EPI senior dog, struggling to get back dialed in

[Carly33]

Hello All,
I have a 19 year old Jack Russell Terrier who was diagnosed with EPI about 5 years ago. I use PanaKare Plus ground up tablets on her food, 1/2 of a tablet with 1/2 cup of food and she has done well with that for years. About 3 months ago she started having these days where she would wake up wanting to eat grass, eventually vomit bile, (I will give her a Cerenia) but she will not eat or drinking anything all day and then eventually eat and drink in the night. My vet recommended upping her PanaKare dose to the 3/4 tablet and that seemed to help for about a week but now we are back to not feeling well. I should also mention she has been on 10 mg of omeprazole for about a month now, I’ve also tried Tums if she seems to be lip smacking frequently, which she often is. Her poops are good. She eats 1/4 cup Taste of the Wild grain free kibble and 1/4 cup chicken breast or Primal bites (she’s a finicky eater and it only motivated to eat new things). Appreciate any suggestions folks may have for alternative ways to help her.

[Eddiespaghetti]

Hello,
19 years old. Hell yeah.
Sometimes, even though it's always worked, you might need to adjust the enzymes as your vet recommended. You might have to go up to a whole tablet. If 3/4th does work, other then the morning throw up. You can probably keep it there.
Instead of or in junction with the Omeprazole, you can try Slippery elm or famotidine. Omeprazole reduces how much acid is produced while SE and pepcid coat the stomach. I am unsure what is exactly causing the bile, but one or all of these should help. Another thing to try is possible, is feed a meal right before bed. It might help keep the stomach full, so they don't throw up bile. Either try to split the normal amount into thirds or just give some extra before bed.

[Olesia711]

hi Carly

WOW!!! You are certainly an excellent care-giver with Sprocket at 19 years old... wow Wow WOW!!!

SO... yes, i too agree with Jeremy and your vet.... it sounds like more enzymes were needed and what you are now describing sure sounds like SID/SIBO/Dysbiosis out of control..... which makes sense cause if little Sprocket is licking his lips, that often is a sign of an upset tummy and an upset tummy in an EPI dog is usually out of control SID.... and if Sprocket was not getting enough enzymes for a little while, that in turn can trigger SDI to get out of control..

We see this happen in a lot of dogs after about 4 years on the enzymes.... they were doing great and all of sudden things aren't going as well as they used to and it usually means the enzymes simply need to upped. ... but in the meantime, because of the unbeknownst under dosing of the enzymes, SID got out of control..... so now that needs to be fixed too.

Typically we suggest a prebiotic (like slippery elm, a tsp of pumpkin or something) and if that fails, then try a prebiotic and probiotic..... and if that fails, then we suggest a course of Tylan twice a day/45 days) . However based on sprocket's age, not sure if you want to go the long route of pre+probiotic or should you just do the Tylan.... Please share this with your vet and ask him/her what they think would be the best course to try Sprocket's out of control SID.

[Carly33]

Thank you both for the reply, this is incredibly helpful and I will share your ideas with my vet. Sounds like the Slippery Elm would be a good next step.
In gratitude,
Carly

[Carly33]

Hi,
One more question - how long do you give a new enzyme quantity before deciding to change that or finding other solutions?

[Olesia711]

i would give it a week to see if this makes things better/worse/or no change at all...

[Carly33]

Great. Thank you again!

[Olesia711]

hi Carly,

You are very welcome and good luck