker's testing, has just been added to the EPI4 directory.

My Tucker has gotten better by using Diane's Enzymes, slippery elm, Proviable, Tylan, and the occasional B12 because for some reason his isn't low.

He got too chubby after treatment, too, and so I cut back his portion. He was an official "Chunky Monkey". Take care----Pam & Tucker
Tucker was a shepherd/lab mix--- TLI 1.3, Folate 9.7, Cobalamin 666, Lipase 38. Took Diane's Enzymes 4 teaspoons/day, Wonderlabs B12 one capsule per day, and Tylan 1/16 teaspoon/ morning (to hold SID at bay). Taste of the Wild High Prairie, 1 1/2 cups/day, with a total of 4 cups of Fresh Pet. Stopped eating everything in sight, and went from 60 to 85 pounds! Tucker was my boyfriend, and my husband was OK with that. Tucker succumbed to hemangiosarcoma, but we cherished every day we had with that wonderful, beautiful boy. I will always, always miss my sweet big boy.

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