NEW to EPI, Vega has been sick since October 2024

[Kaitdcarroll]

Hello, my sweet 2.5 yr old girl. Vega, has been ill since early October 2024. In November 2024, she was diagnosed with IBD through an Endoscopy, and the vet mentioned SIDS is possible. She has tried a variety of antibiotics, probioctics and diets. Currently, Vega is on Chlorambucil, Animal Biome's Gut Restore FMT supplement, and Animal Biome's boulardii + FOS Powder, pumpkin pure, Rayne Nutrition Kangaroo with Quinoa diet. She recently started the FOS powder a week or two ago. It has given have bad gas and loud stomach noises. On Satuday, I started giving her Enzyme Diane's 6x Powder. Started at 1/2 tsp and went down to 1/4 tsp. Her second stool after was very firm. And then overnight she throw up food in liquid form. I have been feeding her eight cups of food per day to keep her at a stable weight (normal dose is 3.5 cup / day). I wonder if she got too backed up but today she has only wanted to eat two cups throughout today and since getting the FOS powder, she wont eat dinner and is clearly uncomfortable. I would love any recommendations or thoughts. I'm thinking about taking out the FOS Powder out of her routine and see how she does with the enzyme. My poor girl is 38.5lbs and use to be in the mid 60s lbs range. I did do the rapid quick test from Enzyme Diane's website and it was positive. I have not asked for a blood test specific to this disease yet. Any help is welcomed. Thank you.

[jilbert57]

Welcome. I am sorry your pup can't get stabilized. It would be best if ypu could have the vet do the fasting Tli and B12 test on your pup so you know if you are treating Epi.
The Quinoa in the diet sticks out to me. Grain interfere with the efficacy of the enzymes. Can you find a grain free kangaroo with 3.5% fiber or less? Also maybe lower the pumpkin.
It is possible the B12 level is low and needs to be higher but that is a guess. The level would need a blood test.
The enzymes, if it is Epi, are dosed at 1 teaspoon per 1 level cup of kibble. Are you adding a little room temperature water, stirring and letting it incubate 15 to 20 minutes before serving?
I am not sure about having a few different probiotics mixed in here someone else will chime in on it.
You might need a course of the antibiotic Tylan twice a day for 45 days if the SID did not resolve itself.

Jill

[Olesia711]

thanks for writing in..... so sorry to hear that Vega is dealing with IBD. If/when possible, we strongly advise having the TLI blood test done to confirm EPI. And just a FYI.... many dogs with EPI also have IBD .

SO.... just based on what you wrote, it is possible that the FOS was too much fiber. Although very beneficial in dealing with dysbiosis (SID/SIBO) from EPI or IBD or IBS.... just enough helps but too much can exacerbate Dysbiosis symptoms. It might help to stop the FOS and see if things improve... if they do, then reinstate using the FOS ... BUT...... only start with less than half the recommended dose and work your way up to a full dose in a week or two. See if this helps. If again, issues crop up, then stop the FOS.

As Jill mentioned, it is also possible that the fiber in the grain (Quinoa) is counter acting with the enzymes, if Vega is dealing with EPI. Although fiber helps with dysbiosis (SID) fiber in grain like Quinoa can interfere with the efficacy of the enzymes from anywhere between 0% to 50%... problem is that we have no idea which dog is affected by this and if they are affected, we have no idea by what %. This is why when a dog is initially diagnosed with EPI, we suggest "starting" with a food that does NOT have grain in it.. ONce a dog is stable then we actually do suggest trying a food WITH grain in it to see if your dog can tolerate it or not.

Next, i know you mentioned that Vega has already been given many different antibiotics ... but has she be given Tylan (Tylosin Tartrate antibiotic powder)??? Many of the antibiotics do nothing for SID, whereas usually Tylan works. Not always but almost always. If your vet has not yet prescribed Tylan, please talk to your vet about it and ask for a 45/twice a day supply. You can order it from Chewy, but it is a prescription, so your vet will have to approve it
https://www.chewy.com/tylan-tylosin-tar ... /dp/173768

[Kaitdcarroll]

Thank you both for your response it means so much to have additional support and people that want to help Vega. I've felt alone in the vet space, thinking Vega is out of options soon. I will work with our vet to do the blood test to confirm EPI.

Regarding diet, there is a Kangaroo option without the quinoa. I can ask our vet to rewrite the prescription so we can try that. And I can lower the pumpkin intake.

For the antibiotic, Vega did dry Tylan. It didn't seem to help. She first tried Metronidazole (which has helped her diaherra in the past) which didn't help in October and then she tried Tylan. Tylan didnt seem to do anything so we stopped (back in November). But I can ask about incorporating it again if that is strongly suggested. I still have some left over.

I will add that I did a gut Test with Microbiome. From what they test, she didn't have any harmful bacteria in amounts that are alarm sounding. She was missing good bacteria though. Happy to share those results if desired.

What I'm noticing is after 2 cups of food (feed about two hours apart)with about 1/4 tsp or 1/8 tsp of Enzyme, Vega will not eat anymore. She is burping a lot as well. Today I haven't given the FOS powder, and it's been almost 24 hrs since she had it. I'm concerned she won't eat more than 2 cups in a day with the enzymes added in because at her normal weight it should be 3 to 3.5 cups per day. Is this a normal reaction? Not wanting to eat (she was once always hungry), and the extremely burping? Again, maybe it's the FOS powder too. But I did remove it today.

I'm also curious when I'd use Enzyme Diane's 6x vs 8x. I have both samples.

Thank you again. I can't express my gratitude enough for this resource...

[Tuckaboo Pam]

Hi Kaitlyn, and welcome to you and Vega. It's so scary when this is happening to our little loves. What kind of dog is she?

If you can, please ask your vet to do the fasting TLi, and be sure you fast her from all but water for 8-12 hours prior to the test. Try and do the blood draw on a Monday or Tuesday, so it gets to Texas A&M before the weekend. I did Tucker's in the morning so he didn't have to go all day without eating.

Eight cups sounds like a LOT of food, even though if she does have EPI she's feeling ravenous. The rule of thumb is 150% of the amount she would eat if she weighed her normal weight, which you said is mid-60s. So, if that is 4 cups, you feed 6, and break it up into at least two meals, three if possible.

So, per each cup of kibble, add I teaspoon enzymes, add a splash of water, stir, and let sit for 20 minutes. You can add toppers like tuna, cottage cheese, sardines, cooked eggs, if it encourages her to eat. The enzymes should help her start to gain weight, and when you get all the results you can start her on B12 if she needs it. EPI dogs need a B12 score over 600, which is more than for other dogs. You don't want to give it now, because hopefully you're going to get her tested soon & it would interfere. The enzymes she is eating will NOT interfere with the test for EPI.

OK, so keep in touch & ask all the questions. I went with the ScheBo test, too, at first. Though the results aren't definitive, they do let you know that EPI is a possibility.

Take Care---Pam & Nina

[Olesia711]

PAm gave you the correct dosage amount for enzymes.... if this is EPI, you are under-dosing with the enzymes.

However.... if she has a strong aversion to the powdered enzymes (which are the best)... what you can "try" instead of powdered enzymes is to go on Amazon and order Micrazym 10,000. these are enteric coated enzymes. you use much less cause the enzymes are enteric coated so 70% of the enzymes are not destroyed via pH.... hence why so much less is needed. Micrazym is like CREON. you DO NOT incubate Micrazym in food... just open the capsule, sprinkle the little enteric coated pellets onto "moist" food and serve immediately. The dog will not taste anything. do not let sit in the food, cuz then the moisture will destroy the enteric coating and it will not longer be potent and can cause sores in the mouth.

The other think you might want to try before doing the above is ask the vet if they would prescribe and let you try pepcid AC or Omeprazole (omeprazole being the better of the the two) see if this helps or not... if not... then try the Micrazym

[Chance]

Sorry to hear of all the issues you're having with poor Vega! It sounds like you've tried a lot of different things already.

I live the fact that you are giving the probiotics! And more than one kind. The only thing I question there is the FOS. S. Boulardii is good, as is the FMT. But some do have issues with the FOS. Maybe try lowering the amount you're giving of that? Or have you trialed it long enough to know it's OK for Vega?

I'll also third the possibility of the grains (quinoa) possibly interfering with enzymes.

And third (or 4rth lol) the suggestion of testing for EPI to know for sure what you're dealing with. In terms of SID, that's treated quite similarly weather it be from EPI or IBD. But for IBD, often high fiber foods are helpful and recommended. For EPI, you want very low fiber. So knowing weather you're dealing with EPI, in addition to IBD, could help determine how best to proceed.

[Kaitdcarroll]

Vega is a 2.5 yr old boxer/lab (mom) and pitt (dad).

I want to thank each of you for taking the time to read and provide ideas for Vega and myself. This forum has provided me with hope and comfort. Sadly, I'm a little confused as to what is going on with Vega and it sounds like it may not be EPI. I'm sad because I thought I was on the way to getting her better and because the forum has been one of the most helpful tools in the past four months and I've been on here for like a week...so thank you all for your love and dedication to our babies.

TPI Blood Test
We did a TPI Blood test in November 2024 ( I didn't realize). The interpretation of the TPI was "subnormal cTLI concentration, but EPI is unlikely." Her vet isn't convinced that doing the test is worth it because she doesn't think she'd tailor the current treatment protocol we are doing.

• TPI Fasting Results: 9.7 (Reference Interview 10.9-50)
  Lipase Immunoreactivity Fasting Results: 54 (Reference Interview </=200)
  Cabalamin Fasting Results: 397 (Reference Interview 251-908)
  Folate Fasting Results: 24.7 (Reference Interview 7.7-24.4)

B12
I forgot to mention that Vega did start B12 injections back in December. She had 4 weekly injections and is now on an injection every 6 weeks.

Diet
They do have a Kangaroo grain free diet, but it's about 4% fiber. I can try that, or I do have some Farmers Dog - Pork in the freezer that she has never had before. I believe it's grain free and less than 2% fiber. I also have her original food of Hill's I/D Low-Fat (b/c she does have IBD), which I believe is less than 3.5% fiber; however, it isn't grain free. I get nervous changing her food because of how quickly she goes back to diarrhea. But it's back now, so it could be a good time to try.

Diarrhea is back even with Enzymes
Unfortunately, Vega started to have loose stool the past few days. Today she had liquid diarrhea. I've been slowly upping the Enzyme amount to give her body less of a shock. She is at about 1/2 tsp or slightly more per cup. The instructions on Enzyme Diane's package said 1/2 - 1 tsp. I'd like to get her to 1 tsp but I'm almost out of the sample. The package doesn't come until Saturday. I do have the sample pack of Panc 8x. I just don't want Vega's body to get tossed and turned. I did add the FOS powder back at 1 scope (full dose is 2 scoops) to see if that would help with the diarrhea. I'm just at a loss. The only other changes would be adding tuna as a topper (which I stopped yesterday) and less pumpkin (which I reduced about 1 to 2 days ago).

Excess burping and gas
Is it normal for the dogs to have so much gas on enzymes? Initially, I thought maybe it was the FOS powder (pre/probiotics), but I took that out and it continued. The vet recommended Gas X at 80mg every 8-12 hours but I can't find that dosage at the store or online. Someone mentioned omeprazole which I've used for another dog in the past - what would that help with again? The burping?

Thank you for providing an alternative to the powdered enzymes if needed. I find it odd that she had an immediate response with firm stool to the enzymes at first, and now things are declining. I have notes on when, how much and stool consistency in an excel document if helpful. I will say she was at 38 lbs and then went back to 40 lbs in a couple days with the enzyme prior to the diarrhea coming back. So I really thought we were on the right path here.

[Chance]

If the dog has EPI, then no, enzymes should not cause excessive gas. It doesn't sound like you are giving too much, so there shouldn't really be any side effects really.

Excessive gas can be related to SID/SIBO. That's certainly common with both IBD or EPI. Since you have ruled out probiotics or FOS as contributing, my guess is it's related to SID

Gas X can be good. Trouble is it doesn't help reduce the gas. It helps break it down, so it's easier to pass, rather than getting trapped and causing pain. If gas is being trapped and causing discomfort, it is very good helping breaking into smaller bubbles so it can be tooted out or burped out easier.

[Eddiespaghetti]

For the most part, pork enzymes are pork enzymes. You don't typically have to worry about weening them off one and on to another.
The biggest thing to worry about if mixing and matching is; dosage.
If the B12 is still in the 397 range that could be an issue. Low B12 can also cause diarrhea. And out of control SIDs can cause diarrhea and low B12.
I suspect, not a vet, you had two different reasons of diarrhea going on and that could be why the Tylan wasn't helping.