Epi4Dogs

Hi all,

Thanks for being so helpful in the past.

I posted before saying that my dog Scottie (2 year old GSD/chowchow/pit mix) was having an issue where she pukes bile after not eating for a while. Usually this happened infrequently enough that we could trace it to not feeding her breakfast early enough and get her to eat earlier, for example. We also do make sure that she eats a little right before bed.
However, this morning and yesterday, she woke us up very early puking bile a few times. Yesterday she continued throughout the morning. Has anyone else had this experience where it gets worse/starts earlier?

Some more background on Scottie-- we found out over the past few months that she has food allergies, so she is strictly on a special Hydrolized Protein diet and if we stray, she gets an ear infection/anal gland issues. So we know it's not allergies to the food, and we also can't try different food trials right now.

Thank you for everything!
Also, does anyone know an EPI specialist who will meet over zoom, or a great vet in LA? Our vet is pretty good, but she's ended up being so complicated that they've kind of admitted the EPI stuff is going over their heads/ they tell us stuff we already tried and we know more than they do.

SO sorry that Scottie is having multiple bile/puking episodes.
Sounds like SID brewing if it has increased in frequency .... OR....it could be a true acid reflux issue and she needs that addressed.

ALL dogs with EPI actually do have issues with the secondary bile acid functionality.... however.... if there are no physical symptoms, we don't try to fix, only if there is a problem.

SOOOOOOO.... since we can't tell yet, if this is SID getting out of control (and again, SID is another thing that ALL dogs with EPI have to one degree or another, but again, we don't treat unless there are symptoms and a need)..... so.... let me present a step by step blueprint for you to try:

1. Just in case this is SID getting out of control.... and or even an acid issue... before trying anything else... first try giving a little SLippery Elm powder to see if that with soothes everything and eliminates the acid reflux... or soothes everything and provides a little bit of the right kind of fiber to address possible SID getting out of control.. Just remember with SLippery Elm powder although helpful, you don't want to give to much cause too much can cause gas and loose stools. ALso... please go to this page for dosing instructions: https://epi4dogs.com/slippery-elm/

2. If the SLippery ELm "appears to help, just not enough (Slippery Elm works quickly, so if you are going to see a difference, you should see a difference within a day to 5 days...) Anyway... if helpful but not enough..... THEN the next step is to try a pre+probiotic..... currently the recommendations are:
Visbiome
Proviable
VetriScience Mega Probiotics
.... although with all probiotics, there are no guarantees since every dog's gut flora is a unique gut flora composition and all the probiotics available today are pretty much one-size -fits- all... but well worth trying!

3. If the above doesn't work at all... then you are most likely looking at a true bile acid issue. In which case, talk to your vet about trying acid reflux meds, such as Omeprazole. If Scottie is already on Omeprazole and has been for a while, then that could also be the problem... many of these dogs that have to take omeprazole long term .... well... every so often it seem that it stops working so you have to stope giving it (short term) and try something else for about a month and then you can go back to the Omeprazole. If the Omeprazole stops working.... talk to your vet about trying Cholestramine... it is a bile acid sequestrant.

Oh..... and if the bile that Scottie is upchucking.... if it is white foamy like stuff.... that indicates BILE
if it is yellow or brown liquid or with chunks.....(. hope you weren't eating while reading this .....................) then you can focus more on SID or a gut bacterial issue.... in which case, if you tried the Slippery Elm and then tried a probiotic and if that didn't help .... THEN talk to your vet about trying Tylan (Tylosin Tartrate soluble powder... just in case this is out of control SID- -you an order this from Chewey with a script from your vet https://www.chewy.com/tylan-soluble-powder/dp/173768) ..... and if the Tylan does nothing (but it also doesn't do harm)..... THEN talk to your vet about a different antibiotic, probably Metro or Amoxy to address something other than SID.

And, regarding your vet...... the best vets are those that may not know a lot about EPI but are willing to listen to what you have to say and work with you.... it kind of sounds like your vet knows they don't know much and that they acknowledge that you know more (this happens a lot with EPI parents ) and as long as they respect what you have to say, do their own research to help you and in short work with you.... i'd stay with them........... besides, i do not know anyone who does zoom... but that sure would be nice, wouldn't it?!!!!

Hope this helps a little and PLEASE keep us posted.

Wow, thank you SO MUCH! I'm so touched by this forum and how helpful and clear this answer was!
It is yellowy, so I'll try focusing on SID first. The vet automatically put her on Tylan when she was first diagnosed, and I don't rememeber her having puking episodes then, so I imagine that's what it is. Also she's already on proviable, and has been since her diagnosis. Our vet told us that is one thing she will always take, in addition to B12.
THANK YOU! I'll order Slippery Elm powder.

Ahhh.... so it is yellow..... yep.... first focus on SID.... try the slippery elm first ... just in case you can correct this without resorting to an antibiotic... but if you don't see any positive changes within jsut a few days, then talk to your vet about giving Tylan......this ought to fix it. ..... i hope!

Please keep us posted!

Hi, we don't have the exact same symptoms, but I have noticed lately that Tucker is very VERY gassy, and his breath smells putrid, so I figure SID is making its annual/biannual appearance at our house, too.

I started increasing his slippery elm, but after a few days it hasn't resolved. SO, back to 45 days of full-dose Tylan. It's on the calendar, day 45, when I begin reducing his dose. I guess this SID guy will be a part of our lives for years to come. Thank goodness we've found a way to make him leave!

Good luck with your situation. --- Pam & Tucker

Thank you all for these replies!

Update: Yesterday we couldn't get Scottie to eat and she was puking bile over and over again, so we ended up taking her to the vet hospital, as our vet didn't have any appointments. He hadn't heard of SID/SIBO so I'm going to keep on with your recommendations, but he did do an xray and said he found a huge amount of poop backed up in her colon! So he removed it. I'm surprised because she poops pretty regularly, but he thinks that might have caused some of the nauseau. I guess we'll see now that she's all cleared out. I ordered slippery elm and will start her on it soon.

Oh wow..... did not suspect that!!!!....Scottie is VERY lucky to have you as her human companion..... THANK GOODNESS you brought her to the vets hospital and that he had time to do an xray..... backed up poo i the colon ?! Never ever would have suspected that this could have been the problem.

Did the vet give you any suggestions on why this may have happened?

Glad you ordered the SLippery ELm, it is a great thing to have in your kitchen... just in case..... but now that the vet found the problem and cleared it out for Scottie..... why don't you let thing settle and see if all goes well now, or f she appears to still have acid/bile / regurg issues.


The good thing about SLippery ELm is that we (EPI community) uses it for loose stools, but it can also be used for constipation.... it's all about the fiber..... but my take on things is if it ain't broke don't fix..... so, if you don't mind, let's see what happens over the next few days.

You are keeping an EPI log (journal)... yes? This will greatly help you keep tabs on things.

Thanks for the update and please continue to keep us posted!

Me neither! I was so surprised. She definitely has a hard time eating enough but she poops very regularly! Had no clue that might be it. His only suggestion was that the backup may have caused the nausea, and that the backup was caused by not having enough water or having to strain to poo. He's not sure, but we will keep in touch with him as we figure it out.

Good idea about waiting a bit until we start on slippery elm. It's not here yet anyways (ordered online), so we're going to monitor the next few days and see if she's eating better and obviously mainly, if the puking stops. I'm hoping that clearing out her system will help her appetite as well, and that we can avoid the constipation in the future. Maybe her allergy food is constipating? I'll do some research.

Thanks again!

Update!
We got her back from the hospital and she does seem to be pooping a bit more/more easily the last few days? But she did puke bile again this morning before breakfast even though we made sure she ate a little right before bed. She also has stomach gurgles all the time and burps a lot.
So going to move on to slippery elm and hope that will help. If not, I'll go back to our regular vet for advice on Tylosin.

THANKS ALL!

Thank you for the update. Glad she is pooping better!
Let us know how the SE goes.

Jill