Recently diagnosed GSD

Epi4Dogs Foundation Inc.’s mission is the advancement of science and education relating to EPI (Exocrine Pancreatic Insufficiency), yielding useful insights and positive outcomes in better managing EPI in dogs and cats. Our goals are to support and/or collaborate with veterinary EPI research and researchers, and to promote EPI awareness by educating the general public, pet owners, pet organizations, rescue and shelter organizations, veterinary schools and veterinarians.
User avatar
SarahC55
Member
Posts: 8
Country: United Kingdom - England
Pet name: Reva
My name: Sarah Coton

Recently diagnosed GSD

Post by SarahC55 » 14 Jul 2022, 07:55

Hi – my name is Sarah, I’m a recently retired veterinary nurse in the UK and I have a 13 month old GSD called Reva. Reva is a small, energetic long haired bitch who has always been slightly underweight as many adolescent high energy GSDs are, and ownership of past GSDs led me to expect her to start “filling out” with approaching maturity. She has no history of digestive problems other than an occasional bout of runny diarrhoea, usually linked to some form of disgusting scavenging, that has always settled down within a couple of days with light diet and probiotics.

Four weeks ago she suddenly started producing smelly “cow pat” poos coinciding with increased appetite and coprophagia. Light diet/probiotics had no effect, so although she is on Nexgard Spectra I added in a broad spectrum wormer. The diarrhoea continued, so next we sent off a 3 day pooled faeces sample in case of nasty bugs or odd parasites but this came back negative. Her visible weight loss and increasingly voracious appetite was becoming worrying, so we decided to trial oral antibiotics for possible bacterial overgrowth. A couple of days later, peering glumly at a curiously greasy, oily looking poo glistening attractively in the chilly dawn, the penny suddenly dropped and I took her back to the surgery for a blood test, kicking myself that I hadn’t recognized the signs before.

Because it was coming up to the weekend we started her on enzymes before waiting for the results, and within 24 hours her poo had firmed up and started to look more normal. EPI was confirmed from the blood test 3 days later.

I’ve fiddled about with diet a bit – started with Royal Canin Sensitivity Control which was in stock at the vets, and trying to get back onto her original RC Large Breed junior which prompted a return of the cowpats, but she’s now on Royal Canin Gastrointestinal which seems to suit her, and I’m gradually changing her from the tins to the dry version.

Although a VN for 40 years I haven’t had a lot of experience with EPI dogs at work, so I'm feeling my way a bit – give me a nice challenging diabetic and I’m in my element – not so sure about the exocrine version - so I'm really pleased to have found this site. I’m wondering what other peoples’ experiences have been with regard getting weight back on. She’s not losing any more, but has gained less than 1kg despite 3 huge meals a day. She’s currently on 200g tinned and 125g dry RC Gastrointestinal at each meal with 1 capsule of Lypex mixed in well. Her poos are not consistent, but fairly predictable – the first of the day is firm, well formed and normal looking. The next, fairly soon after, is also well formed but softer and usually turning runnier at the end. She’ll then produce one, possibly two, cowpats while out on her walk and then probably nothing else for several hours, returning to firmer ones by the evening. Should I worry about the cowpats or assume they are due to increased gut motility stimulated by exercise (this dog’s favourite pastime is running flat out covering the largest area possible or chasing a ball and she hardly ever stops)? She would still eat anything that doesn’t move (and quite a few things that do) but the coprophagia has mostly stopped. Her B12 levels are normal but we’re planning another blood test in a couple of weeks to keep tabs on that.

Sorry this is such a long post – Jill suggested I introduce myself and our story so far and I’ve taken her at her word! I'd appreciate hearing other similar experiences. One thing that has surprised me is the seemingly sudden onset - she seemed completely normal, if a little underweight, right up until the cowpats started!

User avatar
TrixEPIMama
Member
Posts: 65
Country: United States
State: Texas
Pet name: Trixie

Re: Recently diagnosed GSD

Post by TrixEPIMama » 14 Jul 2022, 14:10

Welcome, Sarah and Reva!

Sarah, you are a good writer and storyteller, as well as a diligent and thoughtful dog mom. Glad to have you here.

I'm fairly new to this myself (just six months with my EPI girl) so others will be able to give you better answers than I. But my experience with enzymes and feeding has been the same as yours -- nearly instant reduction of cow pies, somewhat slower with weight gain. After six months, Trixie remains on the slender side while still having a voracious appetite. But she did go from 26 pounds (when we adopted her) to 32, which seems roughly low-normal for her size and breed mix. She is also young and active like Reva.

I'm hoping time and patience will get Reva up to full weight, but I'll be watching this thread for voice-of-experience answers.
Trixie is an Australian cattle dog or mix, likely born in the Fall of 2020. Picked up as a stray, she was already suffering undiagnosed EPI when we adopted her. Test later showed TLI <1 and cobalamin 189.

Her (non-standard) treatment is 1900 mcg of pure freeze-dried pork pancreas from Allergy Research Group per day. Also 1/4 teaspoon of slippery elm powder and 1/2 (previously one) capsule a day of WonderLabs TrinFac-B, all mixed into her food and served immediately, without the usual 20-minute wait.

We feed Canidae Angus Beef and Barley, which may not yet be the perfect food, but she's doing well and has "happy" normal poops.

User avatar
jilbert57
Staff
Posts: 2088
Country: United States
State: Washington

Re: Recently diagnosed GSD

Post by jilbert57 » 14 Jul 2022, 17:01

Hi Sarah nice introduction!
When you day the B12 is normal, keep in mind the B12 needs to be in the upper range of high. Normal is not high enough.
Also you might think about going to a grain free
diet woth little to no peas, lentils, legumes, pea giber. The grain in the food can interfere with the enzymes. I think this is true of Lypex too but maybe another staff member will agree or set it straight.

Jill
My name is Jill and we live on the Hood Canal in Washington State. We currently have 2 Jack russells, TJ is 8 and Sadie is 2.

Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.

Tuckaboo Pam
Member
Posts: 1345
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: Recently diagnosed GSD

Post by Tuckaboo Pam » 14 Jul 2022, 18:16

Hi, Sarah, and a warm welcome to you & Reva, from Pam & Tucker, in Florida!

I am not sure about weights & measurements that are not in cups & pounds, so I'll just ask---Are you feeding her 150% of the amount of food she would eat at her IDEAL weight? And, are you dividing it into three or four meals per day? These are two important steps to take.

Jill's suggestion of grain-free, high quality food, with all the specs she mentioned, is bound to be a good move. Jean will be able to recommend brands that are available in the UK. Please go the the Managing EPI tab & scroll to SID/SIBO, to read up on ideas for treating this part of the condition. All EPI dogs have SID, in varying degrees, and it can come and go, so it's good to be prepared.

I have been here for 3 1/2 years, and my Tucker has gained 20 pounds & looks great. With your credentials, you've definitely got this!

Take Care---Pam
Tucker was a shepherd/lab mix--- TLI 1.3, Folate 9.7, Cobalamin 666, Lipase 38. Took Diane's Enzymes 4 teaspoons/day, Wonderlabs B12 one capsule per day, and Tylan 1/16 teaspoon/ morning (to hold SID at bay). Taste of the Wild High Prairie, 1 1/2 cups/day, with a total of 4 cups of Fresh Pet. Stopped eating everything in sight, and went from 60 to 85 pounds! Tucker was my boyfriend, and my husband was OK with that. Tucker succumbed to hemangiosarcoma, but we cherished every day we had with that wonderful, beautiful boy. I will always, always miss my sweet big boy.

User avatar
Olesia711
Founder & Research Director
Posts: 3857
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Recently diagnosed GSD

Post by Olesia711 » 14 Jul 2022, 20:55

Hi Sara,

Thank you so much for writing us about Reva and her newly diagnosed EPI.
I will try to answer some of your questions.

Weight gain...... it is recommended to feed EPI dogs 150% of what they normally would require until they gain back all the weight or weigh near where they should be. HOWEVER..... what you do not want to do is feed too much in a few feedings... SO... feed more food over the course of a day BUT feed in multiple smaller portions than what you normally would.

SOme of these dogs will forever require more food than what you would expect them to need . For example my Izzy was 35 lbs but she ate twice as much her brother who was a 65 lb male! she was solid but not fat.... because of the EPi she just was just always better maintained on more food.

The stools that you are describing are typical for an EPi dog prior to finding the right balance of the recommended protocol. ALthough part of it probably is attributed to "increased gut motility stimulated by exercise" ..... What we strongly recommend is to "try" a low fiber content food, something without any grain in it and especially no peas or at least not until the peas are the 4th or 5th ingredient on the list.... and avoid products that use multiple pea products like peas, pea protein, pea flour, pea blah, blah, blah.... they are jsut stuffing the food with cheap fillers that give our dogs gastro distress! The problem with fiber is that fiber may inhibit the efficacy of the enzyme efficacy from anywhere between 0% to 50%. Unfortunately we have no idea which dog may inhibit the enzyme efficacy by how much. SO.... we give a blanket statement to everyone to "start" with a low fiber food (something with less than 4% fiber content) and then once the dog is stable if you want try a food with some grain in it. best to start with a food with rice vs. the other grains.... and see how it goes. But in the beginning avoid food with grain in it.

Also.... you most likely are NOT giving enough Lypex.. The instructions show less than what is often needed to be optimally effective...... but i will ask Jean, our Forum Director to chime in on this as she is from the UK and more well versed with the UK enzymes drugs....

The B12 needs to be upper mid range... n the USA, that translates into upper 500's to anywhere in the 600's anything less, supplement. We are finding that a high dose oral B12 (1000 mcg Methylcobalamin or Cyanocobalamin along with some intrinsic factor and 800 or 400 mcg Folate) works as well as the shots. the Methylcobalamin version of B12 appears to actually work better in a lot of cases vs. the shots.

To add weight (if the extra food is not doing it) some folks have found that giving organic coconut oil (cold pressed) is high in calories but a MCT and well tolerated by EPI dogs. Which by the way.. once on enzymes actually do fine with normal amounts of fat in most cases.

And don't beat yourself up about not catching this earlier.... we've ALL been in the same boat!!!! after all, no one even notices anything is wrong until 85% to 95% of the exocrine part of the pancreas has atrophied.

Hope this helps answers some of your questions... Please feel free to ask anything and we will do our best to answer.
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.........

User avatar
Jean
Forum Director
Posts: 1707
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: Recently diagnosed GSD

Post by Jean » 15 Jul 2022, 07:38

Good Morning Sarah from Liverpool, where are you in the uk ?

We had not weight gaining Shepherd who developed EPI at 14 months old her lowest weight was 39 pounds and she was a mess

we started with Lypex and 1 was never enough

the instructions are really useless and I have spoken to Vet Plus in UK on several occasions, and they have never changed the doseage

we were feeding grain free lamb based food most Of Karas life and she thrived from being 39 pounds to 90 for 8 years

so at her worst we were feeding 5 times daily Lypex at 5 per meal feeding her 50% over and above the amount on the food bag food for the weight she SHOULD have been, and she was eating 5 meals a day for probably 5 months, all enzymed , she was starving permanently

the cost was prohibitive, so we changed to Panzym which is a powder and it was a game changer

questions



what antibiotic did you use/ do you use ?

How heavy is she ?

how do you prepare the food and how do you add Lypex ?

this will give me an idea how to advise


Jean
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

User avatar
SarahC55
Member
Posts: 8
Country: United Kingdom - England
Pet name: Reva
My name: Sarah Coton

Re: Recently diagnosed GSD

Post by SarahC55 » 15 Jul 2022, 12:39

Thank you Jean - and all who have replied - it's comforting to know I'm not alone! I’m in the UK, just outside Stratford upon Avon.

In answer to your questions, Reva started a week’s course of Synulox (Amoxycillin/Clavulanic acid) the day before she started on the enzymes and I have also been giving a probiotic paste (Protexin Pro-kolin equivalent) twice a day. Blood results showed raised folate (47.4 nmol/l – n=20.0-30.0) but mid normal range B12 (299 pmol/l – n-200-408).

She weighed 22.8kg in March at 8 months old and had dropped to 20.3kg when she started the enzymes 2 weeks ago. She went up to 20.8kg after 1 week but another week on and she is still 20.8kg today, so no further weight loss but no gain either. She is quite small and lightly built and my initial target weight for her would probably be around 25kg.

She has one Lypex 0.6g capsule sprinkled and mixed with her food at each of three meals daily, so three capsules in total. I like the idea of the Lypex as it consists of a sprinkle capsule of enteric coated micro capsules designed to survive the stomach acid before activating in the small intestine, and which also reduces the risk of oral ulceration which I understand can be a problem with using powdered enzymes. Also, I still appear to be on staff discount three months after retiring which means I get it at cost – although there wouldn't be a problem ordering something different. At the moment I’m mixing the Lypex thoroughly with half a tin (200g) of wet food and then adding in 125g of dry and feeding straight away. The food is Royal Canin Gastrointestinal which is moderate fat, low fibre and lists EPI as one of its uses. Volume-wise this is 150% of her previous diet, is supposedly higher energy and is more than the suggested amount on the packaging for weight gain starting at 20kg, but I’m thinking perhaps it may not be enough if I’m feeding for ideal bodyweight of 25kg?

My gut (no pun intended) feeling is that I should give the current diet a chance – it’s tempting to chop and change which usually just complicates things and she’s only been on it consistently for just over a week. I popped into the vets for a coffee, a weigh-in and a chat this morning and we decided to start B12 supplementation (Protexin Cobalaplex) and aim to retest in about a month and I’ll further increase her food intake.

What do you feel about probiotics? Should she take these all the time? I’ve just run out of the paste which, even with staff discount is quite pricey and doesn't go very far, and wonder what anyone else uses.

User avatar
Olesia711
Founder & Research Director
Posts: 3857
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Recently diagnosed GSD

Post by Olesia711 » 15 Jul 2022, 13:29

THis is Olesia and not Jean, but YES... feel free to continue the probiotics.....the reason why i am suggesting this is because of the ever present SID (small intestinal dysbiosis) in all dogs struggling with EPI. Sooner or later the SID will get a wee bit out of control and the recommendation is to start with prebiotics, if that doesn't work, then try probiotics with prebiotics and if that doesn't work THEN do a course of Tylosin Tartrate antibiotic.... do not use Metronidazole (Flagyl) because Metro will kill ALL the gut flora bacteria, whereas Tylosin Tartrate (Tylan) is a macrolide antibiotic and will only inhibit any further reproduction... so it doesn't cause any issues especially short term. Of course if you have to use Tylan forever.,,,, then sooner or later all the bacteria will also be eliminated.... but sometimes that is simply what has to be done until we come up with better treatment.... and some are now looking at fecal transplants to handle repeated out of control SID.

Unfortunatey with EPI dogs, recent research has discovered that ALL dog with EPI have SID to one degree or another.... the folate test is no longer used as an indicator if there is or isn't SID (SIBO) going on with EPI dogs. Recent research has also discovered that EPI dogs not only do not have enough bacteria in their gut flora, they also do not have enough variety of gut flora bacteria... this is why Metro is advised again. As some of the needed bacteria that Metro kills can never be replenished no matter how many probiotics you give the dog.... this is now why we suggest the above step-by-step protocol to address SID....

SO instead of waiting for SID to get out of control... YES, go ahead and continue with the probiotics..... although i am sure you realize that with most antibiotics, you need to give the probiotics 2 hours away from any antibiotic.....

However.... if you are still not getting the expected results..... when you do the "one-thing-at-a-time" when trying to find the right balance of the recommended EPI protocol.... one thing you can try is stopping the current probiotics and see if that makes a difference. Sometimes some probiotics just don't agree with these dogs. Probiotics can be great BUT they are OTC mass-produced "one-size-fits-all" whereas our dogs all have their very own unique gut flora so not all common probiotics will agree with their unique gut flora.

Your idea of giving the current food a chance sounds like a very good plan... but if you don't see the expected results then try a lower fiber content food (as another "one-thing-at-a-time" change)... and see if it makes things better or worse.
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.........

User avatar
SarahC55
Member
Posts: 8
Country: United Kingdom - England
Pet name: Reva
My name: Sarah Coton

Re: Recently diagnosed GSD

Post by SarahC55 » 16 Jul 2022, 04:38

Thank you Olesia - that's very helpful. Interestingly, she's had no probiotic since running out of it 36 hours ago and so far today she's produced 2 perfect poos and just one softish but formed one out on her walk, so I'll see about trying a different one and start at a low dose. Anyone in the UK have any suggestions on that?

User avatar
Olesia711
Founder & Research Director
Posts: 3857
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Recently diagnosed GSD

Post by Olesia711 » 16 Jul 2022, 10:51

sounds like a good idea. the softish one on the walk might be from the activity of walking...we appear to hear that often from other EPI dogs....... but i still think a pre+probiotic is a good idea especially since we know that all EPI dogs have SID going on to one degree or another.

I am sure others from the UK will suggest a probiotic.... but in the meantime, you can look for a probiotic that specifically has the "Saccharomyces Boulardii" strain in it along with Bifdobacterium strains. Of course there are no guarantees but products with the " Boulardii" strain "appears" to help a little better with some of these dogs (but not all) when included in a probiotic vs. probiotics loaded with just the Lactobacillus bacteria strains.
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.........

Post Reply

Who is online

Users browsing this forum: No registered users and 236 guests