EPI/SID Greyhound Questions

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Supe
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EPI/SID Greyhound Questions

Post by Supe » 25 Jan 2022, 17:20

Hi everyone.

My senior greyhound girl (11.5) was recently confirmed as having EPI and SID/SIBO. Since she was younger, she had a number of bouts of pancreatitis and stress colitis, and in June of 2021, suffered from a severe bout of HGE that had her hospitalized for a few days. She had since fallen in the "SIBO cycle" as I refer to it - bouts of diarrhea and GI distress that would come and go every few weeks, usually knocked out with a probiotic and metronidazole. This last bout, we have been unable to get her over the hump with two rounds of metro coupled with a bland chicken adn rice diet, and that's when the additional blood work confirmed EPI and SID.

She is right around 62 lbs, and was never heavier than 65 her entire life, so thankfully, she is maintaining weight despite all the issues. She also suffers from laryngeal paralysis which thankfully hasn't affected her too much outside of exercise fatigue, a change in bark, and some slowly progressing hind-end weakness.

Her current protocol to address the EPI/SID is:

-B12 injection once a week, just receiving her second injection yesterday
-Tylosin powder, 1/8 tsp 2x daily
-1 tsp PancrePlus enzymes, currently soaking about half of the kibble in it beforehand (1 1/2 cups of kibble)
-Transitioned from Hills Science chicken and rice formula to ProPlan HA Hydrolyzed
-20mg omeprazole 2x/day
-Visbiome probiotic, 2 capsules 2x/daily

She started on the Tylosin and PancrePlus Thursday evening. At this time, she was on a mix of boiled chicken and rice, and kibble (chicken and rice had been in her diet for just over a full year, as it was the only way we could supplement her food to make her eat after grieving from the loss of her littermate sister).

Up to that point, she had yellow, but soft/semi-formed poops. On Friday, her gas and the stomach gurgles were pretty severe, with "wet peanut butter" consistency to her stools. On Saturday, her gas was room-clearing, and she had pure liquid yellow-grey diarrhea. At the recommendation of both my local vet and another very knowledgeable greyhound vet, they proposed stopping the chicken and rice and limiting to the HA kibble only on the basis that she may have IBD as well and developed a chicken sensitivity, which is very common with greyhounds.

By Sunday evening, her poops had returned to the "wet peanut butter"/soft serve consistency, albeit still yellow. Although the gas has subsided considerably from an all-day assault to only the occasional poof/stomach gurgle, all subsequent BM's seem to be stagnating at this consistency with no further improvement over the 6 day period, and I would say are not quite at the pre-treatment level yet.

Does anyone have any recommendations as to how to proceed from here? The current plan is to watch and wait for about a week per my local vet provided she doesn't regress further or have any accidents (none so far), but most literature I've stumbled across so far saw significant improvement within 72 hours from the Tylosin use. I'm wondering what others experiences are for how quickly they respond to the medication/enzyme introduction, thoughts as to why she may have regressed after starting, or any suggestions on what to consider moving forward.

Any help would be greatly appreciated!

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Jean
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Re: EPI/SID Greyhound Questions

Post by Jean » 25 Jan 2022, 17:46

hi there

can you confirm it's one teaspoon of enzyme to 1 cup of kibble the rule.of thumb is 1 teaspoon to 1 cup of kibble
My name is Jean we live in Liverpool in Uk

I am the Forum Director which I am very proud of

My Kara born 21 July 2009 diagnosed with EPI by cTLI test August 2010 TLI = <1...folate 14 Cobalamin 408, shot down to 94, b12 injections every other day

Lowest weight 39 pounds

We used Panzym enzymes, Tylan and Chemeyes b12 capsules

Sadly, on 10th May 2019, we lost her to DM


Jeanx

Supe
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Pet name: Ursala
My name: Bryan

Re: EPI/SID Greyhound Questions

Post by Supe » 25 Jan 2022, 17:55

The vet's initial dosage currently has her on 1 tsp total per meal. I will follow up with her and see if she would like to up that to 1:1 tsp:cups of kibble. Thanks!

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Olesia711
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Re: EPI/SID Greyhound Questions

Post by Olesia711 » 25 Jan 2022, 19:06

Definitely increase the powdered enzymes to 1 tsp of enzymes per 1 cup of food.... i am guessing you most likely will see improvement once this is implemented... as not enough enzymes can trigger SID to get really out of control which sounds like what you are describing...
SO.... even though you are giving Tylan, which you are correct... usually works rather quickly.... if you are not giving enough enzymes, you are kind of defeating things.

as time goes on, sometimes once SID gets really out of whack .... yes the Tylan should help....but what you also most likely will need to do is to introduce pre+probiotics halfway thru the 45 day twice a day course of Tylan. This should help the gut flora imbalance get better in balance.

At this time, what we are suggesting is either Proviable or Visbiome . Talk to your vet about adding this about halfway thru the Tylan course.... BUT...... when you give these pre+ Probiotics.... start with less than 1/2 the recommended dose and work your way up to the full recommended dose over the course of a week or two ... Always best to start SLOW with any probiotic.

The great thing about giving Tylan vs. Metronidazole is that Tylan (a macrolide antibiotic) does NOT kill all the bacteria in the gut like Metro does, but rather Tylan will inhibit bacterial reproduction... so you have a better shot at preserving good gut flora with Tylan vs. Metro. .... and because of this you can give probiotics at the same time as Tylan.... but we still like to recommend giving any probiotic 2 hours away from any antibiotic.... . jsut because :)
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

Supe
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Posts: 26
Country: United States
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Pet name: Ursala
My name: Bryan

Re: EPI/SID Greyhound Questions

Post by Supe » 26 Jan 2022, 07:49

Thanks. She is currently on the Visbiome as part of her regular routine, and has been for a little over a month now. It has always been our most successful go-to as far as probiotics go, but I will certainly talk to my vet about introducing a prebiotic as well.

Supe
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Posts: 26
Country: United States
State: North Carolina
Pet name: Ursala
My name: Bryan

Re: EPI/SID Greyhound Questions

Post by Supe » 27 Jan 2022, 09:35

After messaging my vet, she concurred with trying the increased enzyme dosage. Last night was the first increased dose to two tsp. She wants to try 2.5 tsp, but I need to ensure my other enzyme order arrives first so that I don't run out.

Just for a frame of reference, here was this morning's poo. This is the consistency we have been getting for several weeks, though this one had some slightly firmer chunks in it than previous iterations (typically with the liquid coming at the tail end of the BM), though not so firm as though you could pick them up in one piece. At this point, I'm unsure if the color is related to the EPI/SID, or a byproduct of the Purina HA Hydrolyzed food, which I have seen a few reports can produce khaki-colored BM's. The odor is quite strong as well.
Poo 1-27-2022.jpg
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Supe
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Posts: 26
Country: United States
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Pet name: Ursala
My name: Bryan

Re: EPI/SID Greyhound Questions

Post by Supe » 28 Jan 2022, 09:05

Ursala responded poorly to the 2.5 TSP. Stomach gurgles were high all day, immediately following her meal and rarely subsiding. She vomited a small amount of bile before breakfast, and the poo on her walk yesterday afternoon was even runnier than in the AM. Lots of lip smacking yesterday indicating her stomach acid was high. I don't think she can handle that dosage, so I backed it down to 1:1 this morning until I hear back from the vet.

Tuckaboo Pam
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Re: EPI/SID Greyhound Questions

Post by Tuckaboo Pam » 28 Jan 2022, 16:09

BUMMER, Bryan, but this is a process that requires trial & error, and we have all been where you are. You will get there! I believe getting the enzymes in her can get those juices flowing & trigger the condition called SID. (I may be wrong, but I think I'm right about the rest of this).---

https://epi4dogs.com/antibiotics/

Ursala is considered a "big"dog, and according to the chart she should take 1/4 teaspoon tylosin, twice a day. You will give this for 45 days, and then at that time ask for instructions for weaning her off (I mean ask us).

When you gave her 2.5 teaspoons of enzymes, were you feeding 2.5 cups of kibble? This would be the right combination.

Take Care---Pam & Tucker
Tucker is a shepherd/lab mix; he has tested positive on the ScheBo test for EPI, as well as the fasting TLI. Results--- TLI 1.3, Folate 9.7, Cobalamin 666, Lipase 38. Currently taking Diane's Enzymes 4 teaspoons/day, Wonderlabs B12 one capsule per day, two capsules slippery elm/evening, 1 Proviable capsule/day, and Tylan 1/32 teaspoon/ morning (to hold SID at bay). Sport Dog Elite, herding dogs 4 cups/day. No more poop eating, has gone from 60 to 80 pounds, and he is a happy member of the family, though a bit of a stinker, if you ask the other dogs. Tucker is my boyfriend, and my husband is OK with that.

Supe
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Posts: 26
Country: United States
State: North Carolina
Pet name: Ursala
My name: Bryan

Re: EPI/SID Greyhound Questions

Post by Supe » 28 Jan 2022, 16:28

Pam - she was on 1.75 cups of kibble, so definitely dosed on the high side. I have backed her down to 1.75 tsp this morning, and her stomach is much quieter today. I will stick with this dosage.

My vet suggested we try switching her off the HA food and over to ProPlan GE to rule the food out as an issue, since she has never had a firm stool with it to date. The GE food is lower fiber content, and she did not have any adverse side effects in the past when using it to recover from bouts of pancreatitis or other digestive issues, so I'm hoping it will help rule out the HA kibble as a contributing problem. I will transition her over to it over the next 5 days or so and see how it goes.

I will try upping her antibiotic to 1/4 tsp 2x/day. I don't think it will hurt at this point!

Thanks for your help!

Supe
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Posts: 26
Country: United States
State: North Carolina
Pet name: Ursala
My name: Bryan

Re: EPI/SID Greyhound Questions

Post by Supe » 02 Feb 2022, 14:09

Ursala has now been at a 1:1 tsp enzyme to cups/food for several days (1.5 tsp, 1.5 cups), along with the increased dose of 1/4 tsp of Tylan 2x/day, still on the HA/hydrolyzed kibble. I have not yet tried the switch over to the ProPlan GE food.

We have basically plateaued at the poops we see here, which have been consistent for about 4 days or so. Formed, but soft (usually just firm enough to hold together if picked up), with the darker khaki/green color to it. This was an improvement over the previous mustard yellow poos which were semi-formed and often had very wet poos at the back end. I temporarily stopped with the probiotic, and will reintroduce about half way through the Tylan course. Gas has been minimal, and only had some stomach gurgles for about a day when my daughter spotted her snacking on something in the yard.

Any recommendations on where to go from here? Wait it out longer? I feel like she is very near the upper limit of what she can tolerate with respect to the enzymes at least. Even on 30mg of omeprazole twice a day, she definitely has more reflux and occasional gagging than she did prior to beginning treatment (she always had some gagging and reflux due to laryngeal paralysis), but no vomiting like when we tried the much higher enzyme dose.
UrsPoop.jpg
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