Requesting helpful suggestions for my EPI Puppy

[LisaDorn2024]

Would really appreciate help with my 9 month old male golden retriever puppy who has just been diagnosed with EPI, IBD, Allergic to all protein sources, SID/SIBO/Dysbiosis, and B12/Folate Deficiency. He has struggled with GI issues since I adopted him at 8.5 weeks and they got progressively worse with each passing month. He has been in the ICU for the past 2 weeks and is currently being treated with Creon, Tylan, Proviable, Omeprazole, B12 injections and Prednisone. He is being fed a Purina hydrolyzed protein canned and dry food and his bowels are still very soft and sometimes uncontrollable. What might you suggest that I feed him? How might his treatment protocol be tweaked to improve his status so I can bring him home? I cannot have him home with uncontrollable diarrhea as I have a severe immune deficiency disorder that requires IVIG infusions as I am at risk to infections of any kind. Thank you for your suggestions.

[jilbert57]

Hi Lisa,
Sorry your pup is struggling. Some of the issues you mention go along with Epi:
SID
LOW B12(Epi needs >600 maintain)
The Tylan needs to be dosed 2 times a day for 45 days. That is a good choice as it does not kill good bacteria.
Things should start improving when the SID gets under control, and the B12 level rises.
Is Levi allergic to eggs?
If he is not, I would use eggs, sweet potato and maybe some mashed potatoes with Creon.

Let me know. Also if you have the test results will you post?

Jill

[Jane&Clyde]

It seems like the docs are addressing most issues that are common with EPI. If the pup is still having loose stools, the first thing I would do is find out how much CREON is being given with how much food. It's possible that the CREON dose needs to be increased as some dogs need more than others. If plenty of CREON is being given, you might want to ask about trying a different food. If your pup needs hydrolyzed food, the one that has worked the best for many dogs is Royal Canin Ultamino.

[Olesia711]

Hi LIsa,


I am SOOoooo glad you posted here on the forum, as many folks can help you and not just me.

As mentioned above, i too think you need to increase the CREON... not sure if the vet already increased it to 1+1/2 capsule.... but due to the loose stools that happened a few days after starting the CREON.... you might even want to try 2 capsules per meal.

ALSO.... be sure that the vet in ICU is opening up the capsule, sprinkling the enteric coated pellets onto moist food directly and serve immediately. I already privately explained why this technique should be tried first (due to digestive pH)

AND, Patsy also confirmed what i mentioned to you in one of our earlier communications..... some dogs with IBD/food sensitivities just need to be place on a hydrolyzed food (even though it sure sounds like crap food) the hydrolyzing protein really helps.... a lot.... HOWEVER..... that being said, even though the desired end results are all the same, each true hydrolyzed product can work differently on these dogs... and some simply don't work... What we found with many EPI + IBD dogs is that the Hydrolyzed food that appears to work better than most is the Royal Canin "Ultamino"
... i urge you to ask the vet to please swap out the Purina brand and true this specific hydrolyzed food.

But please know that even though Ultamino has the best batting average with EPI dogs struggling with IBD.... this still is no guarantee that this change will work. Unfortunately with this situation, you simply have to try things one-at-a-time.

What i would like to ask of you though, if you don't mind, is if you can please email me a copy of the Alercept test results... i would like to look at it... and see if i can come up with something to help you out, expedite a positive result, as i understand you can only handle limited loose stool situation due to your own personal immune compromised situation.

[LisaDorn2024]

Thank you to everyone who shared some helpful suggestions regarding my puppy. I was hoping to respond back individually to each person, but I am technologically challenged and could not figure out how to individualize my comments. If someone would be so kind to share this tip, I would truly appreciate it.
Thank you. LOL

My puppy is allergic to EVERY protein source and that includes eggs. He loves eggs, but they did not work out. Thank you for that suggestion, Jill.

I have asked the ICU vet NUMEROUS times to please switch Levi's food to Ultamino and he will not do it. He states that Ultamino is for adult dogs only. Since Levi has experienced maldigestion and malabsorption for many months, the ICU vet wants to make sure Levi is on a food formulated for "growth and development." The vet states that the Purina HA hydrolyzed protein is the only formula for puppies. I just don't know the validity of this, I have an appointment scheduled, but not until April 19th with the Ohio State Veterinary School Nutrition Department. i am looking forward to discussing healthier food options for Levi at that consultation.

The vet did increase the Creon to 1 & 1/2 capsules per meal. I cannot guarantee the hospital is administering them as you recommended. I have asked and put it in writing to the doctor, but the communication is not always the best between staff members. I will double check on it. Thank you for suggesting this.

Olesia, I will be happy to email you a copy of the Allercept testing. I did have a private consultation with HESKA and they explained that a positive IgE antigen does not necessarily indicate a food allergy, I shared with them that our food trials matched their results 100%.

Thank you again to everyone for your responses. I appreciate each one of them.

[jilbert57]

Allright Lisa. Nice to know Olesia has been helping you!

Keep us up to date!

Jill

[Eddiespaghetti]

Have you tried insect based dog food, or the more exotic meats? Kangaroo, bison, stuff like that?
https://www.hillspet.com/dog-food/sd-ca ... insect-dry
https://www.chewy.com/royal-canin-veter ... t/dp/35116