Enzymes no longer working

[sburron]

Hi,

Lemon was a street dog from Texas who I adopted in April of this year. She was in a shelter for a few weeks before being brought to Canada and lost 10+lbs in the shelter before coming here so she was extremely skinny (~1/5 BCS)when I got her. After getting her the vet found hookworms and whipworms in her stool and after treatment for that did not elevate all her symptoms, we realized she had EPI as well. The vet prescribed 10 days metronidazole and enzymes (Pank-Aide) and she started rapidly putting on weight (increased weight by over 10lbs). I am feeding her 3x daily (a mix of kangaroo wet/dry as she seemed to have some allergies/sensitivities after starting the enzymes to chicken, fish, and beef) with 1Tbs of powdered enzyme for each feeding. Her B12 was normal so we did not supplement. Her stool was normal and she seemed to be doing really well with that combination for almost two months and her BCS increased to about a 2-2.5/5. Occasionally she would have periods where her stool had a grayish tinge or was soft/yellowish, though overall it was pretty good and her weight was still going in an overall upward trend even if there were small periods where the enzymes seemed less effective. Unfortunately, over the last month or so I have noticed the periods where the enzymes aren't working is increasing and her stool was loose more often than not. We gave her another course of Metronidazole in hopes that there was just some sort of gut dysbiosis occurring but we have just about finished the course of antibiotics and it seems to have done little. Her stools are now very similar to how they were before she was diagnosed and she seems to be losing a noticeable amount of weight which is worrisome as she still does not have a lot of fat reserves. I am waiting to get some raw pancreas in hopes that that might help though it wont be available anytime soon.

Her vet cannot get her in until next week but I was wondering if anyone had gone through similar things?

Thank you,
Scarlett

[secretlybees]

Hey Scarlet,
I haven't had something similar but I have some ideas on what you can do. First off, the antibiotics you used aren't always great. They tend to kill both good and bad gut bacteria so the problem reoccurs soon after stopping.
https://epi4dogs.com/antibiotics/ check out this for more info. Tylan tends to work better.

Next up, most dogs with EPI need higher than normal b12 so even if they're within decent b12 ranges, you should keep supplementing until they're in the 600-700 range.

Until you can get back to your vet, try to add prebiotics (even prebiotic yogurts) to your dog's food. If that doesn't help, try to add prebiotics too. Slippery elm can also help with the diarrhea.

[Madelon]

Hi Scarlet - I'm so sorry your dog isn't doing well.

First a few questions: what enzymes are you using? how much per cup of food?

A few things stand out besides my question about enzymes. As Alex said B12 is critical to properly managing EPI. Low B12 can affect mood, energy, weight gain, appetite, etc. EPI dogs need their B12 on the high side of normal 600+ and supplementing is for life. Most of us use WonderLabs Pet Factor B12 pills (they ship to Canada - use EPI4DOGS15 for a discount at checkout) or you can do shots with a prescription from your vet.

We typically recommend Tylan antibiotic for 45 days as it is better at addressing SID (small intestinal dysbiosis) than metronidazole. Ask your vet if you can get a prescription for Tylan but in the meantime as Alex said try using Slippery Elm Bark powder - you can get it from a nutrition store or from WonderLabs - here's the dosing instructions https://epi4dogs.com/slippery-elm/ and https://epi4dogs.com/antibiotics/

We also recommend feeding 150% of the food for the weight your dog SHOULD be but in smaller more frequent meals throughout the day until the goal weight is reached.

Keep us posted.