Newly diagnosed - a few questions!

[kob5280]

Hello and thank you for hosting this forum!

Our 5 yr old GSD, Ozzie, was just diagnosed with EPI. He also suffers from an auto immune disease that affects the cells of his cornea (punctate keratitis)AND he has a history of allergies (mostly scratching and loose stools) that has been treated successfully with Cytopoint shots.
Questions....
1. Our vet just prescribed Pivetal Pancresorb tablets and I was just curious if anyone here is familiar or has used this medication. I haven't come across it in the list of meds on the forum (mostly Diane's enzymes).
2. Wondering if anyone has any information on the negative effects of a grain-free diet with EPI dogs? Our vet doesn't generally recommend this protocol, so curious if there's any info out there.

We switched our dog to the Taste of the Wild Pacific Stream dry kibble when we suspected EPI along with Honest Paws probiotics and have had already impressive (poop) results since the switch and before even starting the enzymes!

Thanks in advance for any thoughts/info you can provide. We really appreciate the collaboration.

[Olesia711]

Hi... i am checking into the Pivetal Pancresorb (pancreatic enzyme concentrate) Tablets (100 ct).... so far the price is WAY to cheap for it to have the right potency, although all i can find (so far) is that it is of porcine origin ... but it might be so light in the Lipase enzyme, that you might have to use to many for it to be cost effective.

with regards to why the Taste of the Wild Pacific Stream dry kibble worked even before enzymes is most likely because of the fish ingredients..... many dogs with "sensitivities" tend to do better on fish, (usually white fish is the best) ANyway... this has Salmon and then fish meal.... a combo of an actual protein and the meal of that protein is usually a good food.

WIth regards to WHY we suggest starting with a "grain free food" although that is a misnomer..... we really want you to look for a low fiber content food that is usually found in the grain free section... . for an EPI dog..... is because fiber can destroy the efficacy of the enzymes (that a are needed for an EPI dog to survive) from anywhere between 0% to 50%..... so... since we do not know which dog will be affected by how much, we suggest to start with a low fiber content food (recommended is a 4% or less. fiber content food.. and less is often better) so that this doesn't happen.

We hae an entire section on WHY this is so and all the bruhahah about grain free foods, which basically has been debunked,. it is not so much that grain free is bad, but rather that food companies started stuffing their dogfood with lots of peas and lentils claiming how great it is for dogs when in fact that is one of the worst things you can feed and EPI dog........
https://epi4dogs.com/why-grainfree-foods/
and
https://epi4dogs.com/taurine-grainfree-diets/

It is not that any EPI dog cannot have grains... some can and some actually do better with grain... but when starting out... start with low fiber content found in the grain free section

[Olesia711]

with regards to the Pivetal Pancresorb... the minium amount of porcine lipase USP units you need to give your dog is 33,000 units... but typically we give approx 71,400 USP units of Lipase.

Ak your vet what the Lipase USP units are in these pills (i cant find where they say anything ) and then you will need to crush the appropriate amount of tablets, mix in the food, add a little water to moisten everything, let incubate and the serve.

The reason why your vet "may" have prescribed these pills could be that this is all that is available prescription wise... there is a shortage of porcine pancreatin....

Please let me know what your vet says about the potency of these pills and i will help you with the correct dosage. Pills usually are not the best way to go, but like i said, your vet may have trouble finding an enzyme powder source.

[kob5280]

Thank you for the clarification on the grain-free food. That is super helpful.

The ingredient list of the Pivetal Pancresorb are as follows:
Lipase......9,000 USP units
Protease.....57,000 USP units
Amylase.....64,000 USP units

So, looks like the Lipase is much lower than what you recommend. We also have some of Diane's Enzymes on order, so will start with that once they arrive. We appreciate all of your help and insight.

[Olesia711]

ahh thnks! tht is what i suspected but i didn't want to guess.

FOr now, crush 4 tablets and mix them in with the food and a little bit of room temp water to moisten the food and let sit for 20 minutes.... and let us know how the poo is... you may need to crush more tablets, but start with this for now

This product may be the only thing your vet could get for you... There is a shortage of pancreatic enzymes now.........

[kob5280]

Update....day 5 of Diane's Enzymes

Today we had a small regression to the cow patty style poop after 5 days on Diane's Enzymes.

Here is our feeding schedule

He is getting one b-12 supplement/day
One packet of Honest Paws pre-probiotic/day
approx 1 tsp Dianes Enzymes 6x per meal (feeding 3x/day - 1.5 cups of Taste of the Wild Pacific Stream kibble, 1/2 cup chicken breast and 1/4 c pumpkin)

He is currently not on any antibiotics and the vet hasn't mentioned that at all.

We have also noticed that his tongue seems to have changed color into a darkish pink/purple (almost the color of liver!).

He is a large shepherd that at most has weighed 90 lbs and currently weighs 77 lbs. He looks very thin and we would love to add some additional food/snacks to try and get some weight on him.

Would appreciate any ideas for extra food/snacks. I have seen posts that mention cottage cheese, mashed potatoes, scrambled eggs, but would welcome any advice.

[Barb]

Hi Kelly and welcome.

It looks like you are giving Diane's 6x enzymes 1 teaspoon per meal instead of 1 teaspoon per cup of food. If so, you might want to adjust to 1 teaspoon per cup, which is what we usually recommend to start. That might be the reason for the regression. After you make the adjustment, see how the poos are.

Also, I would tell your vet about the change in color of the tongue. He/she can evaluate or might want to do blood work to see if there are any conditions that need to be addressed.

Hang in there. The beginning is the hardest stage while you are trying to balance everything.

Barb

[Olesia711]

my first suggestion with the dark red almost purple tongue is to PLEASE call your vet... as this can be something the vet needs to take care of.
However...sometimes with an EPI dog, this "might" be indicative of a bacterial infection..... and what you are describing with the loose stools..... could also be SID ... which is small intestinal dysbiosis (which is kind of like gut flora imbalance out of control)... but with dark red/almost purple tongue... you really don't wnt to tke a chance.... have the vet check him out.

Anyway.... SID could be out of control because, as Barb noticed, you may not be giving the proper amount of enzymes to keep everything in check... (1 tsp of enzymes per 1 cup of food (kibble) with enough moisture to wet the enzymes to adhere to the food AND to not get on the inside of the mouth dry... AND to incubate it all for about 20 minutes to avoid mouth sores.

OR..... the other thing that could be happening is that (if you are giving the right amount of enzymes) the enzymes are working and now all the current food is being properly digested... but all the food that was not properly digested in the past (before the proper type and amount of enzymes were given) have accumulated.... is now kind of like being shaken loose.... and consequently this is the result....

I am not sure WHICH is happening if this is the issue... the protocol for this is prebiotics... if prebiotics doesn't work, then try pre+probiotics, and if that doesnt work, then try Tylan (Tylosin Tartrate antibiotics) for 45 days/twice a day with breakfast and dinner.

[Olesia711]

don't give snacks.... not until he is stabilized.... but rather, the first think that you should do is give 150% of food .... what is "normally" required for his weight. HOWEVER... do not give in jsut two feeding.. IN the beginning, while their body is trying to heal... too much food all at once often upsets the tummy and that too will give them loose stools.
.
Instead feed 150% but feed smaller meals, just more meals in a day.

Before you focus on giving "things" to put on weight, first focus on stopping the loose stools.
once that is done, then focus on weight gain.

ONe of the things that helps with a nice slow but steady weight gain is adding coconut oil to the meals... start with just a little (like 12 tsp) then increase slowly if well tolerated (as long as the poos don't get mushy!

THe other thing is.... is he receiving B12? If not, and if needed (and over 80% of all dogs with EPI NEED B12 supplementation) this too will hinder weight gain............