Epi4Dogs

Hi there! New to the group. Hoping to find answers. My 2 1/2 year old GSD, Kilo, was diagnosed with EPI in August. My vet suggested B12 injections, enzymes, and changing his food. We opted for B12 supplements, changed his food to Purina Pro Plan EN Gastroenteric Low Fat, and started giving him PancreVed Powder with his food. We switched his food and started the B12 supplement and his poop changed immediately from loose to normal. As soon as we started adding his enzymes, it was just going right through him. He would have to go poop very shortly after eating with diarrhea. He also hasn't gained any weight back. He went from 85lbs down to 71lbs and isn't gaining any weight. We took him back to the vet about a week ago and all she suggested doing was lowering the amount of enzymes we're giving him. I've done that for about a week and he still has diarrhea. We started off giving him 1 tsp with each meal twice a day. And lowered it to 1/2 tsp per meal. My husband insists on giving him more food than the daily recommended amount since he always seems to be hungry. I'm not sure if that's the right thing to do. I'm hoping to get help here because we don't know what else to do.

Hi and welcome to you and your pup. Will you please post the lab results of the Tli, B12 and folate? It will help us a lot. Also, did you food fast your pup 8 to 12 hrs before the test?
There are 4 cornerstones to Epi:
1. Enzymes: powdered enzymes are given at 1 level teaspoon per 1 level cup kibble. Add small amount room temperature water and enzyme, stir and let incubate for 15 to 20 mins. Stir and serve. Enzymes must be given with all foods and treats for life.
2. Diet: most dogs do good on a grainfree diet, 4% fiber or less and try to stay away from peas and lentils.
3. Antibiotic: most dogs have SID/SIBO when diagnosed. Symptoms are burping and gassy. Tylan is the choice but pre and probiotics can be tried.
4. B12: B12 needs to be 500 to 600 or greater. Can use shots to begin but oral supplementation can work just as good.
I would suggest you are dealing with SID or the grsins in the food maybe don't fit.
Here is a Quick Start:https://epi4dogs.com/epi-quick-guide-usa/

https://epi4dogs.com/sidsibo-in-brief/

Yes, you can add an extra enzymed meal in there to help with weight gain.

Jill

hi and welcome to our group.

1. Can you share with us what his cTLI test results were? And his B12 value.

That is interesting that he developed loose stools when you added the enzymes. How many days went by where he had normal poos on the ProPlan food and B12 before you added the enzymes. Did the poos go sloppy the same day you added the enzymes? And have they been loose every since?

There is a remote (and i mean VERY remote) possibility that your dog has a pork allergy... but before you even entertain this possibility, my very strong suggestion (because we've seen this before where people think it's the enzymes because it is almost simultaneous with the enzymes) but what it could be is SID now coming to the forefront ... this often happens after the enzymes are started.

2. ANother possibility is that you may not be giving enough enzymes with the meal. Enzymes are to be given accordingly with the AMOUNT of the food, not per meal. You start with 1 tsp of the powdered enzymes per 1 cup of food, add a little liquid to moisten the food with the enzymes, let sit for about 20 minutes mostly to avid mouth sores, but this actually helps some dogs better digest things.....

3. If you can let us know exactly how much food (how many cups) you are giving per meal with exactly how much enzymes, that would help us better help you.

4. Also, when EPI dogs are first diagnosed, we strongly recommend feeding approximately 150% of what they would require for their weight....but you feed all this food in smaller portions but more portions through the day. Like breakfast when you get up, lunch when you get home from work, and dinner shortly before you go to bed. Or if you do not need to leave the home for your job, obviously a better schedule can be worked out. SO..... kudos to your hubby, i am guessing that you probably are not feeding enough at this moment in time. ONce an EPI dog gains back all or most of it's weight, or when it stops eating everything in the bowl... that is what determines when to reduce the amount of food back to normal. Although some EPI dogs will always require a little more food than the average dog. It will depend on your dog.

If you are feeding the right amount of enzymes per amount of food, then your vet is correct to suggest trying to lower the dose to see if that helps, but if not,... many times upping the dose is what is needed.

5. If the enzymes dose is correct with the food portion.... then the other thing that might be going on is SID ... All EPI dogs have SID, but oftentimes, once the enzymes are started, shortly thereafter you start seeing bad stools and this is SID, in short, now coming to the forefront. It is almost like now that you are giving enzymes, all the collected putrefaction is being shaken loose. SO if none of the above is the issue, then most likely what you are dealing with is out of control SID. IN which case you will need to talk to your vet and have them prescribe Tylan (do NOT let them give your dog Metronidazole!!!) for 45 days, twice a day. HOWEVER, if you get to this step.... PLEASE let us know within 2 to 3 days after starting the Tylan if the loose stools have improved. If this is SID, you will notice and improvement almost immediately with Tylan .... feel free to even post pictures here.

SO........... after all of this, if you can answer #1 and #3 next, then we can best help you.
Looking forward to hearing from you.

Thank you so much for the quick response! Unfortunately, I don’t have the test results. Our vet called and spoke to my husband over the phone. I did go back and look at the records I had. When we initially took him in July, they ran lots of other tests before running the test for EPI. I have attached those results. They gave us medication and probiotics. None helped and that’s when we took him back in August and they ran the test for EPI.
I have been feeding him 3 cups in the morning and 3 cups in the evening. I was giving him one teaspoon of enzymes with each meal. I cut it back to half teaspoon for each meal.

AHHHhhhhh. that helps. THANK YOU!
3 cups of food with 1 tsp of enzymes and now that you have cut back to 1/2 tsp of enzymes.... you have not seen any improvement.... i strongly STRONGLY suspect this is the problem.

Next meal when you feed 3 cups of food, include 3 level tsps of powdered enzymes, add enough liquid (broth, water, anything wet that is okay to give a dog ) and mix in the enzymes with the food, mix and let sit for 20 minutes. After 20 minutes, mix again and serve.
Let us know how things go after this. The elimination from this meal (with 3 tsps of enzymes) will take anywhere from 12/- hours to 72 hours....so continue with the 3 tsps of enzymes per 3 cups of food and monitor each poo elimination.

I see that your vet prescribed Proviable.... that is an EXCELLENT pre+probiotic. If the above doesn't really work or doesn't work well enough.... and if your dog needs to be placed back on antibiotics. DO NOT ACCEPT metronidazole, but rather insist on a 45 day course of Tylan (Tylosin Tartrate 100 gram soluble powder) and ask for a refill of the Proviable so that you can again implement Proviable about halfway thru the Tylosin/Tylan regimen.

Keep us posted!

IF the added enzymes above

Do you think the amount of food (6 cups) per day is a good amount? If so, is twice a day okay, or should we break it up to 3 times so it might be easier to digest?

did the vets say or do anything further with the clumping platelets? I noticed that the HCT was also high normal.
Since everything else was in GREAT range..... wondering if your dog may have been flirting with a little dehydration when these blood tests were done... or did the vets mention ITP.

My understanding is that most of the time just platelet clumping is not much to worry about....unless there are multiple other red flags........

The vet just gave us the probiotics and antibiotics and that was it. The clumping platelets were not brought up again.

thats good.... means that the clumping is nothing to be concerned about.

Okay...go based on your dog's current weight, whatever the instructions are on the bag as to how much to feed, then feed 1+1/2 that amount..... and feed in small portions .. so that would be more than two meals a day....... usually 3 or 4 meals daily is best. So yes, please do break up into 3 meals, 2 cups each with 2 tsps of enzymes in each of the 3 meals. Just know that this won't be forever, just in the beginning until he settles out and gains back most or all of the weight...

Please keep us posted!

Hi, jumping in to just reiterate, don't give any more of the metrodinazole, or metronidazole, I can never remember (my non-EPI maltipoo has never been the same, after a long course of it), AND to say this about proviable---

Proviable needs to be introduced slowly. I took a week to get Tucker to the full capsule, otherwise the probiotic can cause diarrhea. If you have just started giving it, I would start giving just half the contents of the capsule & take a few days to work up to the whole thing. Maybe add this to the puzzle, along with all the other very likely culprits for the sudden diarrhea.

Also, can you ask your vet to email the test results to you & share them tomorrow?

AND, lastly, WELCOME!!! We are glad to have you & your doggy here. That weight is gonna come back, but it may take a few months. Just be patient, and ask all the questions you have. Take care---Pam & Tucker